Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy

Fleischer, Raymond; Johnson, Matthew T.

doi:10.1155/2010/602783

Cited by 56 publications

(45 citation statements)

References 5 publications

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“…It is a prodrug and can be rapidly converted into acyclovir in vivo (1)(2)(3). In addition to neurotoxicity, acute kidney injury is a well-described side effect of acyclovir administration, since crystal deposition may lead to the development of renal failure (4,5). The side-effects of acyclovir therapy are not well recognized by clinicians.…”

Section: Introductionmentioning

confidence: 99%

Acute renal injury induced by valacyclovir hydrochloride: A case report

Zhang

Cong

Teng

2016

Experimental and Therapeutic Medicine

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Abstract. Acyclovir has been a frequently used antiviral agent in the clinical treatment of leukemia, acute encephalitis, malignant tumor and herpes simplex. The adverse effects of this drug have been widely described in clinical practice. In the present study, a case of a 35-year-old female patient diagnosed with herpes simplex, who developed acute renal injury following treatment with valacyclovir hydrochloride, is described. Kidney biopsy, light microscopy and laboratory examination were performed, and all findings revealed the signs of evident vacuolar degeneration of capillary endothelial and renal tubular epithelial cells, erythrocyte aggregation in partial renal tubule and microvilli exfoliation from epithelial cells. Renal interstitial edema was clearly identified. The clinical evidence observed from this female patient indicated that renal functions should be closely monitored during valacyclovir hydrochloride administration. A variety of effective measures, such as hydration, alkalizing urine, promoting the discharge of medication and the use of antagonists are recommended following the administration of antiviral agents.

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Section: Introductionmentioning

confidence: 99%

Acute renal injury induced by valacyclovir hydrochloride: A case report

Zhang

Cong

Teng

2016

Experimental and Therapeutic Medicine

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“…Although acyclovir is generally well tolerated, severe nephrotoxicity has been reported in some cases [2,3]. Acute kidney injury (AKI) secondary to acyclovir is characterized by a decrease in renal function that usually develops within 12-48 h of drug administration, as indicated by a rapid rise in the serum creatinine [4].…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury due to acyclovir

et al. 2012

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Acyclovir is an antiviral agent widely used in herpetic infections in children. Although acyclovir is generally well tolerated, severe nephrotoxicity has been reported in some cases. In this report, we present a 16-yearold girl who developed acute renal failure due to acyclovir treatment and who needed repetitive hemodialysis. Renal biopsy was performed in order to confirm the diagnosis. A diagnosis of drug-related acute tubulointerstitial nephritis with focal tubular necrosis was made.

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“…This finding could also be related to the concomitant administration of acyclovir, as most cancers (61%) were from hematological origin. Acyclovir is used more commonly in cancer patients and may impair kidney function by precipitating in the renal tubules, a condition usually reversible within a few days [47]. …”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury and Renal Recovery with the Use of Aminoglycosides: A Large Retrospective Study

Paquette

Bernier-Jean

Brunette³

et al. 2015

Nephron

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Background: Recent acute kidney injury (AKI) guidelines, based on studies performed a decade ago, recommend avoiding aminoglycosides (AGs) in patients at risk of AKI. Whether present patient characteristics and management have changed this risk is uncertain. We determined the current incidence, risk factors and outcomes of AG-AKI. Methods: We retrospectively identified adult patients who received gentamicin or tobramycin for ≥5 days in 2 large university-affiliated centers, excluding critically ill and dialysis patients. We assessed the incidence of Risk, Injury, Failure, Loss and End-stage kidney disease criteria of AKI risk and then matched each AKI to 2 controls of same age and gender to determine factors associated with AG-AKI and its recovery, defined by a creatinine within 150% of baseline by 21 days. Results: Since 2001, the frequency of AG administration and dosing declined, but the incidence of AG-AKI remained constant. Of the 562 patients who received AG for ≥5 days, 65 (12%) developed AG-AKI after 11 (IQR 8-15) days, with 56, 29 and 15% having stages 1, 2 and 3 AKI, respectively. We matched these to 130 controls. In this nested case-control study, independent AKI risk factors were vancomycin coadministration, high AG trough levels and heart failure. AG-AKI compared to AG exposure without AKI was associated with greater mortality. Renal recovery occurred in 51% of the AKI patients and was less likely with heart failure and higher AKI severity. Conclusion: AG administration has recently decreased but the risk of AKI remained unchanged and half of the patients did not recover. Vancomycin coadministration, high AG trough levels and heart failure independently predicted AKI.

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Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy

Cited by 56 publications

References 5 publications

Acute renal injury induced by valacyclovir hydrochloride: A case report

Acute renal injury induced by valacyclovir hydrochloride: A case report

Acute kidney injury due to acyclovir

Acute Kidney Injury and Renal Recovery with the Use of Aminoglycosides: A Large Retrospective Study

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