Acute kidney injury occurs frequently in Ebola virus disease; however, providing hemodialysis to these patients was previously thought to be too risky because it involves large needles or catheters and potential contact with highly infectious blood. Clinicians recently accomplished the first known successful delivery of renal replacement therapy with subsequent recovery of kidney function in a patient with Ebola virus disease. Their protocol will be presented at ASN Kidney Week 2014 at the Pennsylvania Convention Center in Philadelphia, PA. It will also appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN) and be released on the JASN website on Friday, November 14th.
The report by Michael Connor, Jr, MD, Harold Franch, MD (Emory University School of Medicine), and their colleagues details the measures the clinicians took to maximize safety and minimize risk of secondary transmission of Ebola virus, including careful considerations to the types of equipment used and the protocols that clinical staff followed. None of the staff developed Ebola virus disease after a 21-day observation period, and no detectable Ebola virus genetic material was found in the patient’s dialysis waste fluids.
“In our opinion, this report confirms that with adequate training, preparation, and adherence to safety protocols, renal replacement therapies can be provided safely and should be considered a viable option to provide advanced supportive care in patients with Ebola” said Dr. Connor.
In light of their success, the team has proposed a set of clinical practice guidelines for acute renal replacement therapy in Ebola virus disease. “More than anything else, in our report, we found that extra training of our volunteer ICU nurses made success possible. We thank them for their bravery and commitment.” said Dr. Franch. “Our case also shows that dialysis is not a death sentence for patients suffering from Ebola virus disease and recovery of kidney function is possible.”
Successful Delivery of Renal Replacement Therapy in Ebola Virus Disease, Colleen Kraft, MD, Aneesh Mehta, MD, Jay Varkey, MD, G. Marshall Lyon, MD, Ian Crozier, MD, Ute Ströher, PhD, and Bruce Ribner, MD, et al., Journal of the American Society of Nephrology, published 14 November 14, 2014.
The authors reported no financial disclosures.
Source: American Society of Nephrology