Anxiety and depression were also common among Chinese PD patients. Those in HSG were more likely to develop PD peritonitis. These psychological symptoms deserved early detection. Further studies are needed to investigate whether intervention can improve the clinical outcome of these patients.
Background
Coronavirus disease 2019 (COVID-19) pandemic has put an enormous burden on healthcare systems worldwide. Limited access to medical care and fear of increased infective risks due to the use of immunosuppressive medication (IM) have increased concerns about IM adherence in kidney transplant recipients (KTR). The aim of this study is to determine the various dimensions of IM non-adherence in KTR during the COVID-19 pandemic.
Methods
This was a single-center, cross-sectional study using a convenient sampling approach. KTR with follow-up in Queen Elizabeth Hospital, Hong Kong between 1st May 2020 and 30th September 2020 were invited to complete a self-reported questionnaire on IM adherence. The sociodemographic factors associated with IM adherence were extracted from medical record.
Results
Total 210 patients completed the questionnaires. The overall IM non-adherence rate was 35.2% in the preceding 4 weeks. None of the patients stopped taking IM without doctors’ instructions. The most common pattern of IM non-adherence was timing adherence (n=63, 30.1%), followed by dose-skipping item. Among the different sociodemographic factors studied, only marital status was an independent risk factor of IM non-adherence (OR: 1.97, 95% CI: 1.04-3.72, P=0.03).
Conclusion
The impact of COVID-19 on IM adherence in KTR was small. All the patients continued their IM despite of the pandemic. Good family support can have a positive influence on treatment adherence in KTR during the COVID-19 pandemic.
Heparin-induced thrombocytopenia (HIT) is a potentially fatal clinical condition which can develop after exposure to unfractionated or low-molecular-weight heparins. Even small doses of heparin such as heparin flushes in hemodialysis catheter can induce the development of HIT. However, the true incidence of heparin lock-related HIT is unknown. We report a 58-year-old woman with acute kidney injury because of obstructive uropathy who developed HIT after heparin-free hemodialysis. She was found to have severe thrombocytopenia with deep vein thrombosis of left lower limb and arterial thrombosis of the right anterior and middle cerebral arteries. The heparin-platelet factor 4 antibody was positive and she was put on plasmapharesis. However, her condition further deteriorated and succumbed shortly. Heparin lock solution in the hemodialysis catheter was believed to be the cause of HIT in our patient.
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