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      Insuficiencia renal aguda secundaria al tratamiento con Aciclovir por herpes zoster en pacientes con lupus eritematoso sistémico: reporte de dos casos Translated title: Acute renal failure secondary to Acyclovir treatment for herpes zoster in patients with systemic lupus erythematosus: report of two cases

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          Abstract

          Se presentan dos casos de pacientes con lupus eritematoso sistémico con recidiva de herpes zoster, que desarrollan insuficiencia renal aguda secundaria al tratamiento con Aciclovir endovenoso. Descripción del plan de cuidados: El plan de cuidados estuvo abocado a tratar las necesidades alteradas según la clasificación de Virginia Henderson. Estas necesidades alteradas fueron: la necesidad de eliminación, higiene e integridad de la piel, dolor y movilización. Para el proceso de atención de enfermería se aplicó la taxonomía NANDA. Evaluación del plan: Tras aplicar el proceso de atención de enfermería se logró mejorar la función renal, recuperar la integridad cutánea, se evitó infecciones por las lesiones en la piel producidas por el herpes zoster, se controló el dolor, y se mejoró la movilidad del brazo izquierdo de una de las pacientes que padecía paresia. Conclusiones: Es menester para enfermería realizar un seguimiento minucioso de los pacientes que presentan tratamiento con Aciclovir, especialmente de aquellos que presentan patologías crónicas de base, como lupus eritematoso sistémico en recidivas con herpes zoster, para prevenir eventos adversos asociados al fármaco.

          Translated abstract

          Case description: Two cases of patients with systemic lupus erythematosus with herpes zoster recurrence, who develop acute renal failure secondary to treatment with intravenous acyclovir, have been studied. Description of the care plan: The care plan was aimed at addressing the altered needs according to the Virginia Henderson classification. These altered needs were the need for elimination, hygiene and skin integrity, pain and mobilisation. The NANDA taxonomy was applied for the nursing care process. Evaluation of the plan: After applying the nursing care process, renal function was improved, skin integrity was restored, infections were avoided due to skin lesions caused by herpes zoster, pain was controlled, and the mobility of the left arm of one of the patients suffering from paresis was improved. Conclusions: Close monitoring by nursing staff of patients treated with acyclovir is necessary, especially those with chronic underlying pathologies, such as systemic lupus erythematosus in relapses with herpes zoster, in order to prevent adverse events associated with the drug.

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          Acyclovir Nephrotoxicity: A Case Report Highlighting the Importance of Prevention, Detection, and Treatment of Acyclovir-Induced Nephropathy

          Acute kidney injury is an unfortunate complication of acyclovir therapy secondary to crystal-induced nephropathy. It is characterized by a decrease in renal function that develops within 24–48 hours of acyclovir administration indicated by a rapid rise in the serum creatinine. Failure to quickly realize this as an etiology of acute kidney injury can lead to excessive morbidity to the patient. The case described in this vignette is an example of the clinical manifestation of acyclovir crystal obstructive nephrotoxicity. We will briefly discuss the pathophysiology, diagnosis, prevention, and management of patients that present with acyclovir nephrotoxicity.
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            Herpes zoster infection in childhood-onset systemic lupus erythematosus patients: a large multicenter study.

            The aim of this multicenter study in a large childhood-onset systemic lupus erythematosus (cSLE) population was to assess the herpes zoster infection (HZI) prevalence, demographic data, clinical manifestations, laboratory findings, treatment, and outcome.
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              Insuficiência renal aguda associada ao uso de aciclovir endovenoso

              OBJETIVO: Avaliar a incidência e evolução da IRA em pacientes que utilizaram aciclovir por via intravenosa. MÉTODOS: Foram revisados, durante um período de sete meses consecutivos, os prontuários médicos de pacientes acima de 13 anos de idade que usaram aciclovir endovenoso (EV) por cinco dias ou mais. A IRA foi considerada quando a creatinina sérica, previamente normal, aumentava acima de 2 mg/dl. Foi analisado o tipo de tratamento instituído nos casos de IRA e sua evolução. RESULTADOS: Oitenta e cinco pacientes receberam aciclovir por via endovenosa durante o período estudado. Foram incluídos no estudo 41 pacientes. A IRA desenvolveu-se em 8 dos 41 pacientes estudados (19,5%). O tempo médio para o início do aumento dos níveis séricos da creatinina, após o início do uso da droga, foi de 4,2 dias, com o pico dos níveis da creatinina sérica aparecendo entre 3 a 14 dias (média 7,1 dias). A recuperação da função renal, avaliada pela queda dos níveis da creatinina, variou de 1 a 7 dias ( média de 3,6 dias). A resolução da IRA ocorreu após medidas gerais de hidratação, aumento do tempo de infusão e ajuste da dose do aciclovir. CONCLUSÃO: O aciclovir provocou IRA em 19,5% dos pacientes, que evoluíram bem em todos os casos observados, com retorno da função renal pré-tratamento após medidas de hidratação, reajuste da dose e aumento do tempo de infusão. Não houve necessidade de hemodiálise em nenhum paciente. A droga apresenta segurança de uso, desde que cuidados sejam implementados durante sua administração.
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                Author and article information

                Journal
                enefro
                Enfermería Nefrológica
                Enferm Nefrol
                Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                2254-2884
                2255-3517
                December 2021
                : 24
                : 4
                : 423-430
                Affiliations
                [3] orgnameInstituto Superior de Enfermería Artémides Zatti Argentina
                [2] Buenos Aires orgnameHospital Naval Cirujano Mayor Dr. Pedro Mallo Argentina
                [1] Buenos Aires orgnameHospital General de Agudos José María Ramos Mejía Argentina
                Article
                S2254-28842021000400010 S2254-2884(21)02400400010
                10.37551/s2254-28842021036
                180381f4-919f-499b-b769-46ac78281338

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 September 2021
                : 08 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 8
                Product

                SciELO Spain

                Categories
                Caso Clínico

                nursing care,adverse effect,systemic lupus erythematosus,acyclovir,herpes zoster,cuidados de enfermería,efecto adverso,lupus sistémico eritematoso,aciclovir,herpes zóster

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