J Korean Ophthalmol Soc.  2010 Nov;51(11):1528-1531. 10.3341/jkos.2010.51.11.1528.

Acyclovir-induced Acute Renal Failure in a Patient With Suspected Acute Retinal Necrosis Syndrome

• Cho JH
• Jang JH
• Lee DH
• Lee YK
• Noh JW
• Bae JH
• Kim HK

• KMID: 2213991
• DOI: http://doi.org/10.3341/jkos.2010.51.11.1528

Abstract

PURPOSE
To report a case of acyclovir-induced acute renal failure (ARF) suspected as acute retinal necrosis syndrome.
CASE SUMMARY
The authors report a 55-year-old male patient who presented with left eye visual disturbance due to suspected acute retinal necrosis syndrome. Non-oliguric ARF developed after the infusion of intravenous acyclovir (850 mg every 8 hours). The patient did not show any uremic symptoms or signs. The crystal was not discovered in the urine. After stopping the acyclovir infusion and hydration, acyclovir-induced ARF was reversed.
CONCLUSIONS
Although possessing critical nephrotoxicity, acyclovir is a useful antiviral drug. Therefore, when using acyclovir, the importance of hydration and preventing acyclovir-induced ARF should be considered.

Keyword

Acute renal failure; Acute retinal necrosis syndrome; Acyclovir

MeSH Terms

Acute Kidney Injury
Acyclovir
Eye
Humans
Male
Middle Aged
Retinal Necrosis Syndrome, Acute
Acyclovir

Figure

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  Figure 1. Initial fundus photograph of the left eye shows retinal necrosis (arrowhead) with retinal hemorrhages (arrowheads), obscured by dense vitreous opacity (A). After 3 months of the initial diagnosis, the vitreous inflammation and necrotic retinal lesions resolved almost completely, leaving behind ischemic retina with occluded retinal vessels inferotemporally (B).

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  Figure 2. Initial fluorescein angiograph of the left eye shows dye leakage from retinal vessels along with nonperfused ischemic retina inferotemporally.

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  Figure 3. Serial changes in serum creatinine levels. * Cr = creatinine; † HD = hospital day.

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