RESUMO
PURPOSE: Indinavir is a protease inhibitor used for treating HIV-1. The drug is lithogenic and was thought to cause a 3% incidence of kidney stones. We evaluated a cohort of patients positive for HIV on indinavir to determine the incidence of indinavir nephrolithiasis and identify risk factors for indinavir stone formation. MATERIALS AND METHODS: Our cohort study of the prevalence of indinavir nephrolithiasis included 155 patients with HIV for 5,732 patient-weeks. The same cohort was then used for a retrospective chart review to assess patient age, weight, duration of drug use, time to stone formation, CD4 count, creatinine, alanine transaminase, and urinary pH and specific gravity as risk factors for stone formation. RESULTS: We estimated the cumulative incidence of indinavir stone formation by the Kaplan-Meier product limit estimator method. At 78 weeks 43.2% of patients had stones (95% confidence interval [CI] 0.292 to 0.543). Increasing age was the only variable that was a statistically significant predictor of indinavair urolithiasis (relative risk 0.955, 95% CI 0.918 to 0.993, p = 0.0159). The mean duration plus or minus standard deviation of indinavir use was statistically the same in each group (42.5 +/- 27. 2 and 40.3 +/- 27.1 weeks in those without and with stones, respectively) despite the observed mean time to stone formation of 23.0 +/- 19.8 weeks. CONCLUSIONS: The clinical prevalence of indinavir nephrolithiasis is much greater than initially reported. Nephrolithiasis during indinavir use does not appear to induce patients to withdraw from the drug.
Assuntos
Inibidores da Protease de HIV/efeitos adversos , Indinavir/efeitos adversos , Cálculos Renais/induzido quimicamente , Adulto , Fatores Etários , Estudos de Coortes , Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/uso terapêutico , HIV-1 , Humanos , Indinavir/uso terapêutico , Análise Multivariada , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de RiscoRESUMO
The antigenicity of transitional cell carcinoma of the bladder has stimulated the search for effective immunotherapeutic agents in the treatment of this disease. Non-specific immunotherapy with local (intravesical/intralesional) and systemic Keyhole Limpet Haemocyanin (KLH) in a FANFT induced murine bladder tumor model was studied. Results showed no difference between control or treated groups in either tumor growth or animal survival.
Assuntos
Antígenos/uso terapêutico , Carcinoma de Células de Transição/terapia , Hemocianinas , Neoplasias da Bexiga Urinária/terapia , Animais , Antígenos/administração & dosagem , Carcinoma de Células de Transição/induzido quimicamente , Carcinoma de Células de Transição/imunologia , FANFT , Feminino , Injeções Subcutâneas , Camundongos , Camundongos Endogâmicos C3H , Neoplasias da Bexiga Urinária/induzido quimicamente , Neoplasias da Bexiga Urinária/imunologiaRESUMO
In 54 patients with renal cell carcinoma, the angiographic T category of the International Union Against Cancer (UICC) clasification correlated with the histopathologic (P) staging in only 44.4 per cent. Staging of the primary lesion in renal cell carcinoma must be based on the P category and not the angiographic appearances.
