Provision of acute renal replacement therapy, using three separate modalities, in critically ill patients during the COVID-19 pandemic. An after action review from a UK tertiary critical care centre

Richard Fisher, Jonathan Clarke, Khaled Al-Arfi, Rohit Saha, Eirini Lioudaki, Reena Mehta, Clemens Pahl, Claire Sharpe, Kate Bramham, Sam Hutchings

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Purpose: The aim of this study is to describe the incidence of Acute Kidney Injury (AKI) amongst patients admitted to the Intensive Care Unit (ICU) with COVID-19. In addition we aim to detail the range of Renal Replacement Therapy (RRT) modalities offered to these patients (including peritoneal dialysis - PD - and intermittent haemodialysis - IHD) in order to meet demand during pandemic conditions. Materials and methods: Single-centre retrospective case note review of adult patients with confirmed COVID-19 admitted to ICU. Results: Amongst 136 patients without a prior history of End Stage Kidney Disease (ESKD), 108 (79%) developed AKI and 63% of admitted patients received RRT. Due to resource limitations the range of RRT options were expanded from solely Continuous Veno-Venous HaemoDiaFiltration (CVVHDF - our usual standard of care) to include PD (in 35 patients) and IHD (in 15 patients). During the study period the proportion of RRT provided within ICU as CVVHDF fell from 100% to a nadir of 39%. There were no significant complications of either PD or IHD. Conclusions: During periods of resource limitations PD and IHD can safely be used to reduce dependence on CVVHDF in select patients with AKI secondary to COVID-19.

Original languageEnglish
Pages (from-to)190-196
Number of pages7
JournalJournal of Critical Care
Volume62
DOIs
Publication statusPublished - Apr 2021

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