Drug Dosing in Chronic Kidney Disease and Dialysis: The Poison Is in the Dose

Eugene C. Kovalik for the American Society of Nephrology Practicing Nephrologists Advisory Group

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A 50-year-old woman who had been receiving dialysis for many years because of complications from inflammatory bowel disease came to dialysis feeling “not quite right.” Her thought processes felt muddled, and her movements were not “right,” either. Upon further questioning, she stated that she had a shingles outbreak and had gone to an urgent care facility, where she was given full-dose acyclovir. After the medication was stopped and routine dialysis continued, her symptoms resolved.

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