Treatment of Herpes Zoster in Chronic Kidney Disease or Impaired Renal Function
When herpes zoster occurs in a patient with chronic kidney disease or impaired renal function, standard antiviral approaches cannot be applied without modification. Reduced renal clearance directly shapes both the choice of antiviral agent and the way it is dosed.
This protocol addresses herpes zoster in patients who have chronic kidney disease or impaired renal function. Because the kidneys play a central role in clearing antiviral agents, this comorbidity requires a specifically adapted treatment strategy rather than a standard one-size-fits-all regimen.
Antiviral therapy is indicated, with the route of administration determined by clinical criteria. In this setting, any antiviral used must be dosed with adjustment for the degree of renal impairment. The specific agent selection, route criteria, and individualised dosing are defined in the full structured protocol.
References
DOI: 10.1111/ddg.14013
For herpes zoster patients with chronic kidney disease, we recommend brivudine (if oral treatment is indicated) or intravenous acyclovir (if intravenous treatment is indicated) given at a dose adjusted to renal function (Table 20).
In patients with impaired renal function, it is recommended to use oral brivudine (if oral antiviral treatment is indicated) or intravenous acyclovir (if intravenous antiviral treatment is indicated; criteria see above) given at a dose adjusted to renal function.
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