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肾疾病患者中新型冠状病毒肺炎的药物治疗选择

Pharmacological Treatment Options for Coronavirus Disease-19 in Renal Patients.

作者信息

Violetta Laurencia, Kartasasmita Arief Sjamsulaksan, Amirullah Roesli Rully Marsis, Rita Coriejati

机构信息

Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia.

Faculty of Medicine, Universitas Padjajaran, Bandung, West Java, Indonesia.

出版信息

Int J Nephrol. 2021 Nov 30;2021:4078713. doi: 10.1155/2021/4078713. eCollection 2021.

Abstract

Patients with chronic kidney disease (CKD), including dialysis and transplant patients, are at greater risk of contracting SARS-CoV-2 due to kidney dysfunction and preexisting comorbidities. To date, a specific guideline on managing these high-risk patients infected with COVID-19 has not been established. As the current management of COVID-19 comprises mainly experimental drugs, the authors aim to provide information on dosing adjustments at different stages of kidney dysfunction and notable renal side effects. We performed a nonsystematical review of currently available COVID-19 drugs exploring several different clinical trial databases and search browsers. Several antivirals and monoclonal antibodies used in COVID-19 treatment require dosage adjustments in kidney dysfunction. In a global pandemic setting, nephrologists need to consider the appropriate dosage according to the renal function and closely monitor the side effects of different drug combinations to obtain the optimum therapeutic effect while avoiding further renal damage. Further studies are required to determine the safety and efficacy of these drugs in renal patients.

摘要

慢性肾脏病(CKD)患者,包括透析患者和移植患者,由于肾功能不全和已有的合并症,感染新型冠状病毒2(SARS-CoV-2)的风险更高。迄今为止,尚未制定针对这些感染新冠病毒疾病(COVID-19)的高危患者的具体管理指南。由于目前对COVID-19的治疗主要包括实验性药物,作者旨在提供关于肾功能不全不同阶段的剂量调整以及显著的肾脏副作用的信息。我们对现有的COVID-19药物进行了非系统性综述,检索了几个不同的临床试验数据库和搜索浏览器。COVID-19治疗中使用的几种抗病毒药物和单克隆抗体在肾功能不全时需要调整剂量。在全球大流行的背景下,肾病学家需要根据肾功能考虑合适的剂量,并密切监测不同药物组合的副作用,以获得最佳治疗效果,同时避免进一步的肾脏损害。需要进一步研究来确定这些药物在肾病患者中的安全性和有效性。

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本文引用的文献

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Effect of COVID-19 on Kidney Disease Incidence and Management.COVID-19 对肾脏病发病和治疗的影响。
Kidney360. 2020 Nov 24;2(1):141-153. doi: 10.34067/KID.0006362020. eCollection 2021 Jan 28.
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Cureus. 2021 Jun 28;13(6):e15986. doi: 10.7759/cureus.15986. eCollection 2021 Jun.
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Initial Effects of COVID-19 on Patients with ESKD.COVID-19 对 ESKD 患者的初始影响。
J Am Soc Nephrol. 2021 Jun 1;32(6):1444-1453. doi: 10.1681/ASN.2021010009. Epub 2021 Apr 8.
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Renal Involvement in COVID-19: A Review of the Literature.新型冠状病毒肺炎的肾脏受累:文献综述
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Tocilizumab in Hospitalized Patients with Severe Covid-19 Pneumonia.托珠单抗治疗重症 COVID-19 肺炎住院患者。
N Engl J Med. 2021 Apr 22;384(16):1503-1516. doi: 10.1056/NEJMoa2028700. Epub 2021 Feb 25.
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COVID-19 vaccines and kidney disease.COVID-19 疫苗与肾脏疾病。
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