Management of Acute Kidney Injury in COVID-19

Acute kidney injury is a common complication in hospitalized patients with COVID-19. Similar to AKI associated with other conditions such as sepsis and cardiac surgery, morbidity and mortality are much higher in patients with COVID-19 who develop AKI, especially in the intensive care unit. Management of COVID-19 associated AKI with kidney replacement therapy (KRT) should follow existing recommendations regarding modality, dose, and timing of initiation. However, patients with COVID-19 are very hypercoagulable and close vigilance to anticoagulation strategies is necessary to prevent circuit clotting. During situations of acute surge, where demand for KRT outweighs supplies, conservative measures have to be implemented to safely delay KRT. A collaborative effort and careful planning is needed to conserve dialysis supplies, to ensure that treatment can be safely delivered to every patient who will benefit for KRT.