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May 22, 2020
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NKF, ASN urge HHS to consider risks for patients with kidney disease in the pandemic

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Kevin Longino

The National Kidney Foundation and the American Society of Nephrology have written a letter to the Trump administration highlighting the “unique needs” of patients with kidney disease as the country re-opens amid the COVID-19 pandemic.

“Kidney patients continue to be extremely vulnerable to severe COVID-19 infection and we must take every precaution to help protect them as the country reopens,” Kevin Longino, CEO of the NKF, said in a related press release. “While kidney patients should continue to shelter in place during reopening, they also need access to a health care system which can support their need to isolate and socially distance. Prioritizing the protection of dialysis and transplant patients will help mitigate the risk of resurgence for COVID-19, protect the most susceptible patients, and assist states with achieving a balance between reopening their economies and ensuring the health of the public.”

First addressing statistical evidence that suggests 20% to 40% of patients admitted to the ICU with COVID-19 develop kidney failure and that the mortality rate for patients on dialysis or who are transplant recipients is significantly higher than the general population (10% to 20% and 30% experience mortality, respectively), the societies asked that federal agencies (such as HHS and CMS) help patients with kidney conditions self-isolate. The societies recommended the following be done:

  • ensure patients with kidney disease and their contacts have personal protective equipment, priority access to COVID-19 testing and early access to any vaccines that may be developed;
  • ensure patients can access dialysis if needed;
  • prioritize organ transplant, as transplant rates have declined during the pandemic;
  • address specific needs of patients who develop AKI as a result of COVID-19; and
  • ensure hospitals have access to dialysis supplies.

The NKF and ASN further noted many parts of the country have inadequate testing for COVID-19 that must be addressed.

In addition, the societies asked the administration continue its efforts with End-stage renal disease Treatment Choice (ETC) and the Kidney Care Choices models, which they wrote will improve access to home dialysis.

“COVID-19 has made an indelible impact on the process of care for patients with kidney diseases,” Anupam Agarwal, MD, FASN, president of the ASN, said in the release. “The administration moved quickly and decisively to address the safe continuity of care for people with kidney diseases. Now we must take the long view to prioritize and expand access to safe and effective treatments and therapies while also addressing the vast clinical consequences of COVID-19 infection on kidney health.”

Reference:

https://www.kidney.org/news/nation-s-largest-kidney-patient-and-professional-organizations-urge-action-to-protect-patients

https://advocacy.kidney.org/wp-content/uploads/2020/05/Re-opening-Recommendations-from-NKF-and-ASN.pdf