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Current treatment of COVID-19 in renal patients: hope or hype?
Palumbo Roberto1, Londrino Francesco1, Cordova Emanuela1
1Nephology and Dialysis Department, Sant'Eugenio Hospital, Rome, Italy.
Abstract:
To date the severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), known as COVID-19, is for clinicians the most difficult global therapeutic problem. In this landscape, the management of patients with chronic kidney disease, acute kidney injury or patients undergoing immunosuppressant therapies for kidney transplant or glomerular diseases, represent a clinical challenge for nephrologists, especially in patients with severe acute lung involvement. Therefore in this setting, due to the lack of anti-COVID treatment schedules, tailored management is mandatory to reduce the side effects, as consequence of impaired renal function and drugs interactions. We report the main treatment actually used against SARS-CoV-2, underlining its possible use in the nephropatic patients and the central role of nephrologists to improve the clinical outcome.
Insights
Managing COVID-19 in kidney patients is challenging due to impaired renal function. Nephrologists play a crucial role in tailoring treatments to minimize side effects and improve outcomes for these vulnerable individuals.
Area of Science:
- Nephrology
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 presents significant therapeutic challenges globally.
- Patients with chronic kidney disease, acute kidney injury, or on immunosuppressants are at high risk.
- Severe lung involvement complicates management in kidney patients.
Purpose of the Study:
- To review current SARS-CoV-2 treatments.
- To assess the applicability of these treatments in nephropathic patients.
- To highlight the essential role of nephrologists in managing COVID-19 in kidney patients.
Main Methods:
- Review of existing SARS-CoV-2 therapeutic strategies.
- Analysis of treatment implications for patients with renal impairment.
- Discussion of drug interactions and side effect mitigation.
Main Results:
- Lack of established COVID-19 treatment protocols necessitates tailored approaches.
- Impaired renal function requires careful drug selection and dosage adjustments.
- Nephrologists are vital in optimizing treatment plans for kidney patients with COVID-19.
Conclusions:
- Individualized management is critical for COVID-19 patients with kidney disease.
- Nephrologists are central to improving clinical outcomes in this population.
- Further research into safe and effective COVID-19 therapies for kidney patients is warranted.
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Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

