Cidofovir in pediatric solid organ transplant recipients: University of Nebraska experience

Pediatr Infect Dis J. 2015 Jan;34(1):47-51. doi: 10.1097/INF.0000000000000487.


Background: Clinical experience with cidofovir in pediatric solid organ transplantation is limited. We assessed the effect of cidofovir use on renal function in pediatric solid organ transplant recipients.

Methods: Wilcoxon signed-rank tests were used to determine if changes in renal function were significant, Wilcoxon rank-sum tests to test the association between changes in glomerular filtration rate and potential confounding factors, and MacNemar tests to compare the proportions of patients at different time points.

Results: We included 25 patients with a mean age of 4.2 years (SD 4.6). More patients were receiving renal replacement therapy while being treated with cidofovir compared with baseline (24% vs. 4%; P = 0.03). For patients not receiving renal replacement therapy, there was no evidence of a significant median change in glomerular filtration rate from baseline to 1 month after cidofovir treatment (P = 0.32) or to the end of cidofovir treatment (P = 0.23) or in creatinine from baseline to the end of cidofovir therapy (P = 0.2). There was a marginal decreased median change in creatinine from baseline to 1 month after cidofovir treatment (P = 0.06). Fewer patients had proteinuria (72.2% vs. 27.8%; P = 0.02) and hematuria (22.2% vs. 0%) after cidofovir treatment.

Conclusion: In our pediatric transplant cohort, cidofovir did not significantly change renal function reflected by creatinine, glomerular filtration rate, hematuria or proteinuria, but a significant number of patients required renal replacement therapy because of fluid overload.

MeSH terms

  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / adverse effects*
  • Child
  • Child, Preschool
  • Cidofovir
  • Cohort Studies
  • Creatinine / blood
  • Cytosine / administration & dosage
  • Cytosine / adverse effects
  • Cytosine / analogs & derivatives*
  • Female
  • Glomerular Filtration Rate / drug effects*
  • Hematuria / chemically induced
  • Hospitals, University
  • Humans
  • Infant
  • Kidney / drug effects*
  • Kidney / physiology*
  • Male
  • Nebraska
  • Organophosphonates / administration & dosage*
  • Organophosphonates / adverse effects*
  • Proteinuria / chemically induced
  • Retrospective Studies
  • Transplants


  • Antiviral Agents
  • Organophosphonates
  • Cytosine
  • Creatinine
  • Cidofovir