Acute renal injury induced by valacyclovir hydrochloride: A case report

Zhang,Yanning; Cong,Yuxi; Teng,Yan

doi:10.3892/etm.2016.3905

Acute renal injury induced by valacyclovir hydrochloride: A case report

Authors:
- Yanning Zhang
- Yuxi Cong
- Yan Teng
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Affiliations: Department of Nephrology, People's Liberation Army No. 202 Hospital, Shenyang, Liaoning 110000, P.R. China
Published online on: November 15, 2016 https://doi.org/10.3892/etm.2016.3905
Pages: 4025-4028

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Abstract

Acyclovir has been a frequently used antiviral agent in the clinical treatment of leukemia, acute encephalitis, malignant tumor and herpes simplex. The adverse effects of this drug have been widely described in clinical practice. In the present study, a case of a 35‑year‑old female patient diagnosed with herpes simplex, who developed acute renal injury following treatment with valacyclovir hydrochloride, is described. Kidney biopsy, light microscopy and laboratory examination were performed, and all findings revealed the signs of evident vacuolar degeneration of capillary endothelial and renal tubular epithelial cells, erythrocyte aggregation in partial renal tubule and microvilli exfoliation from epithelial cells. Renal interstitial edema was clearly identified. The clinical evidence observed from this female patient indicated that renal functions should be closely monitored during valacyclovir hydrochloride administration. A variety of effective measures, such as hydration, alkalizing urine, promoting the discharge of medication and the use of antagonists are recommended following the administration of antiviral agents.

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1	Vachvanichsanong P, Patamasucon P, Malagon M and Moore ES: Acute renal failure in a child associated with acyclovir. Pediatr Nephrol. 9:346–347. 1995. View Article : Google Scholar : PubMed/NCBI
2	Baker DA, Blythe JG and Miller JM: Once-daily valacyclovir hydrochloride for suppression of recurrent genital herpes. Obstet Gynecol. 94:103–106. 1999. View Article : Google Scholar : PubMed/NCBI
3	Tomori K, Isozumi K, Motohashi S, Komatsumoto S and Fukuuchi Y: A young patient of acute encephalitis complicated with acyclovir encephalopathy without renal dysfunction. Rinsho Shinkeigaku. 43:470–476. 2003.(In Japanese). PubMed/NCBI
4	Fleischer R and Johnson M: Acyclovir nephrotoxicity: A case report highlighting the importance of prevention, detection, and treatment of acyclovir-induced nephropathy. Case Rep Med. 2010:6027832010.PubMed/NCBI
5	Delluc A, Mocquard Y, Latour P and Goas JY: Encephalopathy and acute renal failure during acyclovir treatment. Rev Neurol (Paris). 160:704–706. 2004.(In French). View Article : Google Scholar : PubMed/NCBI
6	Linssen-Schuurmans CD, van Kan EJ, Feith GW and Uges DR: Neurotoxicity caused by valacyclovir in a patient on hemodialysis. Ther Drug Monit. 20:385–386. 1998. View Article : Google Scholar : PubMed/NCBI
7	Asahi T, Tsutsui M, Wakasugi M, Tange D, Takahashi C, Tokui K, Okazawa S and Okudera H: Valacyclovir neurotoxicity: clinical experience and review of the literature. Eur J Neurol. 16:457–460. 2009. View Article : Google Scholar : PubMed/NCBI
8	Adair JC, Gold M and Bond RE: Acyclovir neurotoxicity: Clinical experience and review of the literature. South Med J. 87:1227–1231. 1994. View Article : Google Scholar : PubMed/NCBI
9	Obada EN, Level G, Mathieu P, Parent X, Gilson B and Bindi P: Acute renal failure following a treatment with acyclovir. Nephrol Ther. 6:125–127. 2010. View Article : Google Scholar : PubMed/NCBI
10	Rao S, Abzug MJ, Carosone-Link P, Peterson T, Child J, Siparksy G, Soranno D, Cadnapaphornchai MA and Simões EA: Intravenous acyclovir and renal dysfunction in children: A matched case control study. J Pediatr. 166:1462–1468.e1-e4. 2015. View Article : Google Scholar : PubMed/NCBI
11	Rantanen JM, Markvardsen LH, Jakobsen J and Birn H: Acute kidney injury secondary to the first intravenous administration of acyclovir. Ugeskr Laeger. 176:pii2014.(In Danish).
12	Sodhi PK and Ratan SK: A case of chronic renal dysfunction following treatment with oral acyclovir. Scand J Infect Dis. 35:770–772. 2003. View Article : Google Scholar : PubMed/NCBI
13	Yavuz BB, Cankurtaran M, Halil M, Dagli N and Kirkpantur A: Renal dysfunction after oral acyclovir treatment in a geriatric woman: A case report. Scand J Infect Dis. 37:611–613. 2005.PubMed/NCBI
14	Becker BN, Fall P, Hall C, Milam D, Leonard J, Glick A and Schulman G: Rapidly progressive acute renal failure due to acyclovir: Case report and review of the literature. Am J Kidney Dis. 22:611–615. 1993. View Article : Google Scholar : PubMed/NCBI
15	Sagawa N, Tsurutani Y, Nomura K, Okuyama T, Kondo M, Sata A, Miyao M and Mizuno Y: Acyclovir-induced neurotoxicity and acute kidney injury in an elderly diabetic patient treated with valacyclovir: report of a case. Nihon Ronen Igakkai Zasshi. 51:581–585. 2014.(In Japanese). View Article : Google Scholar : PubMed/NCBI
16	Lam NN, Weir MA, Yao Z, Blake PG, Beyea MM, Gomes T, Gandhi S, Mamdani M, Wald R, Parikh CR, et al: Risk of acute kidney injury from oral acyclovir: A population-based study. Am J Kidney Dis. 61:723–729. 2013. View Article : Google Scholar : PubMed/NCBI
17	Seedat A and Winnett G: Acyclovir-induced acute renal failure and the importance of an expanding waist line. BMJ Case Rep. 2012:pii2012.
18	Obada EN, Level G, Mathieu P, Parent X, Gilson B and Bindi P: Acute renal failure following a treatment with acyclovir. Nephrol Ther. 6:125–127. 2010.(In French). View Article : Google Scholar : PubMed/NCBI
19	Sawyer MH, Webb DE, Balow JE and Straus SE: Acyclovir-induced renal failure. Clinical course and histology. Am J Med. 84:1067–1071. 1988. View Article : Google Scholar : PubMed/NCBI
20	Firat H, Brun P, Loirat C and Jacqz-Aigrain E: Kidney failure induced by administration of acyclovir. Apropos of 2 cases. Arch Fr Pediatr. 49:641–643. 1992.(In French). PubMed/NCBI
21	Vashishtha AK and Kuchta RD: Effects of Acyclovir, Foscarnet, and Ribonucleotides on Herpes Simplex Virus-1 DNA Polymerase: Mechanistic Insights and a Novel Mechanism for Preventing Stable Incorporation of Ribonucleotides into DNA. Biochemistry. 55:1168–1177. 2016. View Article : Google Scholar : PubMed/NCBI
22	Perazella MA: Crystal-induced acute renal failure. Am J Med. 106:459–465. 1999. View Article : Google Scholar : PubMed/NCBI
23	Mulay SR, Evan A and Anders HJ: Molecular mechanisms of crystal-related kidney inflammation and injury. Implications for cholesterol embolism, crystalline nephropathies and kidney stone disease. Nephrol Dial Transplant. 29:507–514. 2014. View Article : Google Scholar : PubMed/NCBI
24	De Deyne S, De la Gastine B, Gras G, Dargère S, Verdon R and Coquerel A: Acute renal failure with acyclovir in a 42-year-old patient without previous renal dysfunction. Rev Med Interne. 27:892–894. 2006.(In French). View Article : Google Scholar : PubMed/NCBI
25	Genc G, Ozkaya O, Acikgöz Y, Yapici O, Bek K, Gülnar Sensoy S and Ozyürek E: Acute renal failure with acyclovir treatment in a child with leukemia. Drug Chem Toxicol. 33:217–219. 2010. View Article : Google Scholar : PubMed/NCBI
26	Riba Solé M, Farré Riba R, Badell Serra I and Mangues Bafalluy MA: Acyclovir-induced acute renal failure in a paediatric oncology patient. Farm Hosp. 35:281–282. 2011.(In Spanish). PubMed/NCBI