Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy August 2010 Case Reports in Medicine 2010(3) It accounts for more than 2% to 15% of cases of ARF in patients admitted to the hospital or in the intensive ScienceDirect ® is a registered trademark of Elsevier B.V.Crystal-induced nephrotoxicity associated with acyclovir use in paediatric patient© 2016 Indian Academy of Pediatrics, Infectious Disease Chapter. Intravenous acyclovir should be administered over a one-hour period accompanied by adequate hydration. Acyclovir should be administered after hemodialysis. Available for Android and iOS devices. Plasma levels of acyclovir have been shown to reduce by 60% following 6 hours of dialysis. The goal of treatment is to: promote healing of acute neuritis associated skin lesions The case presents a contrasting scenario to the conventional milieu of risk factors and surmises the possibility of genetic factor predisposition.We use cookies to help provide and enhance our service and tailor content and ads. We comply with the HONcode standard for trustworthy health information - Patients with renal impairment may be at greater risk for neuro- and nephrotoxicity (including further deterioration in renal function, tubular damage and acute renal failure) from acyclovir due to decreased drug clearance. The recommended urine output is a minimum of 500 mL per gram of drug infused.Moderate Potential Hazard, High plausibility. Frances Fua, Dragica Mrkoci. Acyclovir induced nephrotoxicity can occur within 12-72 hours after starting the therapy [4, 14]. Select one or more newsletters to continue. The urine flow should be monitored, especially within the first two hours following infusion when maximum urine concentration occurs. This article provides a summary of the most common mechanisms of drug-induced nephrotoxicity and prevention strategies." Applies to: hemodialysisAcyclovir is substantially removed by hemodialysis. Acyclovir is commonly used to treat herpes simplex virus (HSV) and varicella-zoster virus (VZV). During the last 3 decades, the average age and number of comorbidities of patients have increased, resulting in greater exposure to drugs, diagnostic tests, and therapeutic procedures that may harm renal function. The case described in this vignette is an example of the clinical manifestation of acyclovir crystal obstructive nephrotoxicity. Applies to: Renal DysfunctionAcyclovir is primarily eliminated by the kidney. The current case depicts evolution and management of transient nephropathy in a paediatric patient treated with acyclovir for viral encephalopathy. It is characterized by a decrease in renal function that develops within 24–48 hours of acyclovir administration indicated by a rapid rise in the serum creatinine. Applies to: DehydrationAcyclovir crystals may precipitate in the renal tubules, particularly when the drug is injected intravenously as a bolus. Failure to quickly realize this as an etiology of acute kidney injury can lead to excessive morbidity to the patient. Abnormal renal function may occur, which is usually reversible but may infrequently progress to tubular damage and acute renal failure. The George Washington University Medical Center, Washington, DC. Drug-induced nephrotoxicity has evolved as one of the significant causes of renal failure in the contemporary setting accounting up to 20%. … Applies to: Liver Disease, Electrolyte Abnormalities, Hypernatremia, Phosphate Imbalance, Magnesium Imbalance, Asphyxia, CNS Disorder, Hyponatremia, Dehydration, Hypocalcemia, Hypercalcemia, Acidosis, AlkalosisAcyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Patients with renal impairment may be at greater risk for neuro- and nephrotoxicity (including further deterioration in renal function, tubular damage and acute renal failure) from acyclovir due to decreased drug clearance. Dosage adjustments are recommended in patients with moderate to severe renal dysfunction.Moderate Potential Hazard, High plausibility. Drug-induced nephrotoxicity has evolved as one of the significant causes of renal failure in the contemporary setting accounting up to 20%. Major Potential Hazard, High plausibility. Acute Acyclovir Nephrotoxicity in a Patient with HIV and Herpes Zoster. Clinical evidence of nephrotoxicity in the absence of crystalluria suggests that acyclovir induces direct insult to renal tubular cells. Otherwise, an additional dose may be given after each hemodialysis session.Moderate Potential Hazard, Low plausibility. REVIEW Antiviral Drug–Induced Nephrotoxicity Hassane Izzedine, MD, Vincent Launay-Vacher, PharmD, and Gilbert Deray, MD Drug-induced kidney injury is a major side effect in clinical practice, frequently leading to acute renal failure (ARF). Acute kidney injury is an unfortunate complication of acyclovir therapy secondary to crystal-induced nephropathy. This nephrotoxicity can lead to AKI if it was not early identified and the patient may consequently require hemodialysis [4, 14]. Therapy with acyclovir should be administered cautiously in the elderly and in patients with underlying neurologic abnormalities, severe renal or liver disease, or significant electrolyte abnormalities or hypoxia.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.