Device safety informationMHRA
Continuous renal replacement therapy (CRRT) safety warning over a safety concern
Continuous renal replacement therapy (CRRT) is used for managing severe acute kidney injury and fluid overload. Published evidence has shown that caspofungin can bind to polyacrylonitrile (PAN)-based membranes used in CRRT which may result in ineffective antifungal treatment.
What to do now
Continuous renal replacement therapy (CRRT) is the subject of an MHRA device safety notice.
- If you use this device at home, do not stop treatment without speaking to the team who supplied it.
- Compare the details on the device or its box with the list here.
- Report problems with medical devices to the MHRA Yellow Card scheme.
Why it matters. Device safety information tells healthcare staff and, where relevant, patients about risks and the actions needed.
Replacements and support
Device safety notices are mainly aimed at hospitals, clinics and suppliers, who are told how to replace, update or check affected devices.
If you use the device at home, the team or company that supplied it is responsible for any replacement or correction.
From the official notice
Published by the Medicines and Healthcare products Regulatory Agency (DSI/2026/014). Quoted as issued.
Summary
Continuous renal replacement therapy (CRRT) is used for managing severe acute kidney injury and fluid overload. Published evidence has shown that caspofungin can bind to polyacrylonitrile (PAN)-based membranes used in CRRT which may result in ineffective antifungal treatment.
The risk
Summary Continuous renal replacement therapy (CRRT) is used for managing severe acute kidney injury and fluid overload. Published evidence has shown that caspofungin can bind to polyacrylonitrile (PAN)-based membranes used in CRRT which may result in ineffective antifungal treatment with potentially life-threatening consequences in critically ill patients. It is considered that the potential risk is greatest when a new membrane or filter circuit has commenced. This is because adsorption reduces over time as the membrane becomes saturated [footnote 1] . The same risk cannot be excluded for other membrane types used in CRRT or other drugs with similar properties. Where possible, it is recommended that echinocandins such as caspofungin, and similar drugs, are administered at least six hours [footnote 1] after initiation of PAN-based filter use, and after filter circuit set changes. Advice for Healthcare Professionals:
Advice for healthcare professionals
Continuous renal replacement therapy (CRRT) is used for managing severe acute kidney injury and fluid overload. Published evidence has shown that caspofungin can bind to polyacrylonitrile (PAN)-based membranes used in CRRT which may result in ineffective antifungal treatment with potentially life-threatening consequences in critically ill patients. It is considered that the potential risk is greatest when a new membrane or filter circuit has commenced. This is because adsorption reduces over time as the membrane becomes saturated [footnote 1] . The same risk cannot be excluded for other membrane types used in CRRT or other drugs with similar properties. Where possible, it is recommended that echinocandins such as caspofungin, and similar drugs, are administered at least six hours [footnote 1] after initiation of PAN-based filter use, and after filter circuit set changes.
echinocandins, such as caspofungin, may adsorb onto PAN-based membranes used in CRRT which may result in ineffective antifungal treatment
adsorption risk reduces over time as the membrane becomes saturated
where possible, administration of antifungal treatments, including with echinocandins and similar drugs, should be at least 6 hours after CRRT has been initiated or following routine filter circuit set changes. CRRT should proceed as clinically indicated and should not be delayed or paused solely to facilitate drug administration, unless otherwise deemed necessary by the responsible clinician
all healthcare professionals involved in the CRRT process and set up, as well as the prescribing, dispensing and administration of caspofungin, should be made aware of this recommendation
seek specialist pharmacist, infectious disease, medical microbiology or mycology input if you are concerned about potential loss of therapeutic efficacy
filter adsorption should be considered as a potential reason for treatment non-responders, or sub-therapeutic responses, whilst patients are receiving any concurrent treatment during CRRT
healthcare providers should review and update local protocols and standard operating procedures to reflect the potential for drug adsorption during CRRT, and to include recommendations for timing of medication administration in the context of this DSI
The advice in this DSI is aimed at healthcare professionals in charge of treating and managing patients receiving CRRT. If you have any concerns about this advice, contact your healthcare professional.
There is no advice to distributors related to this DSI
Advice for patients
The advice in this DSI is aimed at healthcare professionals in charge of treating and managing patients receiving CRRT. If you have any concerns about this advice, contact your healthcare professional.
Open the MHRA notice
Questions
Why has Continuous renal replacement therapy (CRRT) been recalled?
Continuous renal replacement therapy (CRRT) is the subject of an MHRA device safety notice. Device safety information tells healthcare staff and, where relevant, patients about risks and the actions needed.
How do I know if my product is affected?
The notice describes the affected product rather than listing codes. Compare the product name, pack size and where you bought it with the official notice.
What should I do now?
If you use this device at home, do not stop treatment without speaking to the team who supplied it. Compare the details on the device or its box with the list here.
Who replaces the device?
Device safety notices are mainly aimed at hospitals, clinics and suppliers, who are told how to replace, update or check affected devices. If you use the device at home, the team or company that supplied it is responsible for any replacement or correction.