Device Safety Information – DSI/2026/014
Published on 13 October 2026
From: NHSScotland Assure
DSI/2026/014 - Continuous renal replacement therapy (CRRT): Consider delayed administration of concurrent echinocandins such as caspofungin
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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 saturated1. 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 hours1 after initiation of PAN-based filter use, and after filter circuit set changes.