Acyclovir-induced acute renal failure

Acyclovir is an effective antiviral agent in the treatment of herpes simplex and varicella–zoster viral infections. The best known side-effects of this drug are significant nephrotoxicity and neurotoxicity. We report on a diabetic patient with acute retinal necrosis who developed non-oliguric acute renal failure during the administration of high doses of intravenous acyclovir (500 mg/m² intravenous infusion every 8 h). No obvious uremic symptoms or signs were noted. No obvious haematuria, proteinuria or crystalluria were noted in the urine. After discontinuing the acyclovir administration, renal function partially recovered. In this paper, we also review the mechanism of acyclovir-induced acute renal failure, and the precipitating factor of acyclovir-induced acute renal failure. Finally, we must once again emphasize the importance of hydration and routine check ups for renal function in preventing acyclovir-induced acute renal failure.