Fisher Richard, Clarke Jonathan, Al-Arfi Khaled, Saha Rohit, Lioudaki Eirini, Mehta Reena, Pahl Clemens, Sharpe Claire, Bramham Kate, Hutchings Sam
Department of Critical Care, King's College Hospital NHS Foundation Trust, London, United Kingdom.
King's Kidney Care, King's College Hospital NHS Foundation Trust, London, United Kingdom.
J Crit Care. 2021 Apr;62:190-196. doi: 10.1016/j.jcrc.2020.12.023. Epub 2020 Dec 28.
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.
Single-centre retrospective case note review of adult patients with confirmed COVID-19 admitted to ICU.
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.
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.
本研究旨在描述入住重症监护病房（ICU）的新冠肺炎患者中急性肾损伤（AKI）的发生率。此外，我们旨在详细说明为这些患者提供的肾脏替代治疗（RRT）方式的范围（包括腹膜透析 - PD - 和间歇性血液透析 - IHD），以满足大流行期间的需求。
对入住ICU的确诊新冠肺炎成年患者进行单中心回顾性病例记录审查。
在136例无终末期肾病（ESKD）既往史的患者中，108例（79%）发生了AKI，63%的入院患者接受了RRT。由于资源限制，RRT选择范围从仅连续静脉 - 静脉血液透析滤过（CVVHDF - 我们通常的标准治疗）扩大到包括PD（35例患者）和IHD（15例患者）。在研究期间，ICU内作为CVVHDF提供的RRT比例从100%降至最低点39%。PD或IHD均无明显并发症。
在资源有限的时期，PD和IHD可安全用于减少新冠肺炎继发AKI的特定患者对CVVHDF的依赖。
