Safety profile of COVID-19 Medication in Chronic Kidney disease patients: renal and hepatic dysfunction associated with anti-viral and Tocilizumab use. Single Centre experience
Main Article Content
Abstract
Introduction: It is challenging to choose appropriate therapy for COVID-19 patients with impaired renal functions due to insufficient & contradictory data about their safety in CKD patients.
Methods: Study aimed to report renal and hepatic dysfunction associated with medications, also to compare drug adverse events between CKD and Non-CKD patients & to identify safety profile of these medications in CKD patients.
Results: Favipiravir, lopinavir-ritonavir, remdesivir & Tocilizumab were used in 75.15%, 15.29% and 13.19% & 25.89% patients respectively. Incidence of renal function deterioration was 18.24%, while an increase in ALT and AST was noted in 34.24% and 23.78%. Patients with GFR <60 ml/min were 15.57% and 74-patients were on hemodialysis. In CKD population, 86.93%, 28.37%, 8.10% and 22.07% were treated with Favipiravir, lopinavir-ritonavir, remdesivir, and Tocilizumab respectively. 37.83%of patients had acute on CKD, while 35.13% and 31.98% had increase in ALT and AST. Incidence of acute renal function deterioration and increase in AST were significantly higher in CKD population. Favipiravir treated CKD patients has significant deterioration of renal functions (p=<0.05), while an elevation in ALT and AST was not significant in the two groups, where as renal & liver injury associated with other medications were not significant between two groups.
Conclusion: We observed significantly higher incidence of kidney injury and elevation in AST in CKD patients. Nevertheless, these abnormal lab parameters must be considered with other risk factors, associated with severe covid-19-infection, thus COVID medicine should not be denied to CKD patients.
Keywords:
Covid-19, CKD, chronic kidney disease, Liver injury, Favipiravir, Lopinavir-Ritonavir, Remdesivir, Tocilizumab
Article Details
How to Cite
GULZAR, Kashif et al.
Safety profile of COVID-19 Medication in Chronic Kidney disease patients: renal and hepatic dysfunction associated with anti-viral and Tocilizumab use. Single Centre experience.
Medical Research Archives, [S.l.], v. 13, n. 8, aug. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6832>. Date accessed: 05 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i8.6832.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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23. Parohan M, Yaghoubi S, Seraji A. Liver injury is associated with severe coronavirus disease 2019 (COVID‐19) infection: a systematic review and meta‐analysis of retrospective studies. Hepatology Research. 2020 Aug;50(8):924-35.
24. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical features of COVID-19-related liver functional abnormality. Clinical Gastroenterology and Hepatology. 2020 Jun 1;18(7):1561-66.
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27. Kumar P, Kulkarni A, Sharma M, Rao PN, Reddy DN. Favipiravir-induced liver injury in patients with coronavirus disease 2019. Journal of clinical and translational hepatology. 2021 Apr 4;9(2):276.
28. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-20.
29. Pilkington V, Pepperrell T, Hill A. A review of the safety of favipiravir–a potential treatment in the COVID-19 pandemic? Journal of virus eradication. 2020 Apr 1;6(2):45-51.
30. Shrestha DB, Budhathoki P, Khadka S, Shah PB, Pokharel N, Rashmi P. Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis. Virology journal. 2020 Sep 24;17(1):141.
31. Batool S, Vuthaluru K, Hassan A, Bseiso O, Tehseen Z, Pizzorno G, Rodriguez Reyes Y, Saleem F. Efficacy and Safety of Favipiravir in Treating COVID-19 Patients: A Meta-Analysis of Randomized Control Trials. Cureus. 2023 Jan 12;15(1):e33676.
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34. Jose S, Nelson M, Phillips A, Chadwick D, Trevelion R, Jones R, Williams DI, Hamzah L, Sabin CA, Post FA. Improved kidney function in patients who switch their protease inhibitor from atazanavir or lopinavir to darunavir. Aids. 2017 Feb 20;31(4):485-92.
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