Remdesivir Use in the Setting of Severe Renal Impairment: A Theoretical Concern or Real Risk?
| Autor: | Cynthia T Nguyen, Jennifer Pisano, Natasha N Pettit, Alison K Lew, Renslow Sherer, Aniruddha Hazra, Kathleen M. Mullane |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
renal impairment
0301 basic medicine Microbiology (medical) medicine.medical_specialty Coronavirus disease 2019 (COVID-19) 030106 microbiology Renal function remdesivir Antiviral Agents Nephrotoxicity 03 medical and health sciences 0302 clinical medicine Internal medicine Chart review Major Article medicine Humans In patient 030212 general & internal medicine Adverse effect Retrospective Studies Alanine SARS-CoV-2 business.industry Incidence (epidemiology) COVID-19 Adenosine Monophosphate COVID-19 Drug Treatment AcademicSubjects/MED00290 Infectious Diseases Toxicity business |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America Clinical Infectious Diseases |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciaa1851 |
| Popis: | BackgroundRemdesivir (RDV) is US FDA approved for coronavirus disease 2019 (COVID-19) but not recommended in severe renal impairment (SRI, Creatinine clearance MethodsHospitalized patients who received RDV between 1 May 2020 and 31 October 2020 were analyzed in a retrospective chart review. We compared incident adverse events (AEs) in patients with and without SRI, including hepatotoxicity, nephrotoxicity, any reported AE, mortality, and length of stay.ResultsOf a total of 135 patients, 20 had SRI. Patients with SRI were significantly older (70 vs 54 years, P = .0001). The incidence of possible AEs was 30% among those with SRI vs 11% without (P = .06). Liver function test (LFT) elevations occurred in 10% vs 4% (P = .28), and serum creatinine (SCr) elevations in 27% vs 6% (P = .02) of patients with SRI vs without, respectively. LFT and SCr elevations were not attributed to RDV in either group.Mortality and length of stay were consistent with historical controls.ConclusionsRDV AEs occurred infrequently and overall were not significantly different between those with and without SRI. While more of patients with SRI experienced SCr elevations, 3 (75%) patients had acute kidney injury prior to RDV. The use of RDV in this small series of patients with SRI appeared to be relatively safe, and the potential benefit outweighed the theoretical risk of liver or renal toxicity. Additional studies are needed to confirm this finding. |
| Databáze: | OpenAIRE |
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