Abstract
Per prescribing guidance, remdesivir is not recommended for SARS-CoV-2 in patients with renal disease given the absence of safety data in this patient population. This study was a multicenter, retrospective chart review of hospitalized patients with SARS-CoV-2 who received remdesivir. Safety outcomes were compared between patients with an estimated creatinine clearance (eCrCl) of <30 ml/min and an eCrCl of ≥30 ml/min. The primary endpoint was acute kidney injury (AKI) at the end of treatment (EOT). Of 359 patients who received remdesivir, 347 met inclusion criteria. Patients with an eCrCl of <30 ml/min were older {median, 80 years (interquartile range [IQR], 63.8 to 89) versus 62 (IQR, 54 to 74); P < 0.001}, were more likely to be on vasopressors on the day of remdesivir administration (30% versus 12.7%; P = 0.003), and were more likely to be mechanically ventilated during remdesivir therapy (27.5% versus 12.4%; P = 0.01) than those with an eCrCl of ≥30 ml/min. Despite these confounders, there was no significant difference in the frequency of EOT AKI (5% versus 2.3%; P = 0.283) or early discontinuation due to abnormal liver function tests (LFTs) (0% versus 3.9%; P = 0.374). Of the 5% of patients who developed EOT AKI on remdesivir with an eCrCl <30 ml/min, no cases were attributable to remdesivir administration per the treating physician. Comparable safety outcomes were observed when 1:1 nearest neighbor matching was applied to account for baseline confounders. In conclusion, remdesivir administration was not significantly associated with increased EOT AKI in patients with an eCrCl of <30 ml/min compared to patients with an eCrCl of ≥30 ml/min.
Keywords: COVID; SARS-CoV-2; SBECD; chronic kidney disease; remdesivir; renal failure.
【저자키워드】 SARS-CoV-2, Remdesivir, Chronic kidney disease, COVID, renal failure, SBECD, 【초록키워드】 Treatment, therapy, Safety, Remdesivir, Acute kidney injury, Chronic kidney disease, outcome, hospitalized patients, kidney, AKI, Patient, liver function tests, Kidney disease, multicenter, renal disease, disease, Guidance, retrospective, renal failure, administration, creatinine, Frequency, primary endpoint, SBECD, creatinine clearance, Liver function test, interquartile range, Vasopressor, Older, no significant difference, inclusion criteria, confounders, vasopressors, mechanically ventilated, renal, patient population, clearance, CrCl, significantly, applied, absence, hospitalized patient, 1:1, baseline, IQR, 【제목키워드】 Safety, Remdesivir, clinical, function, Impaired, Matched,