Abstract:
BACKGROUND:Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients. METHODS:Dialysis unit nephrologists identified 166 suitable patients (38.4% of our HD population) to temporarily convert to twice-weekly haemodialysis immediately prior to the peak of the COVID-19 pandemic in our area. Changes in pre-dialysis weight, systolic blood pressure (SBP) and biochemistry were recorded weekly throughout the 4-week project. Hyperkalaemic patients (serum potassium > 6.0 mmol/L) were treated with a potassium binder, sodium bicarbonate and received responsive dietary advice. RESULTS:There were 12 deaths (5 due to COVID-19) in the HD population, 6 of which were in the twice weekly HD group; no deaths were definitively associated with change of dialysis protocol. A further 19 patients were either hospitalised and/or developed COVID-19 and thus transferred back to thrice weekly dialysis as per protocol. 113 (68.1%) were still receiving twice-weekly HD by the end of the 4-week project. Indications for transfer back to thrice weekly were; fluid overload (19), persistent hyperkalaemia (4), patient request (4) and compliance (1). There were statistically significant increases in SBP and pre-dialysis potassium during the project. CONCLUSIONS:Short term conversion of a large but selected HD population to twice-weekly dialysis sessions was possible and safe. This approach could help mitigate COVID-19 transmission amongst dialysis patients in centres with similar organisational pressures.
journal_name
BMC Nephroljournal_title
BMC nephrologyauthors
Lodge MDS,Abeygunaratne T,Alderson H,Ali I,Brown N,Chrysochou C,Donne R,Erekosima I,Evans P,Flanagan E,Gray S,Green D,Hegarty J,Hyde A,Kalra PA,Lamerton E,Lewis D,Middleton R,New D,Nipah R,O'Donoghue D,O'Riordandoi
10.1186/s12882-020-02172-2subject
Has Abstractpub_date
2020-12-07 00:00:00pages
532issue
1issn
1471-2369pii
10.1186/s12882-020-02172-2journal_volume
21pub_type
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