Use of LAMA in Pt's who have AKI as a result of Covid

I'm a respiratory nurse in primary care.

I have just been reading the latest NICE guidance update issued today which pertains to AKI due to Covid.

I currently use the Cockcroft & Fault formula to calculate the creatinine clearance as much as possible  but will use eGFR if I don't have all information to hand to do this.

At present I ensure all my patients under my care who are on a LAMA are on one which may not affect their eGFR -  ie 45ml/min don't prescribe inhalers with Tiotropium, if eGFR is less than 30ml/min then won't prescribe Glycopyrronium.

Couple of questions:

Do you just use the eGFR or are you are using the Cockcroft & Fault formula to calculate correct creatinine clearance levels?

What advice would you suggest is given to GP's regards witholding/changing a pt's LAMA in light of AKI whilst Covid positive or post covid? Would this be the same as you would for example with the use of Metformin.

Thanks in advance

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  • I'm interested to know what people think about this quite complex question. Vince Mak Clare  any thoughts? And as GPs what advice would you think relevant Steve Holmes  Katherine Hickman

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