Background: To preserve kidney graft function it is necessary to use ganciclovir or valganciclovir as a therapy for fresh CMV infection or prophylaxis in high-risk kidney transplant recipients. Ganciclovir-induced lactic acidosis has thus far not been reported.
Case Report: Three cases of nonrespiratory acidosis in kidney transplant recipients receiving ganciclovir or valganciclovir as anti-CMV therapy or prophylaxis are presented. Lactic acidosis developed in 2 patients, and the other patient had nonrespiratory acidosis of unknown origin. The possible mechanism of the development of lactic acidosis in presented cases is explored.
Conclusions: The analysis of the described cases cannot eliminate the potential negative influence of anti-CMV therapy on acid-base equilibrium, especially with coexisting active viral infection.

Keywords: Kidney Transplantation, Ganciclovir, Valganciclovir, nonrespiratory acidosis