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[Acute renal failure following a treatment with acyclovir]
Erika Nnang Obada1, Gérard Level, Pierre Mathieu
1Centre hospitalier, nephrologie, 2, rue d'Anthouard, 55107 Verdun, France.
Nephrologie & Therapeutique
|February 2, 2010
Summary
Acyclovir, an antiviral drug, can cause severe kidney damage through crystal formation in the kidneys. Promptly stopping acyclovir and increasing fluid intake can restore kidney function.
Area of Science:
- Nephrology
- Virology
- Pharmacology
Background:
- Acyclovir is a widely used antiviral medication.
- Renal dysfunction is a known potential side effect of acyclovir therapy.
- Intratubular crystal precipitation has been implicated as a key mechanism in acyclovir-induced nephrotoxicity.
Observation:
- A 30-year-old immunocompetent woman presented with viral meningoencephalitis and received intravenous acyclovir.
- Despite neurological improvement, she developed acute renal insufficiency, with serum creatinine rising significantly within 12 days.
- Urine analysis revealed birefringent crystals consistent with acyclovir, confirmed by spectrophotometry.
Findings:
- Acyclovir treatment led to acute kidney injury in this patient.
- The presence of acyclovir crystals in the tubules correlated with the observed nephrotoxicity.
- Discontinuation of acyclovir and aggressive hydration resulted in complete recovery of renal function.
Implications:
- This case highlights the risk of acyclovir-induced nephrotoxicity, even in immunocompetent individuals.
- Close monitoring of renal function is crucial during acyclovir therapy.
- Understanding the pathogenetic role of crystal precipitation can guide preventative and therapeutic strategies for drug-induced kidney injury.
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