Building a hemodiafiltration system from readily available components for continuous renal replacement therapy under disasters and pandemics: preparing for an acute kidney injury surge during COVID-19

Area of Science:

• Nephrology
• Critical Care Medicine
• Infectious Diseases

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) can cause acute kidney injury (AKI) through direct cellular toxicity and autoimmune glomerular diseases.
• Managing patients with end-stage renal disease (ESRD) and AKI during a surge of critically ill COVID-19 patients presents significant healthcare challenges.
• Healthcare planning during the COVID-19 era has focused on managing overwhelming patient surges.

Purpose of the Study:

• To present a practical and ingenious solution for renal replacement therapy during a surge of critically ill patients.
• To describe the development of a simple hemofiltration apparatus for use in critical situations.
• To address the management of ESRD and AKI patients amidst overwhelming demand for dialysis services.

Main Methods:

• Utilized a readily available blood pump, dialysis filter, and pre/post-filter replacement fluid setup.
• Integrated multiple intravenous pumps to construct a simple hemofiltration apparatus.
• Focused on creating a functional hemofiltration system using commonly available medical equipment.

Main Results:

• A functional hemofiltration apparatus was successfully developed.
• The proposed setup offers a potential solution for renal replacement therapy during critical surges.
• The apparatus is designed for use when traditional hemodialysis services are overwhelmed.

Conclusions:

• The described hemofiltration setup provides a readily available option for critical situations.
• This approach can help manage the demand for renal replacement therapy during overwhelming patient surges.
• The simple hemofiltration apparatus offers a viable alternative to traditional hemodialysis in resource-limited or surge scenarios.