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Case 3: Indinavir Nephrotoxicity

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D The patient patient likely has indinavir-induced nephrolithiasis and antiretroviral therapy should either temporarily be discontinued or changed to a different regimen that does not include indinavir. The patient should initially be managed conservatively with hydration and pain control.

This answer is correct. Conservative management with hydration and discontinuation of antiretroviral therapy for 1 to 3 days is effective in most cases of indinavir-induced nephrolithiasis. Considering that indinavir is no longer a preferred antiretroviral medication, in this setting, most experts would recommend changing to another antiretroviral regimen that does not include indinavir.

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