Acute kidney injury (AKI) in critically ill patients is multifactorial.
There is little reliable UK data on the incidence and outcomes of patients with COVID-19 and AKI outside the ICU.
At this stage we do not have a full understanding of the aetiology of AKI in COVID-19 and the pathogenic role of systemic inflammation, hypovolaemia or other COVID-19 related pathology (such as thrombotic microangiopathy) in its genesis.
Volume status is critical in reducing the incidence of AKI but the balance between respiratory and kidney function can be challenging.
Preventing avoidable AKI should be a key goal of the management of hospitalised patients, to reduce demand for renal replacement therapy (RRT).
AKI should be promptly recognised and managed appropriately, within the limits of our current understanding.
AKI confers an adverse risk of mortality and its presence reflects underlying morbidity and current illness severity.
The presence of AKI should inform assessments of prognosis and in some cases the appropriateness of escalation of care.
It is critical that we build on existing processes and knowledge and carry on doing the things we currently do well.
FOAMcast reviews Dr Josh Farkas's PulmCrit blog posts on 'Renal microvascular haemodynamics in sepsis: a new paradigm' and 'Renoresuscitation: Sepsis resuscitation designed to avoid long-term complications', in which he posits that renal protection in sepsis may prove beneficial for patients.
Who is this aimed at?
This tool kit is aimed at everyone.
There are different sections for each target group
What will I learn?
Recognition and response to AKI
Primary care management post AKI episode
Embedding a holistic approach to AKI