HIV medication-based urolithiasis

Abstract

Drug-induced renal calculi represent 1-2% of all renal calculi. In the last decade, drugs used for the treatment of HIV-infected patients have become the most frequent cause of drug-containing urinary calculi. Among these agents, protease inhibitors (PIs) are well known to induce kidney stones, especially indinavir and atazanavir, and more recently darunavir. Urolithiasis attributable to other PIs has also been reported in clinical cases such as those during non-PI use. Antiretroviral drug-induced calculi deserve consideration because most of them are potentially preventable. This article summarizes the diagnosis, epidemiology, prevention and management of antiretroviral drug-induced urolithiasis.

Keywords: HIV; antiretroviral; renal failure; urolithiasis.

Fig. 1.

Atazanavir crystal: rodlike-shaped mildly birefringent urine crystal, measuring 8–20 nm and thrusting the white cell.