COVID-19 and dialysis: why we should be worried

Rombolà, Giuseppe; Brunini, Francesca

doi:10.1007/s40620-020-00737-w

Cited by 55 publications

(77 citation statements)

References 11 publications

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“…Patients with kidney disease, especially those receiving chronic dialysis treatment have enhanced risk of severe COVID-19 infection-related complications and poor prognosis including higher risk of hospitalization, intensive-care unit admission, mechanical ventilation, and death. [1,2] In addition to these direct effects, the pandemic may have indirect effects on the psychosocial health of patients on in-center chronic hemodialysis (HD), even if they are not infected with COVID-19. These effects may be particularly overwhelming in a patient population that already has a disproportionately high burden of symptoms such as depression and anxiety.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Impact of COVID-19 Pandemic on Patients with End-Stage Kidney Disease on Hemodialysis

et al. 2020

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Background: The Coronavirus Disease 2019 (COVID-19) may have a negative effect on the mental and social health of patients with end-stage kidney disease on chronic in-center hemodialysis (HD), who have a high burden of psychological symptoms at baseline and unavoidable treatment-related COVID exposures. The goal of our study was to assess the impact of the COVID-19 pandemic on the psychosocial health of patients on chronic in-center HD. Methods: Participants enrolled in the ongoing Technology Assisted Collaborative Care (TĀCcare) trial in Western Pennsylvania and New Mexico were approached for participation in a phone survey in May 2020. Data on the pandemic's effect on participants' physical and mental health, symptoms (such as anxiety, mood, loneliness, sleep and stress), food and housing security was collected. Results: Surveys were completed by 49 participants (mean age 56 years, 53% males, 18% African American, 20% American Indian, 22% Hispanic). Almost 80% of participants reported being moderately-to-extremely worried about the pandemic's effect on their mental/emotional health and interpersonal relationships. More than 85% of the participants were worried about obtaining their dialysis treatments due to infection risk from close contact in the dialysis facility or during transportation. Despite this, 82% of participants reported being not at all/slightly interested in trying home dialysis as an alternative option. Overall, 27% of the participants had clinical levels of depressive symptoms but only 12% had anxiety meeting clinical criteria. About 33% of participants reported poor sleep quality over the last month. Perceived stress was high in about 30% of participants and 85% felt overwhelmed by difficulties with COVID-19, although 41% felt that things were fairly/very often going their way. Conclusions: Our study provides preliminary insights into the psychosocial distress caused by the COVID-19 pandemic among a diverse cohort of patients receiving chronic hemodialysis who are participating in an ongoing clinical trial.

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Section: Introductionmentioning

confidence: 99%

Psychosocial Impact of COVID-19 Pandemic on Patients with End-Stage Kidney Disease on Hemodialysis

et al. 2020

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“…As expected in patients with such high ferritin values, the mortality rate was high.Of interest, we noticed that 6 of the 22 patients were on HD prior to diagnosis. Renal disease is a risk factor for poorer COVID-19 outcomes24 ; it is unclear how HD might impact the inflammatory environment. Additionally, the higher ferritin values were likely not solely driven by SARS-CoV-2 infection, as 15 of the patients had…”

mentioning

confidence: 99%

Ferritin levels in patients with COVID‐19: A poor predictor of mortality and hemophagocytic lymphohistiocytosis

Feld

Tremblay

Thibaud

et al. 2020

Int J Lab Hematology

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Introduction: A hyperinflammatory environment has been a hallmark of COVID-19 infection and is thought to be a key mediator of morbidity. Elevated ferritin has been observed in many patients with COVID-19. Several retrospective studies have shown ferritin levels can be correlated and predictive of poor outcomes in COVID-19, though a rigorous analysis has been lacking. Methods: A retrospective analysis of 942 adult COVID-19 patients admitted in March 2020 at a large New York City health system with available ferritin levels.

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“…Additionally, the need for travel thrice weekly to the dialysis center, clustering of patients in dialysis units, and contact of dialysis staff members for more than one patient also restricts the physical isolation of hemodialysis patients, which is necessary for protection from the virus. Hereby, frequency and mortality are detected as 16% and 16.2%, respectively, in this patient population 5 .…”

Section: Introductionmentioning

confidence: 58%

“…These limitations combined with older age, impaired immune system, and multiple comorbid conditions resulted in increased mortality. In the literature, the mortality rate of patients with maintenance center hemodialysis due to COVID-19 was reported to be between 16% and 30% 4,5 .…”

Section: Discussionmentioning

confidence: 99%

The reliability and success of peritoneal dialysis during the COVID-19 pandemic

Yeter

Oğuz

Akcay

et al. 2020

Preprint

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Aim: This study aimed to evaluate the symptoms, changes in laboratory findings during the COVID-19 pandemic, and the effect of depression on symptoms associated with end-stage kidney disease in patients with peritoneal dialysis (PD).Methods: This was an observational and cross-sectional study. The patients underwent three different PD modalities, including continuous ambulatory PD, automated peritoneal dialysis, and remote monitoring automated peritoneal dialysis (RM-APD). All patients were asked to complete the clinical assessment form and Beck depression and anxiety inventory. Additionally, the last two laboratory evaluations during this period were examined.Results: A total of 123 patients undergoing PD were included. None of the patients were diagnosed with COVID-19 infection. Serum ferritin, creatinine, phosphorus, albumin and parathyroid hormone levels were significantly elevated in the total study population (p=0.03, p=0.01, p=0.02, p=0.02 and p=0.05, respectively). While calcium, phosphorus, and parathyroid hormone tended to increase in patients with APD or CAPD, they remained stable in patients performing RM-APD. Most of the patients did not experience dyspnea, pitting edema, difficulty in blood pressure control, palpitation, bone muscle pain, or peritonitis. Moderate to severe depression was associated with dyspnea, weight gain, fatigue, palpitation, and increased anxiety.Conclusion: PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. PD is a safe method of renal replacement therapy to protect patients from COVID-19 infection. Additionally, RM-APD may be a better choice because it provides more stable bone mineral metabolism. Moreover, evaluating depression and anxiety at phone visits may be necessary for accurate clinical assessment.

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COVID-19 and dialysis: why we should be worried

Abstract: Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Cited by 55 publications

References 11 publications

Psychosocial Impact of COVID-19 Pandemic on Patients with End-Stage Kidney Disease on Hemodialysis

Psychosocial Impact of COVID-19 Pandemic on Patients with End-Stage Kidney Disease on Hemodialysis

Ferritin levels in patients with COVID‐19: A poor predictor of mortality and hemophagocytic lymphohistiocytosis

The reliability and success of peritoneal dialysis during the COVID-19 pandemic

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