Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Renal Epidemiology Group, Columbia University, New York, NY, USA.
Semin Dial. 2021 Nov;34(6):561-566. doi: 10.1111/sdi.12962. Epub 2021 Mar 11.
Severe COVID-19 illness and the consequent cytokine storm and vasodilatory shock commonly lead to ischemic acute kidney injury (AKI). The need for renal replacement therapies (RRTs) in those with the most severe forms of AKI is considerable and risks overwhelming health-care systems at the peak of a surge. We detail the challenges and considerations involved in the preparation of a disaster response plan in situations such as the COVID-19 pandemic, which dramatically increase demand for nephrology services. Taking careful inventory of all aspects of an RRT program (personnel, consumables, and machines) before a surge in RRT arises and developing disaster contingency protocol anticoagulation and for shared RRT models when absolutely necessary are paramount to a successful response to such a disaster.
严重的 COVID-19 疾病以及随之而来的细胞因子风暴和血管舒张性休克通常会导致缺血性急性肾损伤（AKI）。在 AKI 最严重的情况下，需要进行肾脏替代治疗（RRT），而在疫情高峰期，这会给医疗系统带来巨大的压力。我们详细介绍了在 COVID-19 等大流行期间准备灾害应对计划所涉及的挑战和考虑因素，这种情况会极大地增加肾脏病服务的需求。在 RRT 需求激增之前，仔细盘点 RRT 计划的各个方面（人员、耗材和机器），并在绝对必要时制定灾难应急协议抗凝和共享 RRT 模型，对于成功应对此类灾害至关重要。
