title: Acute renal insufficiency due to oral acyclovir in a man with sickle cell trait.
abstract: Several published reports have suggested that oral acyclovir can cause renal insufficiency, but baseline renal function was either abnormal or unclear in those reports. We describe a patient with oral acyclovir-induced acute renal failure and a normal serum creatinine level documented just before exposure to the drug. Conceivably, competition with a cephalosporin for renal tubular elimination predisposed our patient to nephrotoxic serum levels of acyclovir. In addition, the patient had sickle cell trait, which might have contributed to a disproportionate degree of hyperkalemia and acidosis seen early in the patient's clinical course.
authors.affiliation: Department of Medicine, University of South Carolina School of Medicine, Columbia 29203, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Lawson
authors.forename: P A
authors.initials: PA
authors.lastname: Green
authors.forename: A S
authors.initials: AS
authors.lastname: Brett
mesh_terms: D000141:Acidosis, Renal Tubular / Q000150:complications; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000150:complications; D000212:Acyclovir / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006947:Hyperkalemia / Q000150:complications; D008297:Male; D012805:Sickle Cell Trait / Q000150:complications*
chemical_list: D000998:Antiviral Agents; D003404:Creatinine; D000212:Acyclovir