Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
189 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction

Should My Dad With COVID, Reducing Baseline GFR After Starting Remdesivir, Stop The Medication?

Hi my dad is in the hospital with Covid. They thought it was a heart problem but trops, stress test and echo were normal. Then he tested positive. He has a baseline gfr of 38. They started remdesivir iv on Tuesday and today gfr is 26. He is not on O2 and his symptoms are fatigue and a cough. Should he stop the medication?
posted on Fri, 1 Dec 2023
Twitter Tue, 21 Oct 2025 Answered on
Twitter Fri, 31 Oct 2025 Last reviewed on
Report Abuse
General & Family Physician,  's  Response
Hi,

That drop in GFR is definitely concerning, and you’re absolutely right to question whether Remdesivir should be continued. Here’s the thing — Remdesivir can sometimes cause kidney stress, particularly in people with pre-existing renal impairment like your dad (baseline GFR 38). A fall to 26 after just a few doses is a clear signal to reassess.

In most hospital protocols, Remdesivir is not recommended if GFR is below 30 ml/min, mainly because the drug (and its carrier compound, SBECD) can accumulate and worsen kidney function. Since your dad’s new GFR is already near that cutoff, his treating team should definitely pause or stop it and review other causes of the kidney decline (like dehydration, sepsis, or contrast exposure if he had any recent imaging).

Given he’s not hypoxic and only has mild symptoms, the benefit of Remdesivir in his case is limited — it’s most useful for patients needing oxygen but not yet on ventilators.

So yes, it’s reasonable to stop or at least hold the Remdesivir while they monitor kidney function closely and manage hydration. Most nephrology or ID teams would support that.

Make sure they repeat renal function daily, keep him well-hydrated (but not overloaded), and watch urine output. If GFR improves after holding the drug, it pretty much confirms the link. He’s in the safer zone symptom-wise, so the focus now should be supportive care and kidney protection rather than pushing antivirals.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Usaid Yousuf, General & Family Physician
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer. For a more detailed, immediate answer, try our premium service [Sample answer]
Share on
 

Related questions you may be interested in


Loading Online Doctors....
Should My Dad With COVID, Reducing Baseline GFR After Starting Remdesivir, Stop The Medication?

Hi, That drop in GFR is definitely concerning, and you’re absolutely right to question whether Remdesivir should be continued. Here’s the thing — Remdesivir can sometimes cause kidney stress, particularly in people with pre-existing renal impairment like your dad (baseline GFR 38). A fall to 26 after just a few doses is a clear signal to reassess. In most hospital protocols, Remdesivir is not recommended if GFR is below 30 ml/min, mainly because the drug (and its carrier compound, SBECD) can accumulate and worsen kidney function. Since your dad’s new GFR is already near that cutoff, his treating team should definitely pause or stop it and review other causes of the kidney decline (like dehydration, sepsis, or contrast exposure if he had any recent imaging). Given he’s not hypoxic and only has mild symptoms, the benefit of Remdesivir in his case is limited — it’s most useful for patients needing oxygen but not yet on ventilators. So yes, it’s reasonable to stop or at least hold the Remdesivir while they monitor kidney function closely and manage hydration. Most nephrology or ID teams would support that. Make sure they repeat renal function daily, keep him well-hydrated (but not overloaded), and watch urine output. If GFR improves after holding the drug, it pretty much confirms the link. He’s in the safer zone symptom-wise, so the focus now should be supportive care and kidney protection rather than pushing antivirals. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Usaid Yousuf, General & Family Physician