Indinavir and renal toxicity
Anecdotal data show that high exposure to indinavir is associated with an increased risk for urological complaints (flank pain, haematuria, renal colic).
It has been hypothesized that Cmax of indinavir is correlated with renal toxicity.
Recent (preliminary) data of the BEST trial suggest that renal toxicity is more often encountered when used in a RTV/IDV 100/800 mg bid regimen as compared to IDV 800 mg tid alone, suggesting that AUC or time > certain concentration rather than Cmax might be the main determinant of renal toxicity1.
1Gatell, XIII IAC, Durban, 2000, abstract WeOrB484