Assessing Renal Dysfunction Incidence Related to Intravenous Acyclovir Usage

This study aimed to assess the incidence and contributing factors of renal dysfunction among patients receiving intravenous (IV) acyclovir at Khoula Hospital, Muscat, Oman. Specifically, this study aimed to evaluate the incidence of acute kidney injury (AKI) following IV acyclovir administration, associated risk factors and potential preventive strategies to reduce nephrotoxicity.

This retrospective cohort study was conducted at Khoula Hospital and included patients aged 12-80 years who received IV acyclovir between January 2019 and December 2023. Patients with pre-existing renal disease or increased baseline serum creatinine were excluded. The sample size was computed using Daniel's formula, resulting in a minimum sample size of 92 patients.

A total of 99 patients were included; 64.6% were males and 35.4% females. The incidence of AKI was 34.3% (n = 34, 95% confidence interval [CI]: 24.9-43.7). Dose reduction was required in 29.3% of AKI cases, and hydration with slow infusion was applied to all patients. Significant associations were observed with nationality, where non-Omani patients had a higher incidence of AKI compared to Omanis (66.7% versus 27.2%, odds ratio = 5.46, 95% CI: 1.79-16.04; P = 0.001). AKI incidence increased with the number of concomitant nephrotoxic medications (P = 0.004).

Nationality and concomitant nephrotoxic medications were significantly associated with AKI risk in patients receiving IV acyclovir. Non-Omani patients on multiple nephrotoxic agents demonstrated higher susceptibility to AKI.