Kidney stones

Indinavir (Crixivan) can crystallise in the renal tubules, causing build-up of ‘sludge’ or kidney stones. If the crystals are large, they may cause kidney blockage. Symptoms include a dull ache or sharp pain in the flank or groin area, kidney inflammation, difficulty urinating, blood in the urine, and laboratory abnormalities.

The incidence of indinavir crystallisation without symptoms and symptomatic kidney stones varies widely in different studies, ranging from 3 to over 40%.1 2 3 4 The risk is greater when indinavir is boosted with ritonavir (Norvir).

Various factors can increase the risk for kidney stones, including family history, dehydration, and older age. One study found that patients co-infected with hepatitis B or C are more likely to develop kidney stones.5

Kidney stones have also been reported in people taking ritonavir-boosted lopinavir (Kaletra). In a French cohort, 4% of 165 patients taking Kaletra experienced symptoms suggestive of kidney stones, such as severe pain or calculus build-up elsewhere in the body.6


  1. Kopp JB et al. Crystalluria and urinary tract abnormalities associated with indinavir. Ann Intern Med 127: 119-125, 1997
  2. Boubaker K et al. Changes in renal function associated with indinavir. AIDS 12: F249-F254, 1998
  3. Reiter WJ et al. Changes in renal function associated with indinavir. AIDS 12: F249-F254, 1998
  4. Saltel E et al. Increased prevalence and analysis of risk factors for indinavir nephrolithiasis. J Urol 164: 1895-1897, 2000
  5. Malavaud B et al. Increased incidence of indinavir nephrolithiasis in patients with hepatitis B or C virus infection. Antivir Ther 5: 3-5, 2000
  6. Thanh DC et al. Lopinavir-ritonavir (Kaletra) and lithiasis: seven cases. AIDS 18: 705-706, 2004
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.