[Acute renal failure related to intravenous acyclovir].
OBJECTIVE
The aim of this study was to evaluate the incidence and outcome of acute renal failure (ARF) in patients submitted to intravenous (IV) acyclovir treatment.


METHODS
All patients over 13 years of age that used intravenous acyclovir for 5 or more days were retrospectively analyzed. When serum creatinine levels, previously in the normal range, increased above 2 mg/dl, the case was considered an ARF. Treatment and outcome of patients that developed ARF were analyzed.


RESULTS
Eighty-five patients received IV acyclovir during the study period. Forty-one patients were included in the study. ARF developed in 8 out of 41 patients (19.5%). In the ARF cases, after beginning of treatment, the average time for increase of the serum creatinine levels was 4.2 days. Creatinine levels reached their peak in a mean time of 7.1 days (ranging from 3 to 14 days). Recovery of the renal function, evaluated by decrease of the creatinine level, varied from 1 to 7 days (mean of 3.6 days). ARF had a good outcome with hydration, lengthening of drug infusion time and adjustment of the drug dosage.


CONCLUSIONS
Acyclovir induced ARF in 19.5% of the patients. All patients had a positive response with return to a normal renal function after hydration, lengthening of drug infusion time and adjustment of the drug dosage. None of the patients required treatment with hemodialysis. Acyclovir is a safe drug when administered with certain preventive measures.
Pacheco
Leonardo R
LR
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP.
Tavares
Helder M E
HM
Moysés Neto
Miguel
M
Dantas
Marcio
M
Rocha
Luís Sérgio D'Oliveira
LS
Ribeiro
Karina Mota
KM
Figueiredo
José Fernando de Castro
JF
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000212:Acyclovir / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D000998:Antiviral Agents; D003404:Creatinine; D000212:Acyclovir