Clinicians review home dialysis, other interventions for US patients with CKD, COVID-19
The COVID-19 pandemic poses health risks for patients on chronic dialysis. With nearly 88% of these patients on in-center hemodialysis, managing risk for contracting or spreading the virus has been a challenge, according to a press release.
Numerous approaches have limited risks of SARS-CoV-2 infection, including cohorting patients to separate shifts or clinics, distancing patients during hemodialysis treatments and, in at least some cases, reducing total dialysis time per week.
According to the Dialysis Outcomes and Practice Patterns Study (DOPPS) release, another option can be to increase utilization of home-based dialysis therapies. A recent COVID-19 webinar featuring DOPPS investigators from 15 countries in Asia, Europe, the Middle East and the Americas indicated a consistent observation of higher rates of SARS-CoV-2 infection occurring within patients on in-center hemodialysis vs. those on home-based peritoneal dialysis (PD), with mortality rates in the range of 10% to 30% overall for patients on dialysis infected with SARS-Cov-2. In view of the observed lower SARS-Cov-2 infection rates among patients on home-based PD, increasing utilization of home dialysis when feasible would appear to substantially reduce risks for patients on dialysis. However, the release noted, the extent to which such changes have been implemented, and any effects of potentially rapid changes in modality use on clinical outcomes, have not been well-described on a national level as data thus far are limited.
In view of the many challenges posed by the COVID-19 pandemic for the dialysis community, the DOPPS Program will be hosting a roundtable discussion webinar on Thursday, July 2, entitled: “COVID-19 and chronic dialysis in the US: What’s happened so far and what’s next? An open conversation.” Registration is available at https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1326960&tp_key=f6048ed22.)
The roundtable discussion brings together experienced nephrologists, dialysis nurses and patients from recent COVID-19 hotspots to discuss challenges and recommendations in the face now of surging cases nationally. The range of potential topics will be broad, spanning both in-center and home dialysis.
The panel discussion will be moderated by Jeff Perl, MD, of the University of Toronto, Canada, and will include Laurie Amburn, RN, and Kathy Bernardelli, RN, (Henry Ford Hospital, Detroit); Jayson Hood, RN, (Northwest Kidney Centers, Seattle), hemodialysis patient Mark Johnson, Rachel Perlman, MD, (University of Michigan, Ann Arbor, Mich.), Vesh Srivatana, MD, (Rogosin Institute, New York), Suzanne Watnick, MD, (Northwest Kidney Centers, Seattle) and Jerry Yee, MD, (Henry Ford Hospital, Detroit).