Safeguarding the Maintenance Hemodialysis Patient Population during the Coronavirus Disease 19 Pandemic

Abstract

The World Health Organization has recognized the pandemic nature of the coronavirus disease 19 (COVID-19) outbreak. A large proportion of positive patients require hospitalization, while 5-6% of them may need more aggressive therapies in intensive care. Most governments have recommended social separation and severe measures of prevention of further spreading of the epidemic. Because hemodialysis (HD) patients need to access hospital and dialysis center facilities 3 times a week, this category of patients requires special attention. In this editorial, we tried to summarize the experience of our centers that hopefully may contribute to help other centers and colleagues that are facing the coming wave of the epidemic. Special algorithms for COVID-19 spreading in the dialysis population, recommendations for isolation and preventive measures in positive HD patients, and finally directions to manage logistics and personnel are reported. These recommendations should be considered neither universal nor absolute. Instead, they require local adjustments based on geographic location, cultural and social environments, and level of available resources.

COVID-19 in patients undergoing chronic kidney replacement therapy and kidney transplant recipients in Scotland: findings and experience from the Scottish renal registry

“…5 Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK. 6 Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK. 7 Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh Bioquarter, Edinburgh EH16 4SA, UK.…”

“…Patients who have a kidney transplant are presumed to be at high risk due to their obligate immunosuppressive medications. There have been a number of published recommendations on how to mitigate spread of SARS-CoV-2 in dialysis units [4][5][6][7][8]. There is, however, a lack of data regarding clinical course and outcome in patients receiving KRT following infection with SARS-CoV-2.…”

Management and Outcomes of patients on maintenance dialysis during the COVID-19 pandemic: a report from Geneva, Switzerland

“…Few reports have recently been published on dialysis units ongoing experience during the COVID-19 outbreak. They provide epidemiological data on infection and mortality rates within their dialysis population [14][15][16][17] .…”

Challenges in COVID‐19 medical response: A nephrology perspective

“…Another important issue is that haemodialysis (HD) clinics are usually not located in small towns, and these frail patients often travel to their dialysis centre in groups and also cannot keep the 6-feet safe distance during their HD session. 1 The total number of patients on dialysis in Brazil was estimated at 126 583 in 2017. Peritoneal dialysis (PD) was used by 6.9% of patients, the majority of whom were on automated peritoneal dialysis (APD); frequent (>4 times a week) HD by 1.3% and conventional HD by 91.8%.…”