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Determinants of aciclovir-induced nephrotoxicity in children

Ruth Schreiber1, Jacob Wolpin, Gideon Koren

  • 1Division of Clinical Pharmacology/Toxicology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

Paediatric Drugs
|March 19, 2008
PubMed

Insights

Aciclovir can cause kidney damage in children. Risk factors include using other nephrotoxic drugs and having a lower baseline glomerular filtration rate (GFR).

Area of Science:

  • Pediatric Nephrology
  • Pharmacology
  • Infectious Diseases

Background:

  • Aciclovir is a primary treatment for severe herpes virus infections.
  • Nephrotoxicity is a known adverse effect of Aciclovir.
  • Limited data exists on Aciclovir-induced nephrotoxicity in children.

Purpose of the Study:

  • To determine risk factors for Aciclovir-associated nephrotoxicity in pediatric patients.
  • To investigate the impact of concomitant medications and baseline kidney function on Aciclovir nephrotoxicity.

Main Methods:

  • Retrospective review of 126 pediatric patients treated with Aciclovir.
  • Calculation of glomerular filtration rate (GFR) using Schwartz's method at baseline and peak creatinine.
  • Analysis of patient data including age, sex, immunosuppression status, and co-administered drugs.

Main Results:

  • Aciclovir treatment significantly increased serum creatinine and decreased GFR in pediatric patients (p
  • Children receiving other nephrotoxic drugs experienced more severe nephrotoxicity.
  • Concomitant use of nephrotoxic drugs (p = 0.02) and impaired baseline GFR (p = 0.04) were significant predictors of nephrotoxicity.

Conclusions:

  • Aciclovir dosage per kg, age, or sex did not influence nephrotoxicity within recommended schedules.
  • Concomitant nephrotoxic drug use and impaired baseline GFR are key predictors of Aciclovir-induced nephrotoxicity in children.
  • These findings highlight the importance of monitoring kidney function and reviewing concurrent medications in pediatric patients receiving Aciclovir.
Abstract

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