Tubulointerstitial nephritis (TIN) is an inflammatory process primarily involving the renal interstitium and is the cause of acute kidney injury (AKI) in 3-7% of cases confirmed by renal biopsy in children. Aciclovir may have a nephrotoxic effect by crystallization in renal tubules or by inducing an immunologic process that leads to development of TIN.

We report 2 male patients, aged 10 and 8 years, with nephrotic syndrome (NS), in whom disease relapse was triggered by varicella zoster infection. The patients received intravenous aciclovir which resulted in AKI due to acute TIN with the glomerular filtration rate 19.5 and 24.9 ml/min/1.73 m2, respectively. The diagnosis was confirmed by kidney biopsy in one of these patients. Initiation of glucocorticosteroids and withdrawal of aciclovir resulted in resolution of proteinuria and symptoms of AKI.

In children with active NS treated with intravenous aciclovir, a possibility of AKI due to TIN should be taken into account.

中文翻译：

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阿昔洛韦治疗肾病综合征儿童水痘后的急性肾小管间质性肾炎-附两例报告

肾小管间质性肾炎（TIN）是一种主要涉及肾脏间质的炎症过程，是儿童肾脏活检证实的3-7％病例的急性肾损伤（AKI）的原因。阿昔洛韦可能通过肾小管中的结晶或诱导导致TIN发生的免疫过程而具有肾毒性作用。

我们报告了2名年龄分别为10和8岁的肾病综合征（NS）的男性患者，其中水痘带状疱疹感染触发了疾病复发。患者接受了静脉注射阿昔洛韦，这是由于急性TIN导致的AKI，其肾小球滤过率分别为19.5和24.9 ml / min / 1.73 m2。其中一名患者的肾脏活检证实了该诊断。糖皮质激素的启动和阿昔洛韦的退出导致蛋白尿的缓解和AKI症状。

对于静脉注射阿昔洛韦治疗患有活动性NS的儿童，应考虑由TIN引起的AKI可能性。