What renal issue can result from high doses of acyclovir?

Acyclovir is an antiviral medication commonly used to treat infections caused by certain viruses, particularly herpes viruses. One of the potential adverse effects associated with high doses of acyclovir is nephrotoxicity. This occurs primarily due to precipitation of acyclovir in the renal tubules, leading to acute kidney injury. The mechanism involves crystal formation in the renal tubules, which can obstruct urine flow and increase intratubular pressure, ultimately resulting in tubular damage.

The risk of nephrotoxicity is particularly heightened in patients who are dehydrated or those with pre-existing renal impairment. Therefore, it is critical for clinicians to monitor renal function and maintain adequate hydration in patients receiving high doses of acyclovir to mitigate this risk.

Other renal-related options such as acute tubular necrosis and chronic kidney disease can occur through various mechanisms, but in the context of acyclovir dosing, nephrotoxicity is the most directly associated condition due to the specific renal complications linked to the drug’s crystallization.