Indinavir Nephropathy Revisited: A Pattern of Insidious Renal Failure with Identifiable Risk Factors

Robert F. Reilly, Kory Tray, Mark A. Perazella

Research output: Contribution to journalArticle

34 Scopus citations


• Indinavir is a well-known cause of crystal-induced acute renal failure, dysuria and flank pain, and nephrolithiasis. Recently a more insidious tubulointerstitial lesion has been recognized as secondary to the drug. We report a case of a hepatitis C-positive patient on long-term indinavir therapy for human immunodeficiency virus (HIV) who developed a slowly progressive rise in serum creatinine. Renal biopsy revealed a diffuse interstitial infiltrate with numerous eosinophils and scarring. The tubules showed focal necrosis and dilation with elongated crystals present within their lumina. The elevated serum creatinine decreased to a new baseline over several months with the discontinuation of indinavir. We review the literature of renal syndromes associated with indinavir focusing on chronic progressive tubulointerstitial injury and speculate on risk factors and potential mechanisms of indinavir-induced renal injury.

Original languageEnglish (US)
JournalAmerican Journal of Kidney Diseases
Issue number4 SUPPL. 3
Publication statusPublished - Oct 2001



  • Crystals
  • Human immunodeficiency virus (HIV)
  • Hypertension
  • Indinavir
  • Pyuria
  • Renal failure

ASJC Scopus subject areas

  • Nephrology

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