Forecasting continuous renal replacement therapy shortages during the COVID-19 pandemic in The United States

Background: The coronavirus disease 2019 (COVID-19) pandemic has increased continuous renal replacement therapy (CRRT) demand in the US, however total CRRT demand and capacity remain unclear Our objective was to project national and statewide CRRT demand and capacity during the COVID-19 pandemic Methods: We projected CRRT demand using a model in which 4% of patients admitted with COVID-19 develop acute kidney injury (AKI) requiring CRRT for 12 days To estimate non-COVID-19 CRRT demand, we applied the prevalence of AKI requiring CRRT among other ICU patients of 8 8% We assumed capacity would be double this demand and that this demand would decrease to 25% during the pandemic We compared CRRT demand and capacity to estimate shortage In sensitivity analysis, we varied parameters influencing CRRT demand and capacity Results: We estimated a national CRRT shortage of 1529 (95% uncertainty interval:1264-3837) machines with a capacity of 9375 machines, and shortages in 8 states during the COVID-19 pandemic (Table 1 and Figure 1) Conclusions: Several US states are projected to have CRRT shortages during the COVID-19 pandemic A national strategy, such as the creation of a federal stockpile, is needed to mitigate CRRT shortages during this pandemic and future healthcare crises