Managing AKI during a Pandemic

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Renal replacement therapy (RRT) should be initiated for acute kidney injury (AKI) patients who have life-threatening complications and are not responding to medical management, said Anitha Vijayan, MD, FASN, including those with volume overload and respiratory failure, hyperkalemia, or metabolic acidosis. But be wary of aggressive fluid resuscitation, said Vijayan, a professor of medicine at Washington University School of Medicine in St. Louis.

She noted there is no data yet to support early initiation of RRT in COVID patients.

Available RRT modalities that may be employed include continuous renal replacement therapy (CRRT), prolonged intermittent renal replacement therapy (PIRRT), or intermittent