The HIV protease inhibitor indinavir may cause nephrolithiasis and interstitial nephritis. The renal consequences of indinavir-associated nephrotoxicity are uncertain. We report a case of papillary necrosis in a patient treated with indinavir. An asymptomatic HIV-infected woman experienced right-sided renal colicky pain during treatment with indinavir. She passed a non-solid stone and continued indinavir treatment. Intravenous pyelogram performed 20 months later following an episode of left-sided colicky pain showed right-sided papillary necrosis. Indinavir-associated nephrolithiasis and chronic interstitial nephritis were the only possible causes identified in this patient. Physicians should be aware that indinavir nephrolithiasis may cause papillary necrosis.

Indinavir, Nephrolithiasis, Papillary necrosis,
Infection: journal of infectious disease
Erasmus MC: University Medical Center Rotterdam

Dieleman, J.P, van der Feltz, M.J.M, Bangma, C.H, Stricker, B.H.Ch, & van der Ende, M.E. (2001). Papillary necrosis associated with the HIV protease inhibitor indinavir. Infection: journal of infectious disease, 29(4), 232–233. doi:10.1007/s15010-001-1105-y