ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0153

Comparison of Safety and Outcomes Related to Remdesivir Use Among Dialysis Patients Hospitalized with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Zaki, Kirollos Emad, Kaiser Permanente Southern California, Los Angeles, California, United States
  • Huang, Cheng-Wei, Kaiser Permanente Southern California, Los Angeles, California, United States
  • Zhou, Hui, Kaiser Permanente Southern California, Los Angeles, California, United States
  • Chung, Joanie, Kaiser Permanente Southern California, Los Angeles, California, United States
  • Selevan, David C., Kaiser Permanente Southern California, Los Angeles, California, United States
  • Rutkowski, Mark P., Kaiser Permanente Southern California, Los Angeles, California, United States
  • Sim, John J., Kaiser Permanente Southern California, Los Angeles, California, United States
Background

Use of remdesivir in the treatment of dialysis patients with Coronavirus Disease 2019 (COVID-19) has been limited due to inconclusive data regarding safety outcomes among patients with severe renal impairment. For this reason, the FDA has not recommended remdesivir use in patients with eGFR < 30 ml/min per 1.73 m2. We sought to evaluate outcomes among dialysis patients with COVID-19 who received remdesivir in a real-world setting.

Methods

We conducted a retrospective study of patients on hemodialysis or peritoneal dialysis hospitalized with COVID-19 between 5/1/2020 - 1/31/2021 within the integrated health system of Kaiser Permanente Southern California. Patients with a COVID-19 International Classification of Diseases (ICD)-10 code: U07.1 and laboratory confirmed SARS-CoV-2 infection within 14 days prior to admission date to two days after admission date were included. The primary endpoint was 30-day all-cause mortality. Secondary endpoints were intensive care unit (ICU) stay, and evidence of acute liver injury defined as AST and/or ALT values >5x upper limit of normal.

Results

A total of 486 patients (407 hemodialysis and 79 peritoneal dialysis) met inclusion criteria. Among those, 112 patients (23%) were treated with remdesivir, with median treatment time of 4 days (IQR: 2-5). Mean age was 63.8 years with 63.8% male and 63.0% Hispanic patients. There were 80.2% of patients who received treatment with steroids during hospitalization. Relative risk (RR) for all-cause 30-day mortality was 0.74 (95% CI: 0.52-1.05) in remdesivir treated patients compared to untreated patients. Acute liver injury occurred in 1.8% and 2.4% of remdesivir treated and untreated patients, respectively. ICU admissions occurred in 14.3% of remdesivir treated and 16% of untreated patients.

Conclusion

Among dialysis patients hospitalized with COVID-19, treatment with remdesivir was not associated with worse outcomes in terms of liver injury or ICU admission, and demonstrated a trend (26% lower risk) toward decrease in 30-day mortality, though no statistical significance was found due to insufficient power.