Indinavir toxicity is a classic example of the drug-induced nephrotoxicity seen with several antiviral drugs. Patients may be of any age, and present with AKI. Other antiviral drugs may cause similar AKI (eg, acyclovir, foscarnet). Up to 67% of indinavir-treated patients have asymptomatic crystalluria, with symptoms in 8% and nephrolithiasis in 3%. Birefringent indinavir crystals may be seen in the urine, occasionally with sterile pyuria.