#4815 COMPARISON OF DIFFERENT ANTIVIRALS REGARDING THEIR ASSOCIATION WITH HOSPITAL-ACQUIRED ACUTE KIDNEY INJURY AMONG ADULTS WITH HERPES ZOSTER

Abstract Background and Aims Antiviral therapy is commonly used to treat herpes zoster. Though antivirals are generally considered nephrotoxic, few studies compared the relative risk of acute kidney injury in patients with zoster that attributable different antivirals. We aim examine association use hospital-acquired (HA-AKI) among Chinese adults Method The study population was derived from China Renal disease System (CRDS), a retrospective cohort hospitalized 19 medical centers throughout China. selected CRDS 3,847 who received antiviral for during hospitalization. identify stage AKI using patient-level serum creatinine data according Kidney Disease Improving Global Outcomes (KDIGO) criteria. risks HA-AKI treated Cox proportional hazards model, explored non-linear between accumulative dose penalized smoothing spline. Results Among patients, 1,585 (41.2%), 699 (18.2%), 599 (15.6%) 964 (25.1%) were acyclovir/valacyclovir, ganciclovir, penciclovir/famciclovir, foscarnet, respectively. incidence 4.9%, 2.9%, 2.8% 0.8%, respectively, foscarnet. Compared acyclovir/valacyclovir therapy, foscarnet associated 69% reduction (hazard ratio [HR], 0.31; 95% confidence interval [CI], 0.14-0.66), while other nucleoside analogues marginally lower HA-AKI, HR (95% CI) 0.62 (0.36-1.09) penciclovir/famciclovir 0.67 (0.41-1.11) ganciclovir. When (HR, 2.72; CI, 1.28-5.75) showed higher HA-AKI. associations consistent across various subgroups sensitivity analysis. Conclusion therapies zoster, highest appears be dependent. Clinicians should exercise rational drug renal toxicity particular drug.