Renal Toxicity in Pediatric Patients Receiving Cidofovir for the Treatment of Adenovirus Infection

J Pediatric Infect Dis Soc. 2017 Nov 24;6(4):399-402. doi: 10.1093/jpids/pix011.


Treatment options for adenovirus infection in immunocompromised children are limited. Nephrotoxicity has been associated with cidofovir use, but the rate of cidofovir-associated nephrotoxicity in pediatric patients is unclear. In a retrospective review of patients with adenovirus infection treated with cidofovir, neonates (n = 5) had higher viral loads and shorter times to renal insufficiency than older children (n = 24). Higher weekly doses of cidofovir were associated with greater increases in creatinine levels. Of 29 courses of cidofovir, 9 were complicated by acute kidney injury; in these children, mortality was high. Cidofovir dosing in children needs to be optimized, and other therapeutic alternatives should be developed.

Keywords: adenovirus; brincidofovir; cidofovir; nephrotoxicity; pediatrics.

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Adenovirus Infections, Human / drug therapy*
  • Adolescent
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Cidofovir
  • Cytosine / adverse effects
  • Cytosine / analogs & derivatives*
  • Cytosine / therapeutic use
  • Humans
  • Infant
  • Infant, Newborn
  • Organophosphonates / adverse effects
  • Organophosphonates / therapeutic use*
  • Retrospective Studies
  • Young Adult


  • Antiviral Agents
  • Organophosphonates
  • Cytosine
  • Cidofovir