A 15 yr female with HIV infection on anti retroviral therapy presents with nausea vomiting and flank pain. Urine microscopy showed rectangular plate and needle shaped crystals. Serum creatine was raised. What will be the likely cause?
Crystal- induced nephropathy: Indinavir has been commonly associated with crystal- induced nephropathy. Crystallization of the HIV protease inhibitor indinavir within the renal tubules is associated with a range of urinary tract manifestations, including nephrolithiasis, asymptomatic crystalluria, crystalluria with dysuria (or renal colic), and crystal nephropathy, is influenced by alkaline urine. Other drus that may cause crystal nephropathy are acyclovir, atazanavir and sulfazadine methotrexate Ref: CURRENT Diagnosis & Treatment Nephrology & Hypeension - Page 125.
Indinavir
Ritonavir
Nevirapine
Zidovudine