Prospective study of urinalysis abnormalities in HIV-positive individuals treated with indinavir
Prospective study of urinalysis abnormalities in HIV-positive individuals treated with indinavir
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DOI：
10.1053/ajkd.2000.9791
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发表时间：
2000-09-01
影响因子：
13.2
通讯作者：
Tsoukas, CM
中科院分区：
文献类型：
--
作者：
Gagnon, RF;Tecimer, SN;Tsoukas, CM
茚地那韦是一种有效的蛋白酶抑制剂，广泛用于与逆转录酶抑制剂联合治疗人类免疫缺陷病毒（HIV）疾病。接受茚地那韦治疗的个体容易发生泌尿系统并发症，包括肾绞痛、肾结石、下尿路症状和茚地那韦晶体形成。尽管已描述和表征了茚地那韦继发的肾结石，但对晶体形成的发作、频率和意义知之甚少。为了记录茚地那韦结晶症和相关尿液异常的纵向特征，在茚地那韦治疗的第一年中，54名无症状的茚地那韦初治HIV阳性个体最初每周进行尿分析检测，然后每月进行尿分析检测。进行了608次尿分析（11 +/- 2次尿分析/受试者），包括由肾病学家进行的579次显微镜检查（10 +/- 2次检查/受试者）。基线尿分析结果基本正常。治疗开始后，经常观察到茚地那韦结晶（67%的受试者），前2周后，茚地那韦结晶保持恒定，频率约为每个检测点检查的尿沉渣的25%。在39%的受试者中观察到其他尿液异常，主要是白细胞（大于或等于10/高倍视野）和管型。这些异常在5例受试者中更为严重，其中3例伴随血清肌酐水平升高。其他尿液检查结果包括主要为低pH值（72%的尿液分析结果中小于或等于5.5）和高比重（66%的尿液分析结果中大于或等于1.025）。总之，在茚地那韦治疗的第一年期间经常观察到尿分析结果异常，主要结果是高比例的晶体症受试者和始终观察到的相对较高的晶体症频率。这些发现可能偶尔与其他尿液异常相关，推测继发于茚地那韦晶体增多症。(C)2000年由国家肾脏基金会，公司。
Indinavir is a potent protease inhibitor widely used in combination with reverse-transcriptase inhibitors to treat human immunodeficiency virus (HIV) disease. Individuals treated with indinavir are prone to develop urinary complications, including renal colic, renal calculi, lower urinary tract symptoms, and indinavir crystalluria, Although renal stones secondary to indinavir have been described and characterized, little is known about the onset, frequency, and significance of the crystalluria. To document the longitudinal characteristics of indinavir crystalluria and associated urine abnormalities, 54 asymptomatic indinavir-naive HIV-positive individuals had urinalysis testing initially weekly and then monthly during the first year of indinavir treatment. Six hundred eight urinalyses were performed (11 +/- 2 urinalysis/subject), including 579 microscopy examinations performed by a nephrologist (10 +/- 2 examinations/subject). Baseline urinalysis results were essentially normal. After the start of treatment, indinavir crystalluria was frequently observed (67% of subjects), After the first 2 weeks, indinavir crystalluria remained constant at a frequency of approximately 25% of urine sediments examined at each test point. Other urine abnormalities, principally leukocytes (greater than or equal to 10/high-power field) and casts, were observed in 39% of subjects. These abnormalities were more severe in five subjects, with concomitant increasing serum creatinine levels in three of them. Additional urine findings include the predominance of low pH (less than or equal to 5.5 in 72% of urinalyses) and high specific gravity (greater than or equal to 1.025 in 66% of urinalyses). In conclusion, abnormal urinalysis results were noted frequently during the first year of treatment with indinavir, The main findings were the high proportion of subjects with crystalluria and the relatively high frequency of crystalluria observed consistently throughout. These findings may occasionally be associated with other urine abnormalities, presumably secondary to indinavir crystalluria. (C) 2000 by the National Kidney Foundation, Inc.