Acute Kidney Injury Incidence in COVID-19 Patients Receiving Remdesivir Therapy at Awal Bros Panam Hospital
Abstract
Background: Remdesivir is one of the pharmacological therapies for moderate COVID-19 patients. Remdesivir is an antiviral that can increase the risk of nephrotoxicity.
Objective: The study aims to evaluate the incidence of acute kidney injury (AKI) in COVID-19 patients receiving remdesivir.
Methods: This is a cross-sectional analytic study of 238 COVID-19 patients receiving remdesivir therapy at Awal Bros Panam Hospital for the period 2020–2022. AKI was diagnosed using the KDIGO criteria. The chi-square test was used to determine the correlation of AKI incidence with age, gender, and comorbidities, with a significance level of p < 0.05.
Results: AKI was found in 32 patients (13.4%). The majority of AKI patients (75%) were aged 60 years or older, with 65.6% being male. Additionally, 84.4% of these patients had comorbidities, and 53.1% of them died. Around half of the patients were diagnosed with stage 1 AKI, and the majority, specifically 84.4%, did not undergo renal replacement therapy (RRT). The association between the incidence of AKI and age and comorbidities was shown to be statistically significant (p=0.000; RR 5.11; 95% CI 2.44-10.8 and p=0.009; RR 3.05; 95% CI 1.22-7.64, respectively).
Conclusion: The main risk factors for AKI are primarily observed in the older population and individuals with several medical conditions. Greater emphasis should be placed on administering remdesivir to COVID-19 patients who are elderly and have comorbidities, as they are at a higher risk of developing AKI.
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References
Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia. Panduan praktik klinis penatalaksanaan di bidang ilmu penyakit dalam. Alwi I SS, Hidayat R, Kurniawan J, Tahapary DL, editor. Jakarta: Interna Publishing. 2019.
Perhimpunan Nefrologi Indonesia (PERNEFRI). Konsensus dialisis. Jakarta: PERNEFRI. 2003.
Fatoni AZ, Kestriani ND. Acute kidney injury (AKI) pada pasien kritis. Anesthesia Critical Care [Internet]. 2018; 36(2):[64-76 pp.]. Available from: https://macc.perdatin.org/index.php/my-journal/article/view/115/118.
World Health Organization. Weekly epidemiological update on covid-19 2023 [cited 2023 July 13]. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---13-july-2023.
Saleha S, Sumiwi SA, Sanggelorang J, Leniawati I. Review: Efek samping dan manajemen obat covid-19 pada gangguan fungsi ginjal dan hati. Farmaka. 2021;19(4):33-45. doi: 10.24198/farmaka.v19i4.34645.g16839
Kementerian Kesehatan Republik Indonesia. Perkembangan situasi penyakit infeksi emerging minggu epidemiologi ke-27 tahun 2023 2023 [cited 2023 July 13]. Available from: https://infeksiemerging.kemkes.go.id/weekly-update/perkembangan-situasi-penyakit-infeksi-emerging-minggu-epidemiologi-ke-27-tahun-2023.
Dinas Kesehatan Provinsi Riau. Update covid-19 Provinsi Riau [cited 2023 July 13]. Available from: https://corona.riau.go.id/
Data Rekam Medik RS Awal Bros Panam 2023. 2023.
PDPI, PERKI, PAPDI, PERDATIN, IDAI. Protokol tatalaksana COVID-19. Jakarta: Kementerian Kesehatan RI. 2021.
Kale A, Shelke V, Dagar N, Anders H-J, Gaikwad AB. How to use COVID-19 antiviral drugs in patients with chronic kidney disease. Front Pharmacol. 2023;14:1053814. doi: 10.3389/fphar.2023.1053814
Aleem A, Kothadia JP. Remdesivir: StatPearls Publishing, Treasure Island (FL). 2023.
Thakare S, Gandhi C, Modi T, Bose S, Deb S, Saxena N, et al. Safety of Remdesivir in Patients With Acute Kidney Injury or CKD. Kidney Int Rep. 2021;6(1):206-10. doi: 10.1016/j.ekir.2020.10.005
Ren Z, Luo H, Yu Z, Song J, Liang L, Wang L, et al. A Randomized, Open‐Label, Controlled Clinical Trial of Azvudine Tablets in the Treatment of Mild and Common COVID‐19, a Pilot Study. Adv Sci (Weinh). 2020;7(19):e2001435. doi: 10.1002/advs.202001435
Zhang J-L, Li Y-H, Wang L-L, Liu H-Q, Lu S-Y, Liu Y, et al. Azvudine is a thymus-homing anti-SARS-CoV-2 drug effective in treating COVID-19 patients. Signal Transduct Target Ther. 2021;6. doi: 10.1038/s41392-021-00835-6
Wong CKH, Au ICH, Cheng WY, Man KKC, Lau KTK, Mak LY, et al. Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study. Aliment Pharmacol Ther. 2022;56(1):121-30. doi: 10.1111/apt.16894
Silva NAdO, Zara ALdSA, Figueras A, Melo DOd. Potential kidney damage associated with the use of remdesivir for COVID-19: analysis of a pharmacovigilance database. Cad Saude Publica. 2021;37(10):e00077721. doi: 10.1590/0102-311X00077721
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Clinical practice guideline for acute kidney injury. KDIGO. 2012;2(1):1-141. doi: 10.1038/kisup.2012.1
Siada NB, Juanita RA, Sanjaya DA, Meriyani H, Rahayu TA. Penggunaan Antivirus Remdesivir untuk Pasien COVID-19 dengan Kehamilan: Studi Literatur. J Pharm Sci Clin Res. 2022;7(2):179-88. doi: 10.20961/jpscr.v7i2.56753
Rahimi MM, Jahantabi E, Lotfi B, Forouzesh M, Valizadeh R, Farshid S. Renal and liver injury following the treatment of COVID-19 by remdesivir. J Nephropathol. 2021;10(2):e10. doi: 10.34172/jnp.2021.10
Wu B, Luo M, Wu F, He Z, Li Y, Xu T. Acute Kidney Injury Associated With Remdesivir: A Comprehensive Pharmacovigilance Analysis of COVID-19 Reports in FAERS. Front Pharmacol. 2022;13:692828. doi: 10.3389/fphar.2022.692828
Shams G, Kazemi A, Jafaryan K, Morowvat MH, Peymani P, Karimzadeh I. Acute kidney injury in COVID-19 patients receiving remdesivir: A systematic review and meta-analysis of randomized clinical trials. Clinics. 2023;78:100200. doi: 10.1016/j.clinsp.2023.100200
Legrand M, Bell S, Forni L, Joannidis M, Koyner JL, Liu K, et al. Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol. 2021;17(11):751-64. doi: 10.1038/s41581-021-00452-0
Schaubroeck H, Vandenberghe W, Boer W, Boonen E, Dewulf B, Bourgeois C, et al. Acute kidney injury in critical COVID-19: a multicenter cohort analysis in seven large hospitals in Belgium. Crit Care. 2022;26(1):225. doi: 10.1186/s13054-022-04086-x
Chao C-T, Tsai H-B, Lin Y-F, Ko W-J. Acute kidney injury in the elderly: Only the tip of the iceberg. J Clin Gerontol Geriatr. 2014;5:7-12. doi: 10.1016/j.jcgg.2013.04.002
Hidayat, Kestriani ND, Pradian E. Angka kejadian, lama rawat jalan, dan mortalitas pasien acute kidney injury di ICU RSUP Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif. 2020;8(2):108-18. doi: 10.15851/jap.v8n2.2054
Silver SA, Beaubien-Souligny W, Shah PS, Harel S, Blum D, Kishibe T, et al. The Prevalence of Acute Kidney Injury in Patients Hospitalized With COVID-19 Infection: A Systematic Review and Meta-analysis. Kidney Med. 2021;3(1):83-98.e1. doi: 10.1016/j.xkme.2020.11.008
Hirsch JS, Ng JH, Ross DW, Sharma P, Shah HH, Barnett RL, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98(1):209-18. doi: 10.1016/j.kint.2020.05.006
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