Being on hemodialysis during the COVID‐19 outbreak: A mixed‐methods’ study exploring the impacts on dialysis adequacy, analytical data, and patients’ experiences

Abstract

For individuals with end‐stage renal disease (ESRD), the novel coronavirus can present several additional challenges in disease self‐management. This study aimed to explore the impacts of the COVID‐19 pandemic in non‐COVID‐19 patients with ESRD undergoing in‐center hemodialysis (HD). A mixed‐methods study was conducted with a purposive sample recruited from one dialysis unit in Portugal. Quantitative data were collected retrospectively from patients' medical records from February 2020 (T1—before the outbreak) and from April 2020 (T2—during lockdown). Semi‐structured interviews were conducted with 20 patients (66.9 ± 11.9 years old) undergoing HD for an average of 46.1 months (±39.5) in April 2020. Overall results suggested that dialysis adequacy and serum albumin levels decreased significantly at T2, while phosphorus levels increased. The findings from thematic analysis suggested several psychosocial negative impacts and impacts on disease and treatment‐related health behaviors (eg, difficulties managing dietary restrictions during the lockdown and diminished physical activity), which can partially explain these quantitative results. However, some patients were also able to find positive impacts in this experience and problem‐focused and emotional strategies were identified to cope with the demands of COVID‐19. Several recommendations have been made to mitigate patients’ emotional, relational, and educational unmet needs during the current pandemic and in the event of new outbreaks.

Understanding the Impact of Initial COVID-19 Restrictions on Physical Activity, Wellbeing and Quality of Life in Shielding Adults with End-Stage Renal Disease in the United Kingdom Dialysing at Home versus In-Centre and Their Experiences with Telemedicine

“…This was highlighted as being particularly important with individuals from both of our study groups reporting increasingly stressed familial relationships during this time. These findings support recent evidence from Sousa et al [ 56 ], who documented increased stress and anxiety surrounding the COVID-19 virus in an ICHD population in Portugal, with people often suffering in isolation. Similar experiences were captured in the present study, with many reporting feeling that they had lost their freedom and independence.…”

Influence of Officially Ordered Restrictions during the First Wave of COVID-19 Pandemic on Physical Activity and Quality of Life in Patients after Kidney Transplantation in a Telemedicine Based Aftercare Program—A KTx360° Sub Study

“…This constitutes a contrast to previously reported PA reduction in chronically ill populations during the COVID-19 pandemic. Namely, it has been described for patients with Parkinson's [19] and neuromuscular diseases [16], chronic coronary syndrome [20], cystic fibrosis [21], and chronic kidney disease with necessity of hemodialysis [22].…”

Impacts of COVID-19 Pandemic on Psychological Well-Being of Older Chronic Kidney Disease Patients

“…Throughout the COVID-19 epidemic, numerous CKD patients in the early to later phases of kidney disease might have testing arrangements postponed. Failure to detect significant development of CKD has profound implications for both the patient and the community ( Figure 1 ) ( 64 , 91 ).…”