To continue supporting our physicians and nurses who are on the front lines of managing the influx of critically ill patients, many of whom will develop acute kidney injury (AKI) or experience renal failure during this pandemic, we have consolidated support resources to help you with providing these patients Continuous Renal Replacement Therapy (CRRT). We will be updating this page with additional support materials as they become available so please check back regularly.
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Acute kidney injury (AKI) requiring acute renal replacement therapy (RRT) occurs in approximately 15% of all ICU admissions, but this rate is often increased greatly in the setting of severe respiratory failure and acute respiratory distress syndrome (ARDS).
Recommendations on the care of hospitalized patients with COVID-19 and kidney failure requiring renal replacement therapy
Now, more than ever, Continuous Renal Replacement Therapy is a critical therapy to be used for patients with AKI requiring renal replacement therapy and especially for those patients who are hemodynamically unstable. It has been reported in various countries that a subset of patients with COVID-19 will become severely ill, with a sepsis like syndrome and multiorgan failure, including acute kidney injury. In these critical cases, CRRT may be a life sustaining and life saving therapy.
Senior Medical Director
Baxter Healthcare Corporation
The current treatment of COVID-19 with AKI includes general and supportive management and kidney replacement therapy. There is no effective antiviral therapy available at present.
Kidney International (2020) Article in press. https://doi.org/10.1016/j.kint.2020.03.001
In times of uncertainty, the ability to learn and be proactive makes a huge difference. Our understanding of SARS-CoV-2 prevention and treatment evolves day by day. The clinical characteristics of acute kidney injury (AKI) are heterogeneous and its incidence is reported in up to 25% of patients, some of them requiring renal replacement therapy (RRT). Therefore, preparedness is of utmost importance to maximize our capacity for the provision of RRT. Timely initiation, optimal fluid management and protocolized care with consideration for minimizing healthcare provider exposure should be carefully evaluated.
Assistant Professor, Internal Medicine/Nephrology/Bone and Mineral Metabolism Director, Acute Care Nephrology & CRRT Program University of Kentucky Medical Center, Lexington, Kentucky
WEBINAR: COVID-19: The Role of CRRT in AKI
Barbara McLean, MN, RN, CCRN, CCNS-BC, NP-BC, FCCM and Critical Care Clinical Nurse Specialist at Grady Health discusses the role of CRRT in COVID-19 patients.
Phosphate: The Forgotten Electrolyte:
The kidneys' most important function is the regulation of electrolytes, one of which is phosphorous. Greater than 60% of patients will present with hyperphosphatemia with acute renal failure. Pam Waters discusses how you can help critically ill patients with CRRT therapy.
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CRRT: Pre and Post Replacement Solutions - A Guide to Understanding:
Pam Waters, RN, explains the uses and benefits of CRRT replacement solutions, and the differences between pre- and post- replacement solutions.
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