{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:36:58Z","timestamp":1773437818478,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Charlie Lee Charitable Foundation"},{"name":"Baxter Healthcare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Nirmatrelvir-ritonavir is currently not recommended in patients with an estimated glomerular filtration rate (eGFR) &amp;lt;30 mL\/minute\/1.73 m2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>To determine the safety profile and clinical and virological outcomes of nirmatrelvir-ritonavir use at a modified dosage in adults with chronic kidney disease (CKD), a prospective, single-arm, interventional trial recruited patients with eGFR &amp;lt;30 mL\/minute\/1.73 m2 and on dialysis. Primary outcomes included safety profile, adverse\/serious adverse events, and events leading to drug discontinuation. Disease symptoms, virological outcomes by serial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral polymerase chain reaction (PCR) tests, rapid antigen tests, and virological and symptomatic rebound were also recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-nine (69.4%) of the 85 participants had stage 5 CKD and were on dialysis. Eighty (94.1%) completed the full treatment course; 9.4% and 5.9% had adverse and serious adverse events, and these were comparable between those with eGFR &amp;lt; or &amp;gt;30 mL\/minute\/1.73 m2. The viral load significantly decreased on days 5, 15, and 30 (P &amp;lt; .001 for all), and the reduction was consistent in the subgroup with eGFR &amp;lt;30 mL\/minute\/1.73 m2. Ten patients had virological rebound, which was transient and asymptomatic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among patients with CKD, a modified dose of nirmatrelvir-ritonavir is a well-tolerated therapy in mild COVID-19 as it can effectively suppress the SARS-CoV-2 viral load with a favorable safety profile. Virological and symptomatic rebound, although transient with low infectivity, may occur after treatment. Nirmatrelvir-ritonavir should be considered for use in patients with CKD, including stage 5 CKD on dialysis.<\/jats:p>\n                  <jats:p>Clinical Trials Registration.\u2003Clinical Trials.gov; identifier: NCT05624840.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad371","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T15:13:19Z","timestamp":1690989199000},"page":"1406-1412","source":"Crossref","is-referenced-by-count":14,"title":["Safety Profile and Clinical and Virological Outcomes of Nirmatrelvir-Ritonavir Treatment in Patients With Advanced Chronic Kidney Disease and Coronavirus Disease 2019"],"prefix":"10.1093","volume":"77","author":[{"given":"Gordon Chun Kau","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace Chung Yan","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"},{"name":"The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candy Ngai Sze","family":"Wong","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong , Hong Kong SAR , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindy Sin Ting","family":"Yip","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy Chun Man","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine Siu King","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan Kin Ho","family":"Sze","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong SAR , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheuk Chun","family":"Szeto","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5310-5197","authenticated-orcid":false,"given":"Kai Ming","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong , Hong Kong Special Administrative Region (SAR) , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"2024021012510686600_ciad371-B1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/MCP.0000000000000875","article-title":"Advances in the epidemiology, clinical features, diagnosis, clinical management and prevention of coronavirus disease 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