Nicotinamide Riboside in SARS-CoV-2 (COVID-19) Patients for Renal Protection

The study team chose a treatment protocol with NR as a treatment for patients who will be admitted with COVID-19 related illness and develop AKI after admission. Treatment duration will be for 10 days and the primary study endpoint will be the change in whole blood NAD+ from baseline to end of treatment in NR group vs placebo group. The study team will evaluate whole blood NAD+ levels as a marker of efficacy and biological effect of NR.

Inclusion criteria

• Provision of signed and dated informed consent form from a participant or legally authorized representative (LAR);
• Male or female, >18 years old;
• Hospitalized participants with a laboratory diagnosis of COVID-19 infection
• Evidence of persistent AKI as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines (Table 3);
• Willing to adhere to the study intervention regimen;

Exclusion criteria

• Hypersensitivity to nicotinamide riboside (NR);
• Pregnant or lactating women confirmed with positive laboratory pregnancy tests as per local requirements;
• eGFR <15 mL/min/1.73 m2 as per the Chronic Kidney Disease Epidemiology Collaboration equation at admission lab;
• Maintenance renal replacement therapy or initiation of renal replacement therapy before randomization
• Currently on NR or nicotinamide or vitamin B3 (niacin) supplementation (multivitamins are allowed);
• Concomitant cirrhosis of liver or acute liver failure;
• Any medical history or condition that might, in the opinion of the attending physician, put the participant at significant risk if he/she were to participate in the trial;
• Individuals with kidney transplant;
• Individuals with blood platelet count <100,000/microL