All, As the COVID-19 pandemic continues to escalate in the US, we have great concerns that our ability to provide renal replacement therapy will be overwhelmed. Does anyone have any acute PD protocols for AKI in the critically ill COVID-19 patient?

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Prayus, T., Doctor/MD from Delaware, USA asked
All, As the COVID-19 pandemic continues to escalate in the US, we have great concerns that our ability to provide renal replacement therapy will be overwhelmed. Does anyone have any acute PD protocols for AKI in the critically ill COVID-19 patient?

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Doctor (Canada) April 6, 2020

There is currently no universally accepted protocol for acute PD in COVID-positive patients. For PD catheter insertion, bedside insertion would likely be the predominant method in COVID-positive patients as transfer to the OR for surgical insertion or to the IR suite for an insertion under fluoroscopy would be complicated. Once the PD catheter is in, one could follow usual urgent start PD protocols – ie. starting with low volumes in the supine position. Automated PD would be preferred over CAPD to avoid multiple entries into the patient’s room to perform the exchanges. Hopefully some formal guidelines will emerge in the next few weeks to help guide clinicians managing such patients.

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