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新型冠状病毒病 2019 患者肾功能降低或丧失的治疗选择。

Treatment Options for Coronavirus Disease 2019 in Patients With Reduced or Absent Kidney Function.

机构信息

Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.

Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.

出版信息

Adv Chronic Kidney Dis. 2020 Sep;27(5):434-441. doi: 10.1053/j.ackd.2020.09.001. Epub 2020 Sep 17.

Abstract

Coronavirus disease 2019, the disease caused by the severe acute respiratory syndrome coronavirus 2 virus, was first identified in the Hubei Province of China in late 2019. Currently, the only role for therapy is treatment of the disease, as opposed to postexposure prophylaxis, however multiple clinical trials are currently ongoing for both treatment and prophylaxis. Treating coronavirus disease 2019 relies on two components; the first is inhibition of the viral entrance and replication within the body and the second is inhibition of an exacerbated immune response which can be seen in patients with severe disease. Many drugs have shown in vitro antiviral activity; however, clinical trials have not been as promising. This review summarizes the current data for the most commonly used drugs for coronavirus disease 2019 and will cover the unique factors that may affect the dosing of these medications in patients with CKD. While clinical trials are ongoing, most are in patients with normal kidney function. During a pandemic, when patients with CKD are at higher risk of both infection and death, it is imperative to include patients these patients in the clinical trials.

摘要

2019 年冠状病毒病,由严重急性呼吸系统综合征冠状病毒 2 型病毒引起,于 2019 年底在中国湖北省首次被发现。目前,治疗的唯一作用是治疗疾病,而不是暴露后预防,然而,目前正在进行多项针对治疗和预防的临床试验。治疗 2019 年冠状病毒病依赖于两个组成部分;第一是抑制病毒在体内的进入和复制,第二是抑制在重症患者中可见的过度免疫反应。许多药物已显示出体外抗病毒活性;然而,临床试验并不那么有希望。这篇综述总结了目前最常用于治疗 2019 年冠状病毒病的药物的最新数据,并将涵盖可能影响这些药物在 CKD 患者中剂量的独特因素。虽然临床试验正在进行中,但大多数是在肾功能正常的患者中进行的。在大流行期间,CKD 患者感染和死亡的风险更高,因此必须将这些患者纳入临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a9/7498223/6b6b866b8a1d/gr1_lrg.jpg

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