Acute Kidney Injury in COVID-19
Brigham and Women's Hospital COVID-19 Guidelines: Nephrology
Acute Kidney Injury - Summary points
Investigations and Monitoring in COVID-19 patients:
Monitor Creatinine a daily, patients with prexisting CKD will deteriorate more rapidly
Urinalysis if BUN and or creatinine increases
Patients may present with proteinuria (44%), hematuria (26.9%)
Avoid nephrotoxic medications
Assess fluid balance
Escalation:
Consult Renal/nephrology team early, do not wait for severe AKI and need for renal replacement therapy (RRT)/dialysis
Renal Replacement Therapy (RRT)
Estimates for RRT range from 1 to 5% of hospitalized patients
In critically ill patients, need for CRRT ranges from 5 to 23%
Indications for dialysis in COVID-19 patients are the same as the indications for all patients
Triage of Suspected COVID-19 patients
![](https://images.medshr.net/cms/original/20200406143231823-lancet covid triage flowchart.png)
Source: The Lancet Respiratory Medicine 2020 8e11-e12DOI: (10.1016/S2213-2600(20)30071-0)
Useful Resources:
Brigham and Women's Hospital COVID-19 Guidelines: Nephrology
https://covidprotocols.org/protocols/10-nephrology
MedShr Open Article: COVID-19 At-Risk Group: Haemodialysis Patients
References:
Jinnong Zhang, Luqian Zhou, Yuqiong Yang, Wei Peng, Wenjing Wang, Xuelin Chen, Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics , The Lancet Respiratory Medicine , Volume 8 Issue 3 Pages e11-e12 (March 2020), DOI: 10.1016/S2213-2600(20)30071-0
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