Man suffers acute kidney injury after AI misdiagnosis leads to triple-dose medication error

The growing popularity of artificial intelligence (AI) carries potential risks when used for medical diagnosis. A man in Hangzhou, Zhejiang province, developed cold sores (herpes labialis) and, seeking convenience, used an AI for consultation. After purchasing and taking medication based on the AI's advice, he accidentally ingested three times the standard dose of an antiviral drug, resulting in acute kidney injury and requiring emergency hospitalization. Doctors are reminding the public not to replace professional medical diagnosis with AI.

According to reports from mainland media and the Zhejiang Provincial Tongde Hospital, a 45-year-old man surnamed Wu in Hangzhou developed herpes around his mouth and used an AI platform for consultation and treatment recommendations. Following the AI's suggestion, he purchased the antiviral drug "Valacyclovir" to take. Several days later, he felt fatigued and nauseous. Initially thinking he had a cold, he took cold medicine on his own, but his symptoms worsened. He was taken to the emergency room by his family that same night.

Creatinine Levels Skyrocket 10-Fold, Diagnosed with Acute Drug-Induced Kidney Injury

Hospital test results showed Wu's serum creatinine level was as high as 800 µmol/L—nearly eight times the normal upper limit (110 µmol/L) and a tenfold increase from his level of around 80 µmol/L during a physical exam at the end of 2025. An abdominal CT scan further revealed irregular swelling in his ureters and bladder. He was immediately transferred to the nephrology ward. Upon further inquiry, doctors discovered:

• Mr. Wu purchased imported Valacyclovir, where each pill's dosage was three times that of commonly used domestic versions.
• The AI's recommendation only provided the "number of pills per dose" without specifying the "gram amount" or exact dosage.
• He followed the AI's advice and took 8 pills, resulting in an intake exceeding three times the standard dose.
• Adding cold medication on top further burdened his kidneys.

After diagnosis, Wu was confirmed to have "acute drug-induced kidney injury". Following treatment with "hydration therapy" (intravenous fluids to promote drug excretion) and traditional Chinese medicine aimed at activating blood circulation and removing toxins, his serum creatinine levels returned to the normal range within five days. He has since recovered and been discharged.

Doctor's Warning: AI Cannot Replace Clinical Diagnosis, Medication Dosage Must Be Highly Individualized

Dr. Chen Qin, Director of the Nephrology and Rheumatology Department at Zhejiang Provincial Tongde Hospital, pointed out that the risk of drug-induced acute kidney injury cannot be ignored, as kidney function can decline rapidly in a short period. Severe cases can progress to kidney failure, potentially requiring lifelong dialysis. Among all acute kidney injury cases, approximately 20% are drug-related; among elderly populations, the proportion of drug-related kidney injury is even higher.

Chen emphasized that while AI can provide informational references, it absolutely cannot replace the clinical judgment of professional healthcare providers. This is because medication therapy involves significant individual variation:

• Weight Differences: Dosage needs precise calculation based on body weight.
• Liver/Kidney Function: Different metabolic capacities affect medication safety.
• Comorbidities: The presence of conditions like hypertension, diabetes, or gout.
• Drug Interactions: Potential interactions with other medications taken concurrently.
• Disease Severity: Different stages of illness require different medication choices.

Chen added that certain drugs can trigger "allergic interstitial nephritis," a condition that often requires a kidney biopsy for definitive diagnosis and may need long-term hormone therapy. If patients seek medical attention too late, it can lead to irreversible kidney fibrosis, and kidney function may never fully recover.

What is Acute Kidney Injury? What are the Symptoms? Drug-Induced Acute Kidney Injury?

Acute kidney injury occurs when kidney function declines suddenly and severely, impairing the effective filtration of waste from the blood. This leads to the accumulation of harmful waste products in the body and disrupts the blood's chemical balance. Acute kidney injury (formerly called acute renal failure) is most commonly seen in critically ill hospitalized patients. Its severity can range from mild to severe. If severe and not properly treated, it can be life-threatening; however, this injury is also potentially reversible. For patients in otherwise good health, kidney function has a chance to recover to normal or near-normal levels.

Symptoms of acute kidney injury include:

• Decreased urine output
• Fluid retention (may cause shortness of breath, swelling in legs, ankles, or feet)
• Fatigue
• Confusion or mental fogginess
• Nausea
• Abdominal pain or pain on one side below the rib cage
• Weakness
• Irregular heartbeat
• Itching
• Loss of appetite
• Chest pain or pressure
• In severe cases, seizures or coma

It's important to note that sometimes acute kidney injury causes no symptoms. While medications are crucial for disease prevention and treatment, they are also a leading cause of acute kidney injury. Examples of "common medications" that can cause it:

• Antimicrobials: Certain antibiotics (e.g., aminoglycosides), antivirals (e.g., tenofovir), and antifungals can damage kidneys. Strict adherence to medical instructions is essential; never alter dosage or misuse.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Common pain relievers/fever reducers like ibuprofen. Occasional use as directed is acceptable, but persistent pain or fever warrants medical attention, not long-term self-medication.
• Contrast Dyes: Iodine or gadolinium-based agents used in angiography or CT scans can harm kidneys, especially in patients with existing kidney disease. Adequate hydration before and after the procedure helps flush out the dye and lowers risk.
• Anti-Cancer Drugs: Some chemotherapy agents, targeted therapies, and immunotherapies can affect kidney function. Patients should have kidney function markers (like serum creatinine and urine protein) closely monitored during treatment.
• Chinese Herbal Medicines: Some herbs have nephrotoxic properties. They should be used under the guidance of a registered Chinese medicine practitioner; do not trust unverified folk remedies or supplements with unknown ingredients.
• Weight Loss Drugs: Some products may cause dehydration or high uric acid, leading to kidney damage.