acyclovir and Hyperkalemia

Several published reports have suggested that oral acyclovir can cause renal insufficiency, but baseline renal function was either abnormal or unclear in those reports. We describe a patient with oral acyclovir-induced acute renal failure and a normal serum creatinine level documented just before exposure to the drug. Conceivably, competition with a cephalosporin for renal tubular elimination predisposed our patient to nephrotoxic serum levels of acyclovir. In addition, the patient had sickle cell trait, which might have contributed to a disproportionate degree of hyperkalemia and acidosis seen early in the patient's clinical course.

Topics: Acidosis, Renal Tubular; Acute Kidney Injury; Acyclovir; Adult; Antiviral Agents; Creatinine; HIV Infections; Humans; Hyperkalemia; Male; Sickle Cell Trait