伐昔洛韦片不合理用药致急性肾损伤1例

A case of acute renal injury caused by improper administration of valaciclovir tablets

1例慢性病患者在院治疗期间出现了可疑药源性肾损伤,临床药师查阅相关文献评估分析,考虑与伐昔洛韦不合理用药相关。根据临床药师建议,按患者实时肌酐清除率调整伐昔洛韦剂量,并给予补液、利尿等治疗措施后,患者肾功能指标下降,出院6周后门诊随访,肾功能指标稳定。该病例提醒医务人员,伐昔洛韦应用于合并慢性肾脏病患者时,需密切注意肾功能变化,及时调整用药剂量,用药期间补充适当的液体,确保足够的尿量,以避免药物结晶沉积肾小管引起的急性肾损伤。

This article reports a case of suspected drug-induced kidney injury in a chronic disease patient during hospital treatment.Clinical pharmacists reviewed relevant literature and evaluated and analyzed it,considering it to be related to the improper use of valaciclovir.According to the advice of the clinical pharmacist,the dosage of valaciclovir was adjusted according to the patient's real-time creatinine clearance rate,and treatment measures such as fluid replacement and diuresis were given.The patient's renal function and other indicators decreased.After 6 weeks of discharge,outpatient follow-up showed stable renal function indicators.It reminds the medical staff when valaciclovir is used in patients with chronic kidney disease,it is necessary to closely monitor changes in renal function,and adjust the dosage timely,supplement appropriate fluids during medication,and ensure sufficient urine volume to avoid acute kidney damage caused by drug crystallization deposition in the renal tubules.