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Atazanavir nephrotoxicity
Atazanavir is commonly used as one of the key drugs in combination antiretroviral therapy for human immunodeficiency virus (HIV). However, atazanavir has the potential to yield its crystalline precipitation in urine and renal interstitial tissues, leading to crystalluria, urolithiasis, acute kidney...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370314/ https://www.ncbi.nlm.nih.gov/pubmed/25815168 http://dx.doi.org/10.1093/ckj/sfv015 |
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author | Hara, Masaki Suganuma, Akihiko Yanagisawa, Naoki Imamura, Akifumi Hishima, Tsunekazu Ando, Minoru |
author_facet | Hara, Masaki Suganuma, Akihiko Yanagisawa, Naoki Imamura, Akifumi Hishima, Tsunekazu Ando, Minoru |
author_sort | Hara, Masaki |
collection | PubMed |
description | Atazanavir is commonly used as one of the key drugs in combination antiretroviral therapy for human immunodeficiency virus (HIV). However, atazanavir has the potential to yield its crystalline precipitation in urine and renal interstitial tissues, leading to crystalluria, urolithiasis, acute kidney injury (AKI) or chronic kidney disease (CKD). In epidemiological studies, atazanavir/ritonavir alone or in combination with tenofovir has been associated with increased risk of progression to CKD. However, renal biopsies were not provided in these studies. Case reports showing an association between atazanavir use and tubulointerstitial nephritis among HIV-infected individuals provide clues as to the potential causes of atazanavir nephrotoxicity. We now review atazanavir-related kidney disease including urolithiasis, renal dysfunction and interstitial nephritis and illustrate the review with a further case of atazanavir-associated kidney injury with sequential renal biopsies. There are two forms of atazanavir-associated tubulointerstitial nephritis: acute tubulointerstitial nephritis that may develop AKI rapidly (in weeks) after initiation of atazanavir, and chronic tubulointerstitial nephritis that may develop progressive CKD slowly (in years) with granuloma and intrarenal precipitation of atazanavir crystals as well as crystalluria. Caution should be exercised when prescribing atazanavir to patients at high risk of CKD, and therapy should be reevaluated if renal function deteriorates, especially associated with crystalluria and hematuria. |
format | Online Article Text |
id | pubmed-4370314 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-43703142015-03-26 Atazanavir nephrotoxicity Hara, Masaki Suganuma, Akihiko Yanagisawa, Naoki Imamura, Akifumi Hishima, Tsunekazu Ando, Minoru Clin Kidney J Contents Atazanavir is commonly used as one of the key drugs in combination antiretroviral therapy for human immunodeficiency virus (HIV). However, atazanavir has the potential to yield its crystalline precipitation in urine and renal interstitial tissues, leading to crystalluria, urolithiasis, acute kidney injury (AKI) or chronic kidney disease (CKD). In epidemiological studies, atazanavir/ritonavir alone or in combination with tenofovir has been associated with increased risk of progression to CKD. However, renal biopsies were not provided in these studies. Case reports showing an association between atazanavir use and tubulointerstitial nephritis among HIV-infected individuals provide clues as to the potential causes of atazanavir nephrotoxicity. We now review atazanavir-related kidney disease including urolithiasis, renal dysfunction and interstitial nephritis and illustrate the review with a further case of atazanavir-associated kidney injury with sequential renal biopsies. There are two forms of atazanavir-associated tubulointerstitial nephritis: acute tubulointerstitial nephritis that may develop AKI rapidly (in weeks) after initiation of atazanavir, and chronic tubulointerstitial nephritis that may develop progressive CKD slowly (in years) with granuloma and intrarenal precipitation of atazanavir crystals as well as crystalluria. Caution should be exercised when prescribing atazanavir to patients at high risk of CKD, and therapy should be reevaluated if renal function deteriorates, especially associated with crystalluria and hematuria. Oxford University Press 2015-04 2015-03-20 /pmc/articles/PMC4370314/ /pubmed/25815168 http://dx.doi.org/10.1093/ckj/sfv015 Text en © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Contents Hara, Masaki Suganuma, Akihiko Yanagisawa, Naoki Imamura, Akifumi Hishima, Tsunekazu Ando, Minoru Atazanavir nephrotoxicity |
title | Atazanavir nephrotoxicity |
title_full | Atazanavir nephrotoxicity |
title_fullStr | Atazanavir nephrotoxicity |
title_full_unstemmed | Atazanavir nephrotoxicity |
title_short | Atazanavir nephrotoxicity |
title_sort | atazanavir nephrotoxicity |
topic | Contents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370314/ https://www.ncbi.nlm.nih.gov/pubmed/25815168 http://dx.doi.org/10.1093/ckj/sfv015 |
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