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Related Experiment Videos

Renal function after acyclovir intravenous injection.

D Brigden, A E Rosling, N C Woods

    The American Journal of Medicine
    |July 20, 1982
    PubMed
    Summary

    High-dose intravenous acyclovir can elevate plasma urea or creatinine levels, particularly with bolus injections. Slow infusion, hydration, and dose adjustment in renal impairment significantly reduce this risk.

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    Acyclovir: an update of the clinical applications of this antiherpes agent.

    Antiviral research·1984

    Area of Science:

    • Nephrology
    • Pharmacology
    • Virology

    Background:

    • Acyclovir is a crucial antiviral medication used to treat herpes virus infections.
    • Intravenous administration is common for severe cases, but potential renal toxicity is a concern.

    Observation:

    • Elevated plasma urea or creatinine was observed in 58 out of 354 patients receiving intravenous acyclovir.
    • This adverse effect was associated with high-dose intravenous bolus injections.

    Findings:

    • Renal impairment risk was substantially reduced by slow intravenous infusion (over one hour) of the same acyclovir dosage.
    • Adequate patient hydration and dose adjustments for those with pre-existing renal dysfunction further mitigated risk.
    • Animal studies suggest acyclovir-induced nephrotoxicity results from crystal formation in renal tubules, which resolves post-treatment.

    Implications:

    • Clinical protocols for intravenous acyclovir should prioritize slow infusion, hydration, and renal function monitoring.
    • Careful consideration of dosage adjustments is essential for patients with compromised renal function.
    • Understanding the crystalluric mechanism aids in managing acyclovir-related nephrotoxicity, especially in complex cases like herpes encephalitis.

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