What is the above structure in the urine sediment?
The answer to the iSEDIMENT from Feb 5, 2012: These are crystals of the HIV protease inhibitor indinavir (Crixivan).
Approximately 11% of the administered indinavir dose is excreted unmetabolized in the urine. This results in a drug concentration at the limit of its solubility (0.2 to 0.3 mg/ml), favoring precipitation in the collecting ducts. Acidification of the urine in vitro below a pH of 4.5 increases crystal solubility, but high urine pH (6.0 or greater) favors precipitation. The increased solubility at lower urinary pH is independent of urine specific gravity.
The urinary crystals tend to be either flat rectangular plates, fan-shaped, or starburst in appearance.
Renal biopsy reveals unremarkable glomeruli, prominent interstitial fibrosis, and tubular atrophy accompanied by chronic inflammation. Collecting ducts tend to contain crystals associated with histiocytes and giant cells.
Source and to read more here is the link.
What does the urine of this HIV+ patient on treatment demonstrate?
