Technical note and clinical instructions for Acute Kidney Injury (AKI) in patients with Covid-19: Brazilian Society of Nephrology and Brazilian Association of Intensive Care Medicine

Abstract

We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.

Nursing care to COVID-19 patients on hemodialysis and in prone position: an experience report

“…Readjustment of physical structure and reading and discussion of manuals and guidelines directed at the management of COVID-19 patients on hemodialysis were necessary to provide directed and safe care, preventing virus propagation among professionals (9)(10)(11)(12) . Patient evolution to severe COVID-19 conditions, named Severe Acute Respiratory Syndrome (SARS), required extra ICU beds, whose sector was disputed among the young, adults, and mainly older adult patients.…”

“…In COVID-ICU, a new hemodialysis room was adapted with two new points to provide care only to COVID-19 patients. The dialysis points of the hydraulic part were increased from four to nine and seventeen new dialysis points were built in the COVID-ICU, totaling thirty points in the institution, avoiding patient transference and, consequently, minimizing risks of hemodynamic instability during transportation and contamination, which guaranteed increased patient safety (9) .…”

“…In relation to the number of machines, it was necessary to rent double the amount, which was still insufficient. As an alternative, transference of hemodialysis machines and portable osmosis from one bed to another was opted for, after its proper sanitation, which was performed by the team of Nursing technicians (8)(9) .…”

“…Nursing care had to be readjusted, discussed with the team, planned, and registered based on manuals and guidelines directed at COVID-19 patients on hemodialysis and in prone position; this is henceforth described (7,(9)(10)(11)(12)(13)(14) .…”

Multisystem inflammatory syndrome in children associated with COVID-19: nursing care

“…Among the RRT methods, there is prolonged hemodialysis, conventional intermittent hemodialysis, and peritoneal dialysis. The method of choice must be individualized according to the patient and institution 16 .…”