NKF presidential address focuses on COVID-19 impact, health equity
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BOSTON — At its first in-person conference since the pandemic, the presidential address at the National Kidney Foundation Spring Clinical Meetings focused on how COVID-19 impacted kidney care and how nephrologists should move forward.
“The past 2 years, our lives have been completely disrupted by the SARS-CoV-2 virus. I know that we have all been touched by the pandemic in one way or another,” Paul Palevsky, MD, FNKF, president of NKF said in his presidential address. “That our meeting was held virtually for the past 2 years is the least of these effects.”
While the pandemic led to positive changes in nephrology, such as the increased use of telehealth and Zoom, Palevsky highlighted several negative impacts. Following the start of the COVID-19 pandemic, the number of patients receiving chronic dialysis declined as a direct result of COVID-19-associated mortality among those with advanced chronic kidney disease, he said.
During the address, Palevsky requested a moment of silence for all those who died from COVID-19, including the patients of those in attendance.
In addition to the other negative effects of the pandemic, Palevsky highlighted the current shortage of supplies and nurses around the globe. As an organization, Palevsky said the NKF is disappointed in the lack of priority the federal government has given kidney patients, especially after NKF expressed patients’ need for vaccines and medical prioritization.
Health equity
The pandemic highlighted health disparities in all aspects of kidney care, Palevsky said. Compared with white patients, patients of underrepresented groups are more likely to have CKD progression, be hospitalized and are less likely to receive a transplant. During the pandemic, the inclusion of race in the calculation of eGFR led to questions about the race coefficient. The American Society of Nephrology and NKF confirmed that race is a social construct and called for the immediate replacement of eGFR equations that include race.
According to Palevsky, there has been “rapid uptake” of the updated equation by several health systems, the Department of Veterans Affairs, the Department of Defense and large commercial laboratories. Palevsky called upon attendees to urge their labs to adapt the updated equation into practice.
“But while this is an important step toward social justice, we should not deceive ourselves into thinking that this case alone is sufficient to eliminate the deeply rooted inequity in the diagnosis and treatment of patients with kidney disease,” Palevsky said.
Moving forward
The NKF will be funding two health equity community awards designed to prevent, reduce and eliminate health disparities and advance health equity.
In practice, Palevsky called upon attendees to transition more patients to home dialysis and attempt to achieve a transplantation before the patient needs dialysis.
In regard to policy, Palevsky noted the Living Donor Protection Act has entered Congress and encouraged attendees to call upon their representatives to support it.
Palevsky said, “We must strive for equity for our patients, and we must ensure that kidney disease research is adequately funded so that one day we can say to our patients, ‘No, you will not need to go on dialysis or need a kidney transplant because we can cure your kidney disease.’”
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Palevsky P. NKF presidential address. Presented at: National Kidney Foundation Spring Clinical Meetings; April 5-10, 2022; Boston.
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