{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T15:45:43Z","timestamp":1793375143256,"version":"4.5.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CEN Case Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 72-year-old Japanese woman was treated by 3000\u00a0mg\/day of valacyclovir for the herpes zoster in her left back. She had been treated as hypertension with no renal insufficiency. In two days, she visited an emergency room of a regional stroke care center with dysarthria, dexterity disorder and gait disturbance. Neither head CT nor MRI found intracranial lesions, then, laboratory tests revealed that her serum creatinine level was 4.63\u00a0mg\/dL. She was transferred and admitted to our hospital on the following day and received hemodialysis under the diagnosis of AKI due to acyclovir accompanied with encephalopathy. Afterward, her serum concentration of acyclovir revealed as 44\u00a0\u03bcg\/mL, which is extremely high. Her neurological symptom disappeared in parallel with the decrease of serum concentration of acyclovir. She received 3 sessions of hemodialysis and discharged on the 8th day of admission with almost normal renal function and no neurological sequela.<\/jats:p>","DOI":"10.1007\/s13730-022-00748-5","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T12:03:27Z","timestamp":1668773007000},"page":"221-225","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Valacyclovir-associated acute kidney injury and encephalopathy in an elderly woman with normal kidney function: a case report"],"prefix":"10.1007","volume":"12","author":[{"given":"Kazufumi","family":"Kato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8237-5399","authenticated-orcid":false,"given":"Reiichi","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Shiroto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Nagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuyo","family":"Narita-Kinjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Tomita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"748_CR1","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1038\/clpt.1993.196","volume":"54","author":"S Weller","year":"1993","unstructured":"Weller S, Blum MR, Doucette M, Burnette T, Cederberg DM, de Miranda P, et al. Pharmacokinetics of the acyclovir prodrug valacyclovir after escalating single and multiple dose administration to normal volunteers. Clin Pharmacol Ther. 1993;54:595\u2013605.","journal-title":"Clin Pharmacol Ther"},{"key":"748_CR2","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s13730-012-0035-0","volume":"2","author":"C Yildiz","year":"2013","unstructured":"Yildiz C, Ozsurekci Y, Gucer S, Cengiz AB, Topaloglu R. Acute kidney injury due to acyclovir. CEN Case Rep. 2013;2:38\u201340.","journal-title":"CEN Case Rep"},{"key":"748_CR3","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.tjog.2016.06.012","volume":"55","author":"YH Chang","year":"2016","unstructured":"Chang YH, Tseng JY, Chen CY, Sung PL, Yeh CC, Yang MJ. Acyclovir-induced nephrotoxicity in a pregnant woman with chickenpox. 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Am J Ther. 2016;23:e941\u20133.","journal-title":"Am J Ther"},{"key":"748_CR6","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s15010-015-0867-6","volume":"44","author":"Q Kaewpoowat","year":"2016","unstructured":"Kaewpoowat Q, Salazar L, Aguilera E, Wootton SH, Hasbun R. Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes. Infection. 2016;44:337\u201345.","journal-title":"Infection"},{"key":"748_CR7","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1053\/j.ajkd.2012.12.008","volume":"61","author":"NN Lam","year":"2013","unstructured":"Lam NN, Weir MA, Yao Z, Blake PG, Beyea MM, Gomes T, et al. Risk of acute kidney injury from oral acyclovir: A population-based study. Am J Kidney Dis. 2013;61:723\u20139.","journal-title":"Am J Kidney Dis"},{"key":"748_CR8","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz121","author":"KE Barber","year":"2019","unstructured":"Barber KE, Wagner JL, Stover KR. Impact of obesity on acyclovir-induced nephrotoxicity. Open Forum Infect Dis. 2019. https:\/\/doi.org\/10.1093\/ofid\/ofz121.","journal-title":"Open Forum Infect Dis"},{"issue":"Suppl 1","key":"748_CR9","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1086\/510206","volume":"44","author":"RH Dworkin","year":"2007","unstructured":"Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007;44(Suppl 1):S1-26.","journal-title":"Clin Infect Dis"},{"key":"748_CR10","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/0897190018825033","volume":"33","author":"GO Umoru","year":"2020","unstructured":"Umoru GO, Shah PJ, Tariq F. A case report of neurotoxicity after prolonged doses of acyclovir in a patient with renal dysfunction. 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