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Do you manage the renal impact of #covid19 on general wards?
My summarised recommendations on;
✅ AKI
✅ Volume status
✅ ACEi
✅ Transplant & dialysis patients
taken from @RenalAssoc, #eraedta, #nephjc & @UpToDate
= lots of relevant info in 8 tweets👇
#medtwitter #covid4mds
My summarised recommendations on;
✅ AKI
✅ Volume status
✅ ACEi
✅ Transplant & dialysis patients
taken from @RenalAssoc, #eraedta, #nephjc & @UpToDate
= lots of relevant info in 8 tweets👇
#medtwitter #covid4mds
AKI 1
✅ Many potential factors;
✔️hypovolaemia due to fever / GI symptoms
✔️sepsis & cytokine release
✔️rhabdo, even without myalgia; check CK!
✔️direct viral tubule invasion?
✅ Low grade proteinuria & haematuria common
✅ Don’t miss ‘usual’ post-renal AKI; bladder scan +- US
✅ Many potential factors;
✔️hypovolaemia due to fever / GI symptoms
✔️sepsis & cytokine release
✔️rhabdo, even without myalgia; check CK!
✔️direct viral tubule invasion?
✅ Low grade proteinuria & haematuria common
✅ Don’t miss ‘usual’ post-renal AKI; bladder scan +- US
Volume status
Assessment not easy at best of times!
Balance of maintaining volume to prevent AKI & avoiding hypervolaemia which impairs oxygenation in ARDS
🟠 UK Renal Assoc - “target euvolaemia”
🟠 Uptodate - “fluid goals conservative as per ARDS criteria” but individualise
Assessment not easy at best of times!
Balance of maintaining volume to prevent AKI & avoiding hypervolaemia which impairs oxygenation in ARDS
🟠 UK Renal Assoc - “target euvolaemia”
🟠 Uptodate - “fluid goals conservative as per ARDS criteria” but individualise
