Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster,Clinical Journal of the American Society of Nephrology

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Associations between Different Antivirals and Hospital-Acquired Acute Kidney Injury in Adults with Herpes Zoster
Clinical Journal of the American Society of Nephrology ( IF 8.5 ) Pub Date : 2024-03-26 , DOI: 10.2215/cjn.0000000000000452
Ruqi Xu ₁ , Qi Gao ₁ , Yuping Zhang ₁ , Yuxin Lin ₁ , Yanqin Li ₁ , Licong Su ₁ , Shiyu Zhou ₁ , Yue Cao ₁ , Peiyan Gao ₁ , Pingping Li ₁ , Fan Luo ₁ , Ruixuan Chen ₁ , Xiaodong Zhang ₁ , Sheng Nie ₁ , Xin Xu ₁ ,

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n of use of different antivirals with hospital-acquired AKI among Chinese adults with herpes zoster. Methods This study selected 3273 adult patients who received antiviral therapy for herpes zoster during hospitalization from the China Renal Data System. We identified and staged AKI using patient-level serum creatinine data according to the Kidney Disease Improving Global Outcomes 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 of 0.59 (95% confidence interval [CI], 0.37 to 0.94) and 0.27 (95% CI, 0.11 to 0.63), respectively. Compared with intravenous acyclovir, intravenous penciclovir/ganciclovir and foscarnet were associated with a lower risk of hospital-acquired AKI with an adjusted hazard ratio of 0.53 (95% CI, 0.29 to 0.98) and 0.31 (95% CI, 0.12 to 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 the highest risk of hospital-acquired AKI, followed by penciclovir/ganciclovir and foscarnet. Confirmation studies with large samples from other populations are warranted....

更新日期：2024-03-26

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