[Acyclovir-induced acute renal failure: An under-estimated secondary effect?]

Area of Science:

• Pharmacology
• Nephrology
• Infectious Diseases

Background:

• Acyclovir is a primary antiviral medication for herpesviridae infections.
• Increased usage of oral and intravenous acyclovir correlates with a rise in adverse effects.
• Neurotoxicity and nephrotoxicity are significant reported side effects.

Observation:

• This report details two cases of inpatients receiving intravenous acyclovir for genital herpes and viral encephalitis.
• Both patients experienced acute renal failure during their treatment.
• Renal function monitoring is crucial as the failure presents as non-oliguric renal failure.

Findings:

• Intravenous acyclovir administration led to acute renal failure in both reported cases.
• Discontinuation of acyclovir resulted in the resolution of renal failure.
• Outpatient oral acyclovir use may lead to underreporting of renal adverse events.

Implications:

• Healthcare providers must be vigilant for renal complications in patients receiving acyclovir.
• Enhanced monitoring protocols for renal function are recommended, especially for high-dose or prolonged IV acyclovir therapy.
• This underscores the importance of considering renal function when prescribing acyclovir, particularly in vulnerable patient populations.