Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Clinics (Sao Paulo). 2023 Apr 13;78:100200. doi: 10.1016/j.clinsp.2023.100200. eCollection 2023.
Remdesivir is an antiviral agent with positive effects on the prognosis of Coronavirus Disease (COVID-19). However, there are concerns about the detrimental effects of remdesivir on kidney function which might consequently lead to Acute Kidney Injury (AKI). In this study, we aim to determine whether remdesivir use in COVID-19 patients increases the risk of AKI.
PubMed, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, medRxiv, and bioRxiv were systematically searched until July 2022, to find Randomized Clinical Trials (RCT) that evaluated remdesivir for its effect on COVID-19 and provided information on AKI events. A random-effects model meta-analysis was conducted and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. The primary outcomes were AKI as a Serious Adverse Event (SAE) and combined serious and non-serious Adverse Events (AE) due to AKI.
This study included 5 RCTs involving 3095 patients. Remdesivir treatment was not associated with a significant change in the risk of AKI classified as SAE (Risk Ratio [RR]: 0.71, 95% Confidence Interval [95% CI] 0.43‒1.18, p = 0.19, low-certainty evidence) and AKI classified as any grade AEs (RR = 0.83, 95% CI 0.52‒1.33, p = 0.44, low-certainty evidence), compared to the control group.
Our study suggested that remdesivir treatment probably has little or no effect on the risk of AKI in COVID-19 patients.
瑞德西韦是一种具有冠状病毒病（COVID-19）预后改善作用的抗病毒药物。然而，人们担心瑞德西韦会对肾功能造成损害，进而导致急性肾损伤（AKI）。本研究旨在确定 COVID-19 患者使用瑞德西韦是否会增加 AKI 的风险。
系统检索了 PubMed、Scopus、Web of Science、Cochrane 中央对照试验注册库、medRxiv 和 bioRxiv，截至 2022 年 7 月，以查找评估瑞德西韦对 COVID-19 影响并提供 AKI 事件信息的随机临床试验（RCT）。采用随机效应模型进行荟萃分析，并使用推荐评估、制定与评估分级（Grading of Recommendations Assessment, Development, and Evaluation，GRADE）评估证据确定性。主要结局是 AKI 作为严重不良事件（SAE）和因 AKI 导致的严重和非严重不良事件（AE）的组合。
本研究纳入了 5 项 RCT，共涉及 3095 例患者。与对照组相比，瑞德西韦治疗并未显著增加 AKI 被分类为 SAE（风险比 [RR]：0.71，95%置信区间 [95%CI] 0.43‒1.18，p=0.19，低确定性证据）和 AKI 被分类为任何等级 AE（RR：0.83，95%CI 0.52‒1.33，p=0.44，低确定性证据）的风险。
本研究表明，瑞德西韦治疗可能对 COVID-19 患者的 AKI 风险几乎没有或没有影响。
