AKI and Critical Care
Severe acute illness is often complicated by acute kidney injury (AKI) and patients with chronic kidney disease (CKD) are at high risk of critical illness if they develop COVID-19. AKI is more common amongst patients hospitalised with COVID-19 than in patients hospitalised due to other illness. Furthermore patients with COVID-19-associated AKI (C19-AKI) sustain worse outcomes than those who develop AKI associated with other acute illnesses.
The COVID-19 pandemic revealed national shortages of reserve resources and facilities required to meet surges in critical care Renal Replacement Therapy (RRT). Further COVID-19 surges or emergency states risk overwhelming adult critical care RRT capacity, representing a national patient safety risk.
Innovative and flexible cross-specialty working by renal and critical care multi-professional teams helped to sustain RRT delivery in centres across the UK during the early stages of the COVID-19 pandemic. Such collaborative experience and learning also highlighted opportunities to optimise and streamline routine care of critically unwell patients with renal failure, including in centres without on-site renal services.
Do you have experience of managing patients with AKI during COVID-19?
Add your voice to this learning community!
Be it a personal reflection, an innovation you are proud of or something you have learnt, get in touch by completing this short and easy form, or email your story in your own words to kquip@renalregistry.nhs.uk.
Guidelines
- The Intensive Care Society, British Renal Society and Renal Association have jointly developed the following guideline: Renal Replacement Therapy for Critically Unwell Adult Patients: Guidelines for best practice and service resilience during COVID-1
Shared learning
- Resources for caring for patients with AKI
- Training on Acute Kidney Injury and Fluids
Barnsley NHS Foundation Trust - Acute Kidney Injury in COVID-19 – Caring for Patients Requiring Alternative Renal Replacement Therapy in Critical Care Units
The Association of Nephrology Nurses UK - Renal teams supporting AKI in the critically ill patient
Review of London kidney teams’ response to COVID-19