Table 2.

Antiretroviral Nephrotoxicity and Dose Adjustment in Acute Kidney Injury

Antiretroviral Drug Class	Reported Nephrotoxicity	Dose Adjustment in Acute Kidney Injury
Protease inhibitors	Crystalluria/ obstruction	None
	Indinavir	Maintain hydration with indinavir, atazanavir
	Atazanavir
	Case reports with other agents
	Interstitial nephritis
	Indinavir
	Enhanced nucleotide toxicity?
	Ritonavir
Nucleoside reverse transcriptase inhibitors	Lactic acidosis	Estimated GFR<50
	Especially didanosine	Exceptions: abacavir (none), zidovudine (GFR<10)
	Enhanced nucleotide toxicity
	Didanosine
	Rare reports of AKI
Nucleotide reverse transcriptase inhibitors	Proximal tubulopathy	Estimated GFR<50
	Nephrogenic diabetes insipidus
	AKI
Non-nucleoside reverse transcriptase inhibitors	Rare reports of AKI	None
		Limited data for etravirine
Fusion inhibitors	Single case of MPGN	None
	Enfurvitide	Limited data
Integrase inhibitor	Rare reports of AKI	None

AKI=acute kidney injury; MPGN=membranoproliferative glomerulonephritis