J Korean Soc Transplant.  2006 Dec;20(2):253-257.

Crystal-induced Acute Renal Failure due to Acyclovir in a Renal Transplant Patient

• Kang HJ
• Kim CD
• Tak WT
• Park SW
• Bae HS
• Park SH
• Lee JH
• Kim YL

Abstract

Several medications are associated with the production of crystals that are insoluble in human urine. Intratubular precipitations of these crystals can lead to acute renal insufficiency. Many patients who require treatment with these medications have additional risk factors, such as volume depletion, underlying renal insufficiency and immunocompromised state that increase the risk of drug induced intrarenal crystal deposition. We experienced a case of crystal-induced acute renal failure due to acyclovir in a 44 year-old male renal allograft recipient. He was diagnosed as Varicella Zoster at 12 days after transplantation, and treated with intravenous (IV) acyclovir (IV infusion of acyclovir 250 mg mixed with normal saline 100 mL within several minutes three times a day, total seven times). Two days after initiation of IV acyclovir, serum BUN was increased up to 160 mg/dL, serum creatinine was increased up to 9.9 mg/dL and urine output was decreased to anuria. With discontinuation of acyclovir, hemodialysis was started as treatment of renal insufficiency. Renal function was restored after discontinuation of acyclovir.

Keyword

Acyclovir; Crystal; ARF

MeSH Terms

Acute Kidney Injury*
Acyclovir*
Adult
Allografts
Anuria
Chickenpox
Creatinine
Herpes Zoster
Humans
Male
Renal Dialysis
Renal Insufficiency
Risk Factors
Acyclovir
Creatinine