Vol.72 No.5 September 2024
A study on the safety of remdesivir in COVID-19 patients with renal dysfunction
1)Department of Pharmacy, Saiseikai Noe Hospital, 1-3-25 Furuichi, Joto-ku, Osaka, Osaka, Japan
2)Kyoto Pharmaceutical University Certificate Programme
3)Department of Pharmacy, Kobe University Hospital
4)Laboratory of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University
Abstract
In patients with renal dysfunction, remdesivir (RDV) is only considered when the therapeutic benefit is expected to outweigh the risks. In this study, we investigated the safety of RDV in patients with renal dysfunction by classifying patients treated with RDV according to the estimated creatinine clearance (Ccr) using the Cockcroft-Gault (CG) formula.
Patients who received RDV between October 2020 and December 2021 (n=84) were divided into three groups according to the Ccr levels measured prior to the RDV administration, and the incidences of acute kidney injury (AKI), liver dysfunction, and leukopenia were compared among the three groups. The backgrounds of the patients with Ccr <30 mL/min (n=10) who developed AKI were compared.
A relatively high percentage of patients in the Ccr <30 mL/min group developed AKI, although no significant differences among the three groups were observed in the incidence of liver dysfunction or leukopenia. All the patients in the Ccr <30 mL/min group who developed AKI had underlying diabetes mellitus, suggesting that diabetes mellitus may be a risk factor for the development of AKI in patients with poor kidney function receiving RDV.
Our findings suggest that particular caution needs to be exercised against the risk of AKI in patients with underlying diabetes mellitus with Ccr <30 mL/min who are scheduled to receive RDV.
Key word
remdesivir, COVID-19, renal dysfunction, creatinine clearance
Received
January 29, 2024
Accepted
July 3, 2024
Jpn. J. Chemother. 72 (5): 381-385, 2024
