The reliability and success of peritoneal dialysis during the COVID‐19 pandemic

Abstract

We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID‐19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross‐sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID‐19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ferritin levels significantly elevated at the end of 97 ± 31 days. PTH and phosphorus levels remained stable in remote monitoring automated PD (RM‐APD) group ( p = 0.4 and p = 0.5), they tended to increase in continuous ambulatory PD group and significantly increased in automated PD group ( p = 0.09 and p = 0.01 for PTH and p = 0.06 and p = 0.001 for phosphorus, respectively). Moderate to severe depression was associated with dyspnoea, weight gain more than 5 kg, fatigue, palpitation and increased anxiety. PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. Also, RM‐APD may be a better choice because of providing more stable bone‐mineral metabolism. Moreover, evaluating depression and anxiety is essential for the accurate clinical assessment.

The perspectives of dialysis patients about the Covid‐19 pandemic and differences between the modalities

“…To our knowledge, there are no previous studies evaluating and comparing concerns or anxiety among dialysis patients. However, in an observational study from Turkey, PD patients did not have any concerning‐level anxiety, which is concordant with our results of less concerned PD patients [18]. Although preventive strategies were applied properly in the dialysis facilities, more concerned HD patients considered changing the current dialysis modality due to the outbreak in our study.…”

“…They initiated PD in 64 patients and succeeded to monitor 946 PD patients during the pandemic by telemedicine utilization [20]. While success and reliability of PD was reported during the pandemic [18,20], by published and unpublished experiences dialysis initiation approaches seem to be changing [8]. In clinical practice with advantages and positive perspectives, we could guide patients for PD preference during the pandemic.…”

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

“…As the COVID‐19 pandemic persists, the fear of transmission remains a prominent factor limiting engagement of CKD patients with the health care system 18,19 . 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 …”

The utility of remote patient management in peritoneal dialysis

“…One of the studies conducted with 1023 PD patients on the RPM program showed that patients’ treatment adherence was improved, the proportion of poorly controlled hypertension decreased and the peritonitis rate did not change significantly [ 12 ]. In another study, PD modalities were compared during the lockdown period [ 18 ]. The study results showed that CAPD, APD and RPM–APD had a similar effect on hypervolaemia, blood pressure control, residual renal function, hospitalization and peritonitis episodes.…”