Abstract
Oseltamivir is an influenza virus neuraminidase inhibitor that is considered to be effective for treatment or prevention of influenza virus A and B infection. However, there have been few studies about the use of oseltamivir to treat or prevent influenza virus infection in ESRD patients on maintenance dialysis and dosing recommendations are not available for either the treatment or prevention of influenza infection in ESRD patients. We experienced an influenza outbreak at our hemodialysis center during the 2006/2007 season. Patients with ESRD are susceptible to influenza and have an increased risk of complications. Therefore, effective treatment and prevention of influenza virus infection is considered essential. Among 385 hemodialysis patients at our dialysis center, patients who consented were administered an oral dose of oseltamivir (75 mg) one time after a dialysis session. We enrolled 339 hemodialysis patients, but 31 patients did not take the drug. Oseltamivir was given to nine patients for treatment and to 299 patients for prevention. All nine patients treated for influenza improved rapidly and none of them showed deterioration. None of the patient developed influenza after administration for prevention. Among those who did not receive preventive administration, however, two patients were infected by influenza A virus. These two patients improved soon after oseltamivir administration. In this study, the incidence of adverse gastrointestinal events were less frequent than that reported for patients without renal dysfunction in a previous study, but insomnia was more frequent. Laboratory parameters did not show any significant differences between oseltamivir treated patients and untreated patients. Our data suggest that a single oral dose of oseltamivir (75 mg) is effective and well tolerated for the treatment and prevention of influenza in hemodialysis patients.
