NICE has published a new Covid-19 rapid guideline to help healthcare professionals who are not kidney specialists to prevent, detect and manage acute kidney injury (AKI) in patients in hospital with suspected or confirmed Covid-19.
The guideline highlights that AKI may be common in patients with Covid-19 and can lead to worse outcomes for patients. Maintaining the optimal level of body fluids is critical to prevent and manage AKI, but this can be hard to achieve.
There is also emerging evidence that suggests the coronavirus might directly harm the kidneys. So, it is important that patients are assessed for AKI on admission to hospital or transfer, monitored for AKI throughout their stay and AKI is managed appropriately if it develops.
If body fluid levels are low and fluid needs cannot be met through drinking or via a feeding tube, patients should be given fluid via an intravenous (IV) drip. If AKI is worsening, or has not resolved after 48 hours, patients should be referred to a specialist.
Support patient's anxiety about Covid-19
In all cases healthcare professionals should discuss the risks, benefits and likely outcomes of treatment options with patients with Covid 19, and their families and carers. This will help them make informed decisions about their treatment goals and wishes, including treatment escalation plans where appropriate. Decision support tools (when available) should be used and discussions and decisions should be clearly documented.
It also advises that healthcare professionals communicate with patients, their families and carers, and support their mental wellbeing to help alleviate any anxiety they may have about Covid-19.
Useful charities to signpost to are Kidney Care UK, National Kidney Federation and local kidney patient organisations and support groups (including NHS Volunteer Responders) and UK government guidance on the mental health and wellbeing aspects of COVID-19.