Guidelines for Dialysis of COVID – 19 patients By ISN and MoHFW Described by Dr Jigar Shrimali
Guidelines for Dialysis with reference to COVID-19 Infection
•patients already on maintenance dialysis
•patients requiring dialysis due to acute kidney injury (AKI)
•patients critically ill requiring continuous renal replacement therapy (CRRT)
GUIDELINES FOR HEMODIALYSIS
I. For Patients
a. Before Arrival to Dialysis Unit
b. Screening Area
▪ Symptoms suspected of COVID-19 as discussed.
▪ History of contact with a diagnosed case of COVID 19
• History of contact with person who has had recent travel to foreign country or from high COVID-19 prevalence area within our country as notified by the Central and State/ UT governments respectively.
c. Inside Dialysis Unit
a. Screening Area
b. During Dialysis
Bleach solution
Alcohol based solutions
- Use of cytokine removal therapies with Cytosorb,Oxiris and other similar devices is unproven and is not recommended except in the context of a clinical trial.
- Cytokine storm associated with elevated levels of IL-6, IL-18 and IFN gamma are associated with more severe disease and higher mortality. Extracorporeal therapies using high volume hemofiltration or adsorption to decrease cytokine levels may theoretically be expected to confer benefit and 1 study of HVHF at 6L/hr showed cytokine reduction and improvement in SOFA scores in septic patients.
1. Patients already on CAPD
2. New patient planned for CAPD
3. Acute PD
•These include:
Hand hygiene
Respiratory etiquette
Face mask
Masks management
General Cleaning
Water supply
Article Courtesy – Dr. Jigar Shrimali
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