Division of Nephrology, Washington University in St. Louis, St. Louis, MO.
Division of Nephrology, Washington University in St. Louis, St. Louis, MO.
Adv Chronic Kidney Dis. 2020 Sep;27(5):377-382. doi: 10.1053/j.ackd.2020.08.002. Epub 2020 Aug 6.
Acute kidney injury is a common complication in hospitalized patients with coronavirus disease 2019. Similar to acute kidney injury associated with other conditions such as sepsis and cardiac surgery, morbidity and mortality are much higher in patients with coronavirus disease 2019 who develop acute kidney injury, especially in the intensive care unit. Management of coronavirus disease 2019-associated acute kidney injury with kidney replacement therapy should follow existing recommendations regarding modality, dose, and timing of initiation. However, patients with coronavirus disease 2019 are very hypercoagulable, and close vigilance to anticoagulation strategies is necessary to prevent circuit clotting. During situations of acute surge, where demand for kidney replacement therapy outweighs supplies, conservative measures have to be implemented to safely delay kidney replacement therapy. A collaborative effort and careful planning is needed to conserve dialysis supplies, to ensure that treatment can be safely delivered to every patient who will benefit for kidney replacement therapy.
急性肾损伤是 2019 冠状病毒病住院患者的常见并发症。与脓毒症和心脏手术等其他情况相关的急性肾损伤类似，发生急性肾损伤的 2019 冠状病毒病患者的发病率和死亡率要高得多，尤其是在重症监护病房。采用肾脏替代疗法治疗 2019 冠状病毒病相关急性肾损伤时，应遵循现有建议，包括治疗方式、剂量和起始时机。但是，2019 冠状病毒病患者的血液非常容易凝结，必须密切关注抗凝策略，以防止回路凝血。在急性需求激增的情况下，肾脏替代治疗的需求超过供应，必须采取保守措施安全地延迟肾脏替代治疗。需要齐心协力、精心规划，以节约透析用品，确保可以安全地为每一位受益于肾脏替代治疗的患者提供治疗。
