Indinavir-associated asymptomatic nephrolithiasis and renal cortex atrophy in two HIV-1 infected children

Elevated plasma concentrations of indinavir have been associated with urological complications (renal colic, flank pain or haematuria). The high AUC or the high C sub(max) may thus have contributed to the nephrotoxicity in these two children. We therefore advise the routine monitoring of plasma concentrations of indinavir in children and adjusting the dosage in order to reach normal adult plasma concentrations. In addition, we propose regularly performing renal ultrasounds in children who are treated with indinavir and who have an abnormal urinalysis.