Introduction: Papillary necrosis results from ischemia of the renal medulla and papillae, induced by a variety of mechanisms. Papillary necrosis is a rare adverse effect of continuous protease-inhibitor therapy with indinavir.
Case: We describe the case of a patient who developed bilateral papillary necrosis. It was reversible after treatment interruption and increased hydration.
Conclusion: This case shows the need to monitor kidney markers in patients under continuous treatment with indinavir.