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. 2020 Jul 3:8:413.
doi: 10.3389/fped.2020.00413. eCollection 2020.

Kidney Replacement Therapy in COVID-19 Induced Kidney Failure and Septic Shock: A Pediatric Continuous Renal Replacement Therapy [PCRRT] Position on Emergency Preparedness With Resource Allocation

Rupesh Raina  1   2 , Ronith Chakraborty  1 , Sidharth Kumar Sethi  3 , Timothy Bunchman  4
Affiliations

Kidney Replacement Therapy in COVID-19 Induced Kidney Failure and Septic Shock: A Pediatric Continuous Renal Replacement Therapy [PCRRT] Position on Emergency Preparedness With Resource Allocation

Rupesh Raina et al. Front Pediatr. .

Abstract

The recent worldwide pandemic of COVID-19 has had a detrimental worldwide impact on people of all ages. Although data from China and the United States indicate that pediatric cases often have a mild course and are less severe in comparison to adults, there have been several cases of kidney failure and multisystem inflammatory syndrome reported. As such, we believe that the world should be prepared if the severity of cases begins to further increase within the pediatric population. Therefore, we provide here a position paper centered on emergency preparation with resource allocation for critical COVID-19 cases within the pediatric population, specifically where renal conditions worsen due to the onset of AKI.

Keywords: COVID-19; acute kidney injury; extracorporeal therapy; kidney replacement therapy; pediatrics.

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Figures

Figure 1
Figure 1
Potential mechanism of COVID-19 and postulated treatments. ACE2, angiotensin-converting enzyme 2; ARDS, acute respiratory distress syndrome; CKRT, continuous kidney replacement therapy; CVVH, continuous venovenous hemofiltration; CVVHD, continuous venovenous hemodialysis; CVVHDF, continuous venovenous hemodiafiltration; GSCF, granulocyte-colony stimulating factor; IL, interleukin; IP-10, Interferon-inducing protein-10; KRT, kidney replacement therapy; MCP, monocyte chemoattractant protein 1; RNA, ribonucleic acid; SLEDD-f, sustained low-efficiency daily diafiltration; TNF-α, tumor necrosis factor-alpha. Designed and created by Joshua Colina, joshcolina@gmail.com.
Figure 2
Figure 2
Nephrologist/Interventionist emergency preparedness plan with resource allocation. ALF, acute liver failure; CDC, Centers of Disease Control and Prevention; CKRT, continuous kidney replacement therapy; CVVH, continuous venovenous hemofiltration; CVVHD, continuous venovenous hemodialysis; CVVHDF, continuous venovenous hemodiafiltration; EPA, Environmental Protection Agency; ICU, intensive care unit; IJ, intrajugular vein; KRT, kidney replacement therapy; PD, peritoneal dialysis; PPE, personal protective equipment; RA, right atrium; SLEDD-f, sustained low-efficiency daily diafiltration, UF, ultrafiltration rate.
Figure 3
Figure 3
Pediatric ECMO 2.0 with CVVHDF circuit. CKRT, continuous kidney replacement therapy; ECMO, extracorporeal membrane oxygenation. Adapted from Chen et al. (51).
See this image and copyright information in PMC

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References

    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. (2020) 323:1239–42. 10.1001/jama.2020.2648 - DOI - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Yi, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. (2020) 395:497–506. 10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed
    1. Zick M. Can COVID-19 Cause Sepsis? Explaining the Relationship Between the Coronavirus Disease and Sepsis. Global Sepsis Alliance. (2020). Available online at: https://www.global-sepsis-alliance.org/news/2020/3/4/can-covid-19-cause-...
    1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. (2020) 395:507–13. 10.1016/S0140-6736(20)30211-7 - DOI - PMC - PubMed
    1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. (2020) 323:1061–9. 10.1001/jama.2020.1585 - DOI - PMC - PubMed