Acute Kidney Injury During Treatment with Intravenous Acyclovir for Suspected or Confirmed Neonatal Herpes Simplex Virus Infection.
Acute Kidney Injury
/ chemically induced
Acyclovir
/ administration & dosage
Administration, Intravenous
Adolescent
Child
Child, Preschool
Cohort Studies
Female
Herpes Simplex
/ drug therapy
Humans
Infant, Newborn
Male
Pregnancy Complications, Infectious
/ drug therapy
Retrospective Studies
Risk Factors
AKI
HSV disease
HSV infection
epidemiology
infant
neonate
nephrotoxicity
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
25
10
2019
revised:
22
11
2019
accepted:
26
12
2019
pubmed:
11
2
2020
medline:
12
9
2020
entrez:
11
2
2020
Statut:
ppublish
Résumé
To describe the epidemiology of and risk factors associated with acute kidney injury (AKI) during acyclovir treatment in neonates and infants. We conducted a multicenter (n = 4), retrospective cohort study of all hospitalized infants age <60 days treated with intravenous acyclovir (≥1 dose) for suspected or confirmed neonatal herpes simplex virus disease from January 2011 to December 2015. Infants with serum creatinine measured both before acyclovir (baseline) and during treatment were included. We classified AKI based on changes in creatinine according to published neonatal AKI criteria and performed Cox regression analysis to evaluate risk factors for AKI during acyclovir treatment. We included 1017 infants. The majority received short courses of acyclovir (median, 5 doses). Fifty-seven infants (5.6%) developed AKI during acyclovir treatment, with an incidence rate of AKI at 11.6 per 1000 acyclovir days. Cox regression analysis identified having confirmed herpes simplex virus disease (OR, 4.35; P = .002), receipt of ≥2 concomitant nephrotoxic medications (OR, 3.07; P = .004), receipt of mechanical ventilation (OR, 5.97; P = .001), and admission to an intensive care unit (OR, 6.02; P = .006) as risk factors for AKI during acyclovir treatment. Among our cohort of infants exposed to acyclovir, the rate of AKI was low. Sicker infants and those exposed to additional nephrotoxic medications seem to be at greater risk for acyclovir-induced toxicity and warrant closer monitoring.
Identifiants
pubmed: 32037154
pii: S0022-3476(19)31735-4
doi: 10.1016/j.jpeds.2019.12.056
pmc: PMC7096264
mid: NIHMS1557999
pii:
doi:
Substances chimiques
Acyclovir
X4HES1O11F
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
126-132.e2Subventions
Organisme : NICHD NIH HHS
ID : K23 HD091365
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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