新型冠状病毒肺炎合并急性肾损伤潜在治疗药物的肾毒性

Nephrotoxicity of Potential Therapeutic Agents for COVID-19 Infection with Acute Kidney Injury

自新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)爆发以来,国家卫健委、军队前方专家组等制订了多版疾病诊疗方案,其中的药物治疗方案成为了学者们研究和讨论的热点。同时,部分临床医师在重症新冠肺炎患者中发现,急性肾损伤(acute kidney injury,AKI)是患者死亡的一个重要危险因素。COVID-19患者发生AKI的机制尚未明确,可能与病毒感染或药物毒性相关,药物相关AKI直接影响着临床治疗方案的选择和患者的远期预后。笔者针对目前推荐用于治疗COVID-19的磷酸氯喹、洛匹那韦/利托那韦、干扰素-α、利巴韦林、阿比多尔和托珠单抗,讨论药物相关肾损伤,特别是AKI的发生风险、临床病例特点和肾毒性机制,为临床诊疗提供参考。

Since the outbreak of coronavirus disease 2019(COVID-19),the National Health Commission and the expert group of the army have formulated multiple versions of diagnosis and treatment scheme,and drug therapy regimens have become a research hotspot for scholars.Meanwhile,some clinicians found that acute kidney injury(AKI)was an important risk factor in the death of patients with severe COVID 19.The mechanism of AKI in COVID-19 patients is still unclear and the causes may be related to virus infection or drug toxicity.Drug-related AKI directly affects the clinical treatment options and the patient′s long-term prognosis.This article targets interferon-α,lopinavir/ritonavir,ribavirin,chloroquine phosphate,abidol and tocilizumab.This article reviewed potential novel coronavirus pneumonia treatment-related AKI,characteristics of the clinical cases,and mechanisms of renal toxicity,to provide a reference for clinical treatment.