Safety of Remdesivir in Patients With Acute Kidney Injury or CKD.
Safety of Remdesivir in Patients With Acute Kidney Injury or CKD.
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DOI：
10.1016/j.ekir.2020.10.005
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发表时间：
2021-01
影响因子：
6
通讯作者：
Jamale T
中科院分区：
文献类型：
--
作者：
Thakare S;Gandhi C;Modi T;Bose S;Deb S;Saxena N;Katyal A;Patil A;Patil S;Pajai A;Bajpai D;Jamale T
结果2020年7月7日至9月22日在我科重症监护室或肾脏病高度依赖病房收治的157例新冠肺炎患者中，有急性肾功能衰竭或慢性肾脏病。157例患者中有46例(29.3%)接受了瑞希韦治疗。这些患者的中位年龄为53.1岁(范围15-84岁)，其中30人(65.2%)为男性。肾脏诊断为终末期肾病16例(34.7%)，急性肾损伤30例(65.2%)。46例患者中有8例(17.4%)接受活体供肾移植。在30名AKI患者中，有3名(6.5%)、2名(4.3%)和25名(83.3%)患者的肾脏疾病：改善全球预后AKI分期分别为1、2和3。值得注意的是，所有1期和2期AKI患者都是肾移植接受者。表1显示了这些案例的基线特征。合并高血压35例(76%)，糖尿病26例(56.5%)，冠心病4例(8.7%)，肾结石3例(6.5%)，HIV感染1例(2.2%)。12名患者(26%)在重症监护病房接受治疗。术中需氧量：无创呼吸机(n=7)、高流量鼻导管(n=1)、无重复呼吸面罩(n=11)、面罩(n=15)、鼻叉(n=12)。此外，在病程中，9例(19.5%)患者需要有创机械通气。
ResultsOne hundred fifty-seven patients with COVID-19 who were admitted to the intensive care unit or our nephrology high dependency unit between July 7 and September 22, 2020 had either AKI or CKD. Forty-six of 157 (29.3%) cases were treated with remdesivir. The median age of these patients was 53.1 years (range 15–84 years) and 30 (65.2%) were male. Renal diagnoses were ESRD in 16 (34.7%) and AKI in 30 (65.2%%) patients. Eight (17.4%) of 46 patients were recipients of live donor kidney transplants. Of 30 patients with AKI, 3 (6.5%), 2 (4.3%), and 25 (83.3%) patients had Kidney Disease: Improving Global Outcomes AKI stages 1, 2, and 3, respectively. Notably, all patients with stage 1 and 2 AKI were kidney transplant recipients. Table 1 shows the baseline characteristics of these cases. Comorbidities included hypertension in 35 (76%) patients, diabetes in 26 (56.5%) patients, coronary artery disease in 4 (8.7%) patients, nephrolithiasis in 3 (6.5%) patients, and HIV in 1 (2.2%) patient. Twelve (26%) patients were treated in the intensive care unit. At the time of initiation of remdesivir, oxygen requirements were as follows: noninvasive ventilation (n= 7), high flow nasal canula (n= 1), nonrebreathing mask (n= 11), face mask (n= 15), and nasal prongs (n= 12). Further in the course of illness, 9 (19.5%) patients required invasive mechanical ventilation.
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