Covid-19 is usually severe and represents a poor outcome, particularly in patients who have underlying co-morbidities. Among end-stage renal disease patients dependent on dialysis, covid-19 was related to increased morbidity and mortality. There is no causative therapy currently for covid-19. Thus prevention is mainly the best attempt to limit the burden of the disease. The preventive measure may depend on vaccination and public behavior in controlling the spread of the SARS-CoV-2. In the setting of the dialysis center, the patients' and caregivers' compliance with preventive measures is critical in preventing the spreading of Covid-19. The individual's knowledge and attitudes of COVID-19 are likely to influence individual adherence. Evidence suggests that an individual’s knowledge is critical in combating pandemics. Current community service was aimed to increase family caregivers of dialysis patients’ knowledge on covid-19 prevention.

The pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The clinical manifestation of COVID-19 is broad, ranging from an asymptomatic carrier state to severe disease leading to the death penalty. There is also emerging evidence that kidneys are affected early in COVID-19. Proteinuria and haematuria have been reported in 44% and 26.7% on admission, respectively.   This literature review shows clinical manifestations of acute kidney injury (AKI) in a patient with COVID-19 infection. Literature reviews are carried out on various sources found on Google Scholar and Pubmed to search for articles, journal research, case reports, systematic reviews, meta-analyses, and textbooks. Various studies demonstrate the possibility of coronavirus infecting the kidney with several mechanisms such as cytokine storm syndrome (CSS), direct viral infection, and imbalance of renin-angiotensin-aldosterone (RAAS). Haematuria and proteinuria are associated with higher mortality and may signify aggressive disease early. Thus all patients should have a baseline urinalysis. There is a number of different causes of AKI in COVID-19, and some mechanisms by which COVID-19 affects kidneys remain unclear.

Background: Impaired kidney function in Chronic Kidney Disease (CKD) results in increase sympathetic nerve activation, therefore CKD patients often experience hypertension (Ht). Increased sympathetic nerve tone is mediated by increment of sympathetic neurotransmitter which is Neuropeptide Y (NPY).Objective: this study aims to identify Neuropeptide (NPY) levels effect on blood pressure (BP) in CKD patients with hypertension and compare with healthy population.Methods: This case-control study involved 43 CKD patients with regular hemodialysis, 20 non-dialysis CKD stage 1-5 patients and 25 healthy controls. NPY levels were checked by enzyme-linked immunosorbent assay (ELISA). It said to be signifi cant if p value < 0.05. Results:This study shows that NPY levels have a signifi cant effect on BP. Patients with Ht grade II had higher NPY levels (885.80 ng/L) than Ht grade I (423.18 ng/L) or controlled Ht (464.06 ng/L) (p=0.024), but it was higher in controlled (937.56 ng/L) than CKD patients (617.14 ng/L) (p=0.06).Conclusions: NPY levels affect BP. It seem displays a bidirectional effect in cardiovascular tissue, acting as a cardio-depressant and a cardio-stressor.; lowers BP in healthy populations but increases BP in CKD patients. Further research is needed to prove bidirectional effect of NPY levels and control other factors that infl uence BP, such as adherence to Ht medication, infl ammation, and ages so that the results of this study can represent a large population.

Objective:Studies have reported intradialytic hypertension and inadequate antihypertension drugs in hemodialysis patients. Garlic and its components like Allicin have biological activities in lowering blood pressure by induction of endothelin nitric oxide synthase (eNOS) to hydrogen sulfide (H2S), which leads to calcium channel closure and relaxation, which leads to vasodilation of vessels. This study aims to analyze the effect of garlic extract supplementation on lowering blood pressure in chronic hemodialysis patients at Moh Hoesin General Hospital, Palembang, Indonesia.Design and method:This study was a crossover randomized, placebo-controlled, double-blind trial. The subjects were 40 CKD stage 5 patients with chronic hemodialysis, randomly divided into 2 groups, namely the group that received 1000 mg of garlic extract per day (2x500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks, and then the two groups were crossover. Each group measured the blood pressure before and after treatment.Results:The wilcoxon test revealed that systolic blood pressure before and after garlic extract administration was 144,5 ± 12,1 mmHg and 140 (125–164) mmHg with p = 0,037, respectively (vs placebo, p = 0,55). Diastolic blood pressure before and after garlic extract administration was 80 (70–100) mmHg and 80 (70–100) mmHg, with p = 0,703 (vs placebo, p = 0,9).Conclusion:There was an effect of garlic extract on lowering systolic blood pressure in patients with chronic HD at Moh Hoesin Hospital, Palembang, Indonesia.