Case Report
Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy
Table 1
Risks, diagnosis, prevention, and treatment of acyclovir crystal nephropathy.
| Risk factors | Laboratory and clinical findings | Prevention | Treatment |
| Hypovolemia | Increased Cr, rapid and usually within 12–48 hours | Establish euvolemia before medication administration | If possible, discontinue or reduce dose | Rapid IV infusion | Pyuria | Infuse drug slowly (over 1-2 hours) | Establish high urinary flow with IV fluids and furosemide (150 cc/hr) | Concurrent acute kidney injury before medication administration | Hematuria | Adjust dose for renal function | Hemodialysis if necessary | Excess medication dosage in relation to renal function | Birefringent Needle-shaped crystals | Avoid other nephrotoxic agents | May replace acyclovir with famciclovir in certain instances while increasing urinary flow rate | Concurrent use of other nephrotoxic agents | Pt. may complain of associated flank pain | | | | Pt. may be oliguric | | |
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IV: intravenous, Cr: Creatinine, cc: milliliters, and hr: hour
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