Associaçäo entre inibidores de protease e urolitíase / Indinavir associated nephrolithiasis

RESUMO

Introduction: The use of protease inhibitors, mainly the indinavir, drug recently introduced for the treatment of patients with the human immunodeficiency virus (HIV), has shown formations of crystals and urinary calculi as side effects. Surch conditions are found in 4 percent of patients using indinavir. Case Report: An HIV positive 32 years old male patient taking indinavir and AZT is presented. During treatment, the patient presented left flank pain and left uretero-hydronephrosis at renal ultrasound. Retrograde pyelography showed an image compatible with ureteral calculi. Six month later the patient presented for consultation and an intravenous pyelography and renal ultrasound were normal. Probably, the calculous had passed spontaneously. Conclusions: The benefits of the protease inhibitors for HIV positive patients are enormous and their use are rapidly increasing. Thus, physicians should be aware of this benign complication. Most of these cases are benign and the treatment should be analgesia and oral and parenteral hydration. Patients using indinavir must be advised to maintain adequate hydration