{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:36:40Z","timestamp":1787312200893,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,20]],"date-time":"2024-10-20T00:00:00Z","timestamp":1729382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bpspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacology Res &amp; Perspec"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Antiviral use has been linked to encephalopathy and elevated serum creatinine concentrations in individuals with chronic kidney disease (CKD) in case reports. Using linked healthcare data in Ontario, we conducted a population\u2010based cohort study on adults aged \u226566\u2009years not receiving dialysis and newly prescribed oral acyclovir, valacyclovir, or famciclovir in the outpatient setting (2008\u20132022) at higher versus lower doses. The primary composite outcome, a hospital visit with encephalopathy or acute kidney injury (AKI) within 14\u2009days of initiating antiviral treatment, was examined in a primary cohort. AKI was assessed in a secondary cohort of older adults with CKD with available linked hospital\u2010based laboratory (lab) data. We used inverse probability of treatment weighting on the propensity score to balance comparison groups on baseline health. Weighted risk ratios (RR) and risk differences (RD) were obtained using modified Poisson and binomial regression. In the primary cohort, higher\u2010 versus lower\u2010dose antiviral was not associated with an increased 14\u2010day risk of hospital visit with encephalopathy or AKI. However, Higher\u2010 versus lower\u2010dose antiviral was associated with a higher risk of a hospital visit with AKI when assessed using lab values (weighted number of events, 70 of 8407 [0.83%] versus 18 of 8230 [0.22%], respectively; weighted RR, 3.83 [95% CI, 1.87\u20137.87]; weighted RD, 0.62% [95% CI, 0.37%\u20130.86%]). In older adults with CKD, starting an antiviral at a higher versus lower dose was associated with a higher risk of AKI, although the absolute risk of this event was &lt;1%.<\/jats:p>","DOI":"10.1002\/prp2.70028","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T02:29:37Z","timestamp":1729477777000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Higher dose antiviral therapy for herpes infections is associated with a risk of serious adverse events in older adults with chronic kidney disease"],"prefix":"10.1002","volume":"12","author":[{"given":"Patricia","family":"Olar","sequence":"first","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Department of Biochemistry Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit X.","family":"Garg","sequence":"additional","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"},{"name":"Division of Nephrology, Department of Medicine Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Weir","sequence":"additional","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"},{"name":"Division of Nephrology, Department of Medicine Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"McArthur","sequence":"additional","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Lawson Health Research Institute London Health Sciences Centre  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngan N.","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Sontrop","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"},{"name":"Division of Nephrology, Department of Medicine Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-6564","authenticated-orcid":false,"given":"Flory T.","family":"Muanda","sequence":"additional","affiliation":[{"name":"ICES Western  London Ontario Canada"},{"name":"Department of Epidemiology and Biostatistics Western University  London Ontario Canada"},{"name":"Department of Physiology and Pharmacology Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,20]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Acyclovir (product monograph). 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