Top stories from Healio Nephrology: Dialysis during the COVID-19 pandemic
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The nephrology community has faced unique challenges since increasing numbers of people have become infected with the novel coronavirus, deemed COVID-19.
To keep nephrologists, dialysis providers and other health care professionals informed as expert recommendations shift in this uncertain time, Healio Nephrology has compiled a list of our top stories regarding how to best care for patients who require dialysis during the pandemic. These stories include a debate on temporarily reducing dialysis treatments, how hospitals located in COVID-19 hotspots have changed procedures, the plea by kidney societies to worldwide health agencies for help with dialysis supply shortages and what needs to be done in the realm of kidney care before the next virus strikes.
Nephrologists debate value, risk of reduced treatments during pandemic
During the COVID-19 pandemic, temporarily reducing the number of dialysis treatments in an outpatient setting could help limit potential exposure to the virus for patients and staff and save personal preventive equipment, suggest Stanford University nephrologist Timothy W. Meyer, MD, and colleagues.
However, with limited data available on the impact of cutting dialysis sessions from three to two per week, the benefits may not outweigh the risk of fluid overload, even temporarily, noted Rajnish Mehrotra, MD, of the Kidney Research Institute at the University of Washington in Seattle. Read more.
Mount Sinai Hospital reports its procedures for patients who require dialysis during COVID-19 pandemic
In an article published in Kidney Medicine, nephrologists from Mount Sinai Hospital in East Harlem, New York, outline how they are ensuring patients who require dialysis receive safe and effective care during the COVID-19 pandemic.
According to Osama El Shamy, MD, and colleagues, New York City has the densest population of any municipality with a population of more than 100,000 in the United States. Therefore, the COVID-19 pandemic has presented health care professionals in the region with “extraordinary challenges,” including limited resources, such as hospital beds, personal protective equipment and staff. Read more.
Experts release guidance on caring for pediatric patients on dialysis during COVID-19 pandemic
Nephrologists from around the globe — and primarily from China as this is where the virus may have originated — have developed a set of recommendations for the care of pediatric patients undergoing either in-center or home dialysis during the COVID-19 pandemic.
The guidance, recently published in Pediatric Nephrology, is based on “epidemiological features” of the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2 virus] and COVID-19 disease. Read more.
Guest Commentary by Gaurav Jain, MD, FASN, and Masood Ahmad, MD: Supply shortage impacts COVID-19 decision-making
The nephrology community, both patients and physicians, are still grappling with recent reports on the possible rationing of ventilators for critically ill patients with COVID-19, including the exclusion of patients with advanced kidney disease. Now we are faced with news suggesting a shortage of dialysis equipment and staff in some cities across the nation due to high rates of acute kidney injury, especially in “hot spots” for COVID-19. That is leading to crucial decisions on how to manage renal replacement therapy in the face of this global health crisis. Read more.
Kidney societies ask health agencies worldwide to help patients with COVID-19 who need dialysis
The presidents of the American Society of Nephrology, the International Society of Nephrology, and the European Renal Association/European Dialysis and Transplant Association have released a joint statement asking international health agencies to meet the increasing demand for dialysis supplies and equipment for kidney patients with COVID-19.
“On behalf of our three societies, we ask that government agencies overseeing dialysis centers in the developing world ensure that they provide support to staff, nephrologists, and other health professionals delivering life-saving dialysis treatments to these vulnerable patients. At the same time, government agencies must make rapid testing capabilities and personal protective equipment an utmost priority,” they wrote. Read more.
Kidney care needs a paradigm shift before the next virus strikes
The kidney care community must change the way dialysis is provided to most patients with end-stage kidney disease before the next pandemic arrives, two nephrologists wrote in a recently published editorial.
“COVID-19 has exposed critical weaknesses in our health care system, notably including our dependence on in-center hemodialysis for more than half a million U.S. residents,” Daniel E. Weiner, MD, MS, and Suzanne G. Watnick, MD, wrote in the editorial. Read more.