Peritoneal Dialysis During the Coronavirus Disease-2019 (COVID-19) Pandemic: Acute Inpatient and Maintenance Outpatient Experiences

Shamy, Osama El; Sharma, Shuchita; Winston, Jonathan; Uribarri, Jaime

doi:10.1016/j.xkme.2020.04.001

Cited by 35 publications

(44 citation statements)

References 2 publications

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“…Third, staff can be educated on how to safely perform PD with few resources and in a short time. As mentioned in El Shamy et al, 16 PD training is less technically challenging as compared with intermittent HD or CKRT machine training and is therefore an obvious choice for nurse and technician training during a pandemic. Finally, unlike intermittent HD, PD does not require a dialysate supply water connection, which was a limiting factor in several temporary ICU locations constructed in our medical center in response to the COVID-19 surge.…”

Section: Discussionmentioning

confidence: 99%

Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States

Sourial

Dalsan

et al. 2020

American Journal of Kidney Diseases

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Bronx, NY, the first case of coronavirus disease 2019 (COVID-19) was admitted on March 11, 2020. At the height of the pandemic, there were 855 patients with COVID-19 admitted on April 13, 2020. Due to high demand for dialysis and shortages of staff and supplies, we started an urgent peritoneal dialysis (PD) program. From April 1 to April 22, a total of 30 patients were started on PD. Of those 30 patients, 14 died during their hospitalization, 8 were discharged, and 8 were still hospitalized as of May 14, 2020. Although the PD program was successful in its ability to provide much-needed kidney replacement therapy when hemodialysis was not available, challenges to delivering adequate PD dosage included difficulties providing nurse training and availability of supplies. Providing adequate clearance and ultrafiltration for patients in intensive care units was especially difficult due to the high prevalence of a hypercatabolic state, volume overload, and prone positioning. PD was more easily performed in non-critically ill patients outside the intensive care unit. Despite these challenges, we demonstrate that urgent PD is a feasible alternative to hemodialysis in situations with critical resource shortages. Complete author and article information provided before references.

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Section: Discussionmentioning

confidence: 99%

Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States

Sourial

Dalsan

et al. 2020

American Journal of Kidney Diseases

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“…[1][2][3][4][5][6][7] However, few studies, including case reports and the experience of centers, have included sufficient numbers of patients to have a complete overview of their real risk and course of illness. [8][9][10][11][12][13][14][15][16] In those studies, case fatality varied from 14% to 31%.…”

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confidence: 99%

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

Couchoud¹,

Bayer²,

Ayav³

et al. 2020

Kidney International

119

101

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The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.

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“… ○ PD and home hemodialysis patients should use telehealth rather than in-person visits to avoid unnecessary travel and clinic/hospital visits [ 15 , 18 , 36 ]. ○ For home dialysis patients, consider the option of visit by laboratory services to draw blood for monthly tests [ 28 ]. Role of CRRT or variations of maintenance hemodialysis for ESRD patients admitted to the hospital during the pandemic: ○ Critically ill maintenance hemodialysis patients with suspected or confirmed COVID-19 should undergo CRRT in cohorted units.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

COVID-19 and maintenance hemodialysis: a systematic scoping review of practice guidelines

et al. 2020

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Background Coronavirus Disease 2019 (COVID-19) has substantially impacted the provision of medical services. During the pandemic, many medical services, including facilities providing care to patients with end stage renal disease faced challenges in safeguarding patients and staff while providing clinical care. This study aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance hemodialysis to understand the research gaps and propose recommendations for future research. Methods Using the terms: “Dialysis” OR “RRT” OR “Renal replacement therapy” AND “SARS-COV-2” OR “COVID-19” OR “novel coronavirus” OR “2019-nCov”, we performed a multi-step systematic search of the literature in the English language in Pubmed, Scopus, Embase, and Web of Science published from December 1, 2019, to May 13, 2020. Two authors separately screened the title and abstracts of the documents and ruled out irrelevant articles. We obtained a full report of the papers that met our inclusion criteria and screened the full texts. We conducted a descriptive analysis of the characteristics of the included articles and performed a narrative synthesis of the results. We conducted this scoping review in accordance with the PRISMA-ScR Checklist. Results We included 22 articles in this scoping review. Perspectives (n = 9), editorials (n = 4), and case series (n = 5) were the most common types of articles. Most articles were from Italy and the United States. Seventeen (77.3%) of the articles focused on the topic of recommendation for outpatient hemodialysis units. While many of the recommendations overlapped in several articles, there were also many unique recommendations. Conclusions most of the articles are based on single-center experience, which spontaneously developed best practices. Many of these practices have formed the basis for policies and guidelines that will guide future prevention of infection and management of patients with End Stage Renal Disease (ESRD) and COVID-19.

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Peritoneal Dialysis During the Coronavirus Disease-2019 (COVID-19) Pandemic: Acute Inpatient and Maintenance Outpatient Experiences

Cited by 35 publications

References 2 publications

Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States

Urgent Peritoneal Dialysis in Patients With COVID-19 and Acute Kidney Injury: A Single-Center Experience in a Time of Crisis in the United States

Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

COVID-19 and maintenance hemodialysis: a systematic scoping review of practice guidelines

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