Understanding Prolonged Intermittent kidney Replacement Therapy (PIkRT) in COVID-19 Treatment & Management


The novel coronavirus (COVID-19) outbreak evolved quickly, with new developments every day. Considering the potential for ICU patient surge, Dr. Casey Gashti* reviews his expertise regarding what is known about COVID-19 and how hybrid therapies, such as Prolonged Intermittent Kidney Replacement Therapy (PIKRT), may improve resource utilization while treating patients with AKI.1


  • Early clinical experience with COVID-19
  • An overview of hybrid options for Renal Replacement Therapy
  • An overview of PIKRT
    • Patient selection
    • PIKRT prescription
    • Antibiotic dosing recommendations
  • Personal experiences & observations on performing renal replacement therapy in patients with COVID-19**


Casey Gashti, MD
Associate Professor of Nephrology and Medical Director for Inpatient Plasmapheresis
Rush University Medical Center
Chicago, IL

Casey Gashti, MD, is board certified in Nephrology and Internal Medicine and is affiliated with Rush University Medical Center, Chicago, Illinois. He completed his residency in Internal Medicine and his Fellowship in Nephrology at Rush University Medical Center, where he is currently Associate Professor of Nephrology and the Medical Director for Inpatient Plasmapheresis.

Dr. Gashti is a member of the American College of Physicians (ACP), American Society for Apheresis (AFSA) and the American Society of Nephrology (ASN).

*Paid speaker for NxStage Medical, Inc.
**Not all customers may experience these benefits.

Renal replacement therapy, as with any medical therapy, is not without risks. The decision of which therapy to use should be made by the physician, based on previous experience and on the individual facts and circumstances of the patient. There is no literature demonstrating one therapy is clinically better than another.1

1. Kraus MA. Selection of Dialysate and Replacement Fluids and Management of Electrolyte and Acid-Base Disturbances. Seminars in Dialysis; Vol 22, No 2 (March-April) 2009 pp. 137-140.



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