8 Referral in patients with suspected or confirmed COVID-19

8 Referral in patients with suspected or confirmed COVID-19

8.1 Refer patients with acute kidney injury (AKI) for further specialist advice if:

  • there is diagnostic uncertainty about the cause of AKI, which may need further tests or imaging

  • they have abnormal urinalysis results, which may be a sign of COVID‑19-induced kidney damage or other intrinsic renal disease

  • fluid management needs are complex

  • AKI is worsening despite initial management or has not resolved after 48 hours

  • they have usual indications for renal replacement therapy, particularly if there is no urine output, such as:

    • life-threatening hyperkalaemia

    • refractory fluid overload

    • severe metabolic acidosis.

8.2 If patients are being considered for critical care admission see the NICE COVID-19 rapid guideline: critical care in adults.