Remdesivir (Veklury) is an antiviral medication that treats several viral infections, including COVID-19. It may affect kidney health.
Some experts believe that remdesivir is generally safe and effective, while others recommend against using it to treat COVID-19 due to the risk of kidney injury.
Other medications may be effective and pose a lower risk of kidney damage.
This article reviews current research into remdesivir and its potential to cause kidney damage.
Remdesivir is an antiviral medication that targets the RNA in viruses to prevent replication. The Food and Drug Administration (FDA) approved the use of intravenous remdesivir to treat people with severe COVID-19. It is suitable for adults and children who are 28 days or older and weigh at least 6.6 pounds, or 3 kilograms.
In the hospital, a person takes remdesivir intravenously through a vein, in a procedure that takes 30–120 minutes. They receive the medication once per day for around 5–10 days.
Remdesivir underwent several studies and showed general effectiveness in treating COVID-19. A 2020 study of over 1,000 people hospitalized with the disease found that it safely and effectively shortened the time to recovery in adults.
Remdesivir may cause kidney failure in people with reduced kidney function. Therefore, health experts recommend testing a person’s kidney function before they start the medication. Doctors do not recommend it for individuals with kidney failure.
This precaution is due in part to how remdesivir works. Both the powdered and liquid versions of the medication contain what health experts consider safe levels of a substance known as sulfobutylether beta-cyclodextrin sodium (SBECD).
Typical kidneys can remove SBECD from the body. However, people with kidney impairment or failure may experience liver or kidney toxicity due to the release of this substance.
Additionally, research suggests a link between remdesivir and kidney failure that may lead to severe lung issues.
In a 2020 study, researchers found that remdesivir had little or no effect on the risk of kidney damage. Other experts added that the powdered form may be safe for people with kidney issues.
However, several other studies point to remdesivir having potentially adverse effects on kidney health.
Researchers in a
A 2022 study noted that acute kidney injury is a potential complication of COVID-19 that could be due to the use of remdesivir. The authors highlighted the significant association between remdesivir and acute kidney injury and urged the need for more studies into its safety.
With so much conflicting research, doctors do not yet know the likelihood that a person taking remdesivir will experience kidney damage.
People with kidney issues should avoid using remdesivir. Though some experts suggest this medication may be safe, several others do not recommend its routine use.
A person with reduced kidney function should discuss this with a doctor. Healthcare professionals can devise a treatment plan that considers the potential for damage to the kidneys.
Other antiviral medications may help treat COVID-19 and be safer for the kidneys. These medications
- tocilizumab (Actemra)
- dexamethasone (DexPax)
- sarilumab (Kevzara)
A person should discuss the potential side effects of any drug with a doctor before taking them.
Remdesivir may cause several side effects. In
- breathing difficulties
- organ dysfunction
- low potassium
- a low red blood cell count
- low albumin, a protein that the liver produces
- a low platelet count
- skin discoloration
A person may also experience pain, bleeding, or bruising at the injection site.
Individuals should speak with a doctor or nurse immediately if they experience the following symptoms during or after their remdesivir infusion:
- shivering or chills
- dizziness upon standing up
- wheezing or difficulty breathing
- unusually fast or slow heartbeat
- swelling of the face, throat, tongue, lips, or eyes
- yellow eyes or skin
- dark urine
- pain or discomfort in the right upper stomach area
- chest pain
Doctors may stop or adjust a person’s treatment if they experience any of these side effects.
Remdesivir received attention in recent years due to its use in treating COVID-19.
Several studies suggested this medication may increase the risk of kidney injury, while a few highlight its overall safety and effectiveness in treating viral infections, including the infection that leads to COVID-19.
People with existing kidney damage should not take remdesivir and should discuss any concerns with a doctor.
Other medications may be effective for treating infections and carry a reduced risk of adverse effects on the kidneys.