阿昔洛韦致急性肾损伤的临床分析

Clinical analysis of acute kidney injury induced by acyclovir

目的总结阿昔洛韦导致急性肾损伤的临床特点,为临床安全用药提供参考。方法收集我院2012年1月至2016年12月因阿昔洛韦导致急性肾损伤的患者的临床资料,记录患者性别、年龄、既往史、用药剂量和频次、用药至发生急性肾损伤不良反应的时间、临床表现、实验室化验检查、治疗措施及转归等信息,分析阿昔洛韦致急性肾损伤的临床特点。结果收集到21例患者,各年龄段均有发病,平均年龄为(46.67±16.92)岁;临床表现有腰酸腰痛、恶心呕吐等,其中少尿型4例,非少尿型17例;肌酐(437.63±187.21)μmol/L,尿素氮(14.43±4.76)mmol/L;所有患者给予水化、碱化尿液、降低肌酐等对症处理,2例患者因肌酐过高行血透治疗,患者预后良好。结论阿昔洛韦导致急性肾损伤为急性过程,以非少尿型为主,对症处理后患者预后良好,为避免不良反应,预防是关键。

Objective To summarize the clinical features of acute kidney injury induced by acyclovir so as to provide references for clinical rational drug use. Methods The clinical data of the patients with acyclovir-induced acute kidney injury treated from January 2012 to December 2016 in our hospital was collected, and the gender, age,previous history,drug dosage and frequency, time from medication to the occurrence of acute kidney injury, clinical manifestations,laboratory findings, treatment measures and outcomes were recorded to analyze the clinical characteristics of acute renal injury induced by acyclovir. Results Twenty-one patients of all ages were collected, the average age being（ 46. 67 ± 16. 92） years old; the clinical manifestations included soreness of waist, lumbago,nausea and vomiting, and in the patients, there was oliguria in 4 cases and non-oliguria in 17 cases; the average creatinine was（ 437. 63 ± 187. 21）μmol/L and the average BUN was（ 14. 43 ± 4. 76） mmol/L. All the patients were given treatment of hydration, alkalization of urine, reducing creatinine and other symptomatic routine tneatment. Two patients with high creatinine were treated with hemodialysis. The prognosis of all the patients was good. Conclusion Acute kidney injury induced by acyclovir is an acute process,mainly in non-oliguric type. Patients have good prognosis after symptomatic treatment; in order to avoid adverse reactions,prevention is the key.