Impact of <scp>COVID</scp>‐19 on the worsening crisis of chronic kidney disease: the imperative to fund early detection is now

Dwyer, Karen M.; Sum, Caitlin; Johnson, David W.

doi:10.1111/imj.15670

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…A ten-fold increase in mortality rates was observed in patients with chronic kidney disease (CKD) and COVID-19 compared with CKD patients without COVID-19. The higher exposure rates to healthcare facilities in patients undergoing maintenance dialysis treatment is a potential factor contributing to the higher incidence of COVID-19 infections in these patients [63]. A study by Chen et al focused on identifying the higher-risk comorbidities and fragile populations among Omicron patients, who were hospitalized.…”

Section: Renal Diseasesmentioning

confidence: 99%

A Review on the Impact of the SARS-CoV-2 Omicron Subvariant on Elderly Patients with Diverse Co-Morbidities

et al. 2023

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The SARS-CoV-2 virus has caused a catastrophic impact on the world for the past 3 years. The virus has now returned with the emergence of the Omicron (B.1.1.529) variant. Within two months of its first emergence in South Africa, Omicron became the most dominating SARS-CoV-2 variant around the world, being the cause of the majority of new infections at present. Omicron has presented with the greatest transmission rate of all the previous variants despite the presence of mass vaccinations and acquired immunity. Several monoclonal antibodies and mRNA vaccines have failed to produce desired effects owing to a large number of mutations present in the Omicron variant. The introduction of the booster dose of the present mRNA vaccines has proven to be a great addition to the therapeutic armamentarium against the Omicron variant. Immunocompromised patients including the elderly, cancer patients, organ transplant recipients, and those with multiple comorbidities have been at a greater risk of developing severe diseases since the pre-Omicron era. The emergence of Omicron again raised a threat against this population. The protection from severe disease and mortality rates through the utilization of multiple immunizations and monoclonal antibodies has been controversial in this subgroup of patients. Thus, designing large-scale studies to evaluate the effectiveness of monoclonal antibodies and vaccines in these patients can provide evidence-based recommendations to improve survival in this population. This article attempts to discuss the different subvariants of Omicron, differences in the mutational aspects along with the particular focus on the consequences of the Omicron infection in the elderly population with diverse comorbidities.

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Section: Renal Diseasesmentioning

confidence: 99%

A Review on the Impact of the SARS-CoV-2 Omicron Subvariant on Elderly Patients with Diverse Co-Morbidities

et al. 2023

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Older patients and dialysis shared decision-making. Insights from an ethnographic discourse analysis of interviews and clinical interactions

Dahm,

Raine,

Slade

et al. 2024

Patient Education and Counseling

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Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients

Dahm,

Raine,

Slade

et al. 2023

BMC Nephrol

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Background Effective interpersonal communication is critical for shared decision-making (SDM). Previous SDM communication training in nephrology has lacked context-specific evidence from ethnographic analysis of SDM interactions with older patients considering treatment options of end stage kidney disease (ESKD). This study explores communication strategies in SDM discussions in nephrology, specifically focusing on older patients considering dialysis as kidney replacement therapy (KRT). Methods We conducted a qualitative study analysing naturally-occurring audio-recorded clinical interactions (n = 12) between Australian kidney doctors, patients aged 60+, and carers. Linguistic ethnography and qualitative socially-oriented functional approaches were used for analysis. Results Two types of communication strategies emerged: (1) Managing and advancing treatment decisions: involving active checking of knowledge, clear explanations of options, and local issue resolution. (2) Pulling back: Deferring or delaying decisions through mixed messaging. Specifically for non-English speaking patients, pulling back was further characterised by communication challenges deferring decision-making including ineffective issue management, and reliance on family as interpreters. Age was not an explicit topic of discussion among participants when it came to making decisions about KRT but was highly relevant to treatment decision-making. Doctors appeared reluctant to broach non-dialysis conservative management, even when it appears clinically appropriate. Conservative care, an alternative to KRT suitable for older patients with co-morbidities, was only explicitly discussed when prompted by patients or carers. Conclusions The findings highlight the impact of different communication strategies on SDM discussions in nephrology. This study calls for linguistic-informed contextualised communication training and provides foundational evidence for nephrology-specific communication skills training in SDM for KRT among older patients. There is urgent need for doctors to become confident and competent in discussing non-dialysis conservative management. Further international research should explore naturally-occurring SDM interactions in nephrology with other vulnerable groups to enhance evidence and training integration.

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Impact of COVID‐19 on the worsening crisis of chronic kidney disease: the imperative to fund early detection is now

Cited by 3 publications

References 16 publications

A Review on the Impact of the SARS-CoV-2 Omicron Subvariant on Elderly Patients with Diverse Co-Morbidities

A Review on the Impact of the SARS-CoV-2 Omicron Subvariant on Elderly Patients with Diverse Co-Morbidities

Older patients and dialysis shared decision-making. Insights from an ethnographic discourse analysis of interviews and clinical interactions

Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients

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