Tubulointerstitial nephritis caused by the antiviral agent foscarnet

Nyberg, Gudrun; Svalander, Christian; Blohmé, I; Persson, Hans

doi:10.1007/bf02414539

Cited by 7 publications

(2 citation statements)

References 11 publications

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“…Foscarnet has long been considered nephrotoxic. [41][42][43] There was also increasing evidence for the nephrotoxicity associated with nucleoside analogs such as acyclovir and ganciclovir. [44][45][46][47] Our study showed that foscarnet was associated a significantly lower risk of hospitalacquired AKI compared with acyclovir.…”

Section: Discussionmentioning

confidence: 99%

Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster

Xu,

Gao,

Zhang

et al. 2024

CJASN

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Background: To examine the association of use of different antivirals with hospital acquired acute kidney injury (AKI) among Chinese adults with herpes zoster. Methods: The study selected 3273 adult patients who received antiviral therapy for herpes zoster during hospitalization from the China Renal Data System (CRDS). We identified and staged AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. We compared the relative risks of hospital acquired AKI among patients treated with different antivirals using Cox proportional hazards models. Results: Among 3273 patients, 1480 (45%), 681 (21%), 489 (15%) and 623 (19%) were treated with acyclovir/valacyclovir, ganciclovir, penciclovir/famciclovir, and foscarnet, respectively. During the follow-up period, a total of 111 cases of hospital acquired AKI occurred, predominantly classified as AKI stage 1. The cumulative incidences of hospital acquired AKI were 5%, 3%, 3% and 1%, in the patients receiving acyclovir/valacyclovir, ganciclovir, penciclovir/famciclovir, and foscarnet, respectively. Compared with acyclovir/valacyclovir, penciclovir/famciclovir/ganciclovir and foscarnet were associated with a lower risk of hospital acquired AKI, with an adjusted hazard ratio [aHR] of 0.59 (95% CI, 0.37-0.94) and 0.27 (95% CI, 0.11-0.63), respectively. Compared with intravenous acyclovir, intravenous penciclovir/ganciclovir and foscarnet were associated with a lower risk of hospital acquired AKI with an aHR of 0.53 (95% CI, 0.29-0.98) and 0.31 (95% CI, 0.12-0.76), respectively. The associations were consistent across various subgroups and sensitivity analyses. Conclusions: Among antiviral therapies for herpes zoster, we found different risks of hospital acquired AKI among the patients receiving different antivirals, in particular, those administered intravenously. Among intravenous antivirals, acyclovir was associated with highest risk of hospital acquired AKI, followed by penciclovir/ganciclovir and foscarnet. Confirmation studies with large samples from other populations are warranted.

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Section: Discussionmentioning

confidence: 99%

Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster

Xu,

Gao,

Zhang

et al. 2024

CJASN

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“…Diffuse tubular necrosis was reported in a patient treated for a CMV pneumonitis. 11 In eight renal transplant recipients, Nyberg and associates 12,13 described a tubulointerstitial nephritis with focal epithelial cell degeneration in the straight part of proximal tubules. These adverse effects could be avoided by correct hydration.…”

Section: Discussionmentioning

confidence: 99%

Irreversible glomerular lesions induced by crystal precipitation in a renal transplant after foscarnet therapy for cytomegalovirus infection

Justrabo

Zanetta²,

Martin

et al. 1999

Histopathology

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Opportunistic infections in children following renal transplantation

Harmon

1991

Pediatr Nephrol

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Opportunistic infections following renal transplantation in children are a major cause of severe morbidity and mortality. These infections account for the majority of early post renal-transplant deaths in children. General risk factors which affect the incidence and severity of these infections include: transmission of the infectious agent by the donor organ; history of immunity in the recipient prior to transplantation; type and amount of immunosuppression including treatment for rejection episodes; availability of specific treatment for the infection. Children are at particular risk because of the lack of exposure to certain pathogens prior to transplantation. There have been recent advances in the prevention and treatment of important infections which occur in children following transplantation, including varicella, Pneumocystis carinii pneumonia (PCP) and cytomegalovirus (CMV) disease. Varicella is treatable with acyclovir, often without decreasing immunosuppression and placing the graft at risk. Prophylaxis against PCP may be achieved by provision of alternate-day trimethoprim sulpha, but clear guidelines for determining who should be treated are lacking. Treatment of this disease with high-dose trimethoprim sulfa or pentamidine is usually successful. CMV disease is frequently severe, especially when the donor is seropositive and the recipient seronegative. In these situations, prophylactic CMV immunoglobulin reduces the morbidity and the mortality of the disease and prophylactic oral acyclovir may decrease its incidence. Treatment of severe CMV disease with gancyclovir is promising.

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Tubulointerstitial nephritis caused by the antiviral agent foscarnet

Cited by 7 publications

References 11 publications

Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster

Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster

Irreversible glomerular lesions induced by crystal precipitation in a renal transplant after foscarnet therapy for cytomegalovirus infection

Opportunistic infections in children following renal transplantation

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