Management of peritoneal dialysis under COVID-19: The experience in Sichuan Province People’s Hospital, China

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) is becoming a severe challenge to China and the whole world. By now, there is no report about medical support to peritoneal dialysis (PD) patient during COVID-19 pandemic. In this essay, we summed up our safety measures on how to protect PD patients and our staffs, and our experience on how to ensure the dialysis treatment of PD patients during the pandemic period. Using of telehealth has potential to improve patient care quality. As a result, by applying all the actions and efforts above, most of patients got enough medical support. According to the patient survey, 11 patients (3.3% of the total) reduced their treatment of dialysis exchange due to the shortage of PD solution or the affection of the pandemic. None of the PD patient and staff reported COVID-19. We successfully prevented COVID-19 transmission and ensured medical safety in our PD patients during the crisis.

The COVID‐19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta‐analysis

“…Patients with chronic illness such as CKD have continued to avoid clinic visits or haemodialysis sessions due to this fear 18,20–22 . As such, an increase in the demand for home therapies, including peritoneal dialysis and telehealth consultations was observed 22–24 …”

“…18,[20][21][22] As such, an increase in the demand for home therapies, including peritoneal dialysis and telehealth consultations was observed. [22][23][24] For some patients, peritoneal dialysis was the preferred mode of dialysis because it allowed them to stay home and conduct telehealth appointments remotely, thus alleviating fears of transmission as compared with haemodialysis. This finding is consistent with studies examining access to dialysis services during the H1N1 pandemic in 2009 (citation required).…”

Should More Patients with Kidney Failure Bring Treatment Home? What We Have Learned from COVID-19

“…Survey findings from Sichuan Province People’s Hospital, China, confirmed that existing PD patients felt their PD to be mostly unchanged by the COVID-19 environment [32]. Concerns highlighted by PD patients included the fact that some patients require support that should be led by the managing HCP (e.g., 3% reduced their dialysis because of a shortage of PD solution; 24% stopped erythropoietin injections due to the suspension of outpatient services in some community hospitals) [32]. On the other hand, although studies have identified that patients undergoing in-center HD can experience negative psychosocial impacts related to their treatment, as well as significant distress during confinement [48, 49], other patient surveys identify high levels of patient reluctance to change from in-center HD to home-based dialysis [49].…”

“…Furthermore, remote patient management was highly regarded and desired by the patients surveyed [47]. Survey findings from Sichuan Province People’s Hospital, China, confirmed that existing PD patients felt their PD to be mostly unchanged by the COVID-19 environment [32]. Concerns highlighted by PD patients included the fact that some patients require support that should be led by the managing HCP (e.g., 3% reduced their dialysis because of a shortage of PD solution; 24% stopped erythropoietin injections due to the suspension of outpatient services in some community hospitals) [32].…”

“…Rate of COVID-19 in patients with kidney failure receiving PD versus HD[8,13, 15,16,[32][33][34][35]37] Denominator from 2019 Annual Dialysis Data Report, JSDT Renal Data Registry [15, 16]. b Data are for COVID-19 hospitalizations.…”