Acute kidney injury, secondary to valacyclovir use during pregnancy for the prevention of fetal cytomegalovirus infection

High dose valacyclovir treatment of pregnant women has become a common treatment for primary CMV infection, to prevent vertical transmission to the fetus. We present a case of a healthy young pregnant female with primary CMV infection during the first trimester who was diagnosed with acute kidney injury secondary to valacyclovir treatment. This case serves as a reminder to clinicians that prescription of high dose valacyclovir, to prevent vertical transmission of CMV to the fetus, carries a risk of approximately 1% of AKI.