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The Impact of Cidofovir on the Renal Function of Pediatric Solid Organ Transplant Recipients

Session: Poster Abstract Session: Pediatric - Viral Studies
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: The experience with cidofovir in pediatric SOT is limited. The study aimed to assess the impact of cidofovir use on the renal function.  

Methods: Summary statistics were presented for demographics and outcomes, Wilcoxon signed-rank tests to compare changes in renal function and Wilcoxon rank-sum tests to test association with potential confounding factors.

Results: We included 25 patients (mean age 4.2years; SD 4.6): liver-small bowel (15), small bowel (4), liver (3) and  kidney (3) transplant recipients. Viral infections: adenovirus (20), BKv (2), HHV6 (1), and EBV (1). 24% of patients while on cidofovir compared with 4% at baseline (p=0.03) were on renal replacement therapy (RRT). For patients not on RRT, there was no difference: 1) in the median creatinine clearance between baseline and one month after (p=0.32) or end of cidofovir treatment (p=0.23); 2) in the creatinine from baseline to end of cidofovir therapy (p=0.2); there was marginal decrease in the median creatinine from baseline to one month post-cidofovir treatment (p=0.06).  Less patients had proteinuria (72.2% vs. 27.8%;p=0.02) and hematuria (22.2% vs. 0%) at the end than at the beginning of cidofovir treatment. No evidences of associations were found between changes in creatinine clearance (by univariate analysis) with: exposure to vancomycin (p=0.44), amikacin (p=0.13), dopamine (p=0.66), epinephrine (p=0.99), norepinephrine (p=0.48), intravenous contrast (p=0.41) and surgery (p=0.59).

Conclusion: Cidofovir was mainly used to treat adenovirus infections. In our study, cidofovir did not have nephrotoxic effects during the treatment and 1 month after treatment in pediatric transplant recipients, although they required RRT while on cidofovir because of fluid overload.

Diana F. Florescu, MD1, Heather Chambers, APRN2, Fang Qiu, PhD3, Michael Morris, MD4, David F. Mercer, MD4 and Marius C Florescu, MD5, (1)Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, (2)University of Nebraska Medical Center, Omaha, NE, (3)Biostatistics Department, Nebraska Medical Center, Omaha, NE, (4)Transplant Surgery Division, University of Nebraska Medical Center, Omaha, NE, (5)Nephrology Department, University of Nebraska Medical Center, Omaha, NE


D. F. Florescu, None

H. Chambers, None

F. Qiu, None

M. Morris, None

D. F. Mercer, None

M. C. Florescu, None

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