Objective: The aim of this study was to evaluate the incidence and outcome of acute renal failure (ARF) in patients submitted to intravenous (IV) acyclovir treatment.
Methods: All patients over 13 years of age that used intravenous acyclovir for 5 or more days were retrospectively analyzed. When serum creatinine levels, previously in the normal range, increased above 2 mg/dl, the case was considered an ARF. Treatment and outcome of patients that developed ARF were analyzed.
Results: Eighty-five patients received IV acyclovir during the study period. Forty-one patients were included in the study. ARF developed in 8 out of 41 patients (19.5%). In the ARF cases, after beginning of treatment, the average time for increase of the serum creatinine levels was 4.2 days. Creatinine levels reached their peak in a mean time of 7.1 days (ranging from 3 to 14 days). Recovery of the renal function, evaluated by decrease of the creatinine level, varied from 1 to 7 days (mean of 3.6 days). ARF had a good outcome with hydration, lengthening of drug infusion time and adjustment of the drug dosage.
Conclusion: Acyclovir induced ARF in 19.5% of the patients. All patients had a positive response with return to a normal renal function after hydration, lengthening of drug infusion time and adjustment of the drug dosage. None of the patients required treatment with hemodialysis. Acyclovir is a safe drug when administered with certain preventive measures.