Friday, April 17, 2020

Covid-19, kidney failure, and dialysis

Corona virus and kidney failure are a bad combination, whichever way you look at it. On the one hand, Covid-19 is causing kidney failure. On the other, if you are already on dialysis, you are exposed to Covid-19 infection whenever you go to spend a few hours at a crowded dialysis clinic.

Frank McCormick points me to this story from Politico:
U.S. races to stock up on dialysis supplies as kidney failure ravages virus patients
Approximately 20 percent of coronavirus patients in intensive care around the city need the kidney treatment, often for weeks.

"Hospitals in New York City are running out of dialysis fluids as thousands of coronavirus patients develop kidney failure, an unexpected development that could presage the next critical supply shortage nationwide.

"Approximately 20 percent of coronavirus patients in intensive care around the city need the kidney treatment, often for weeks, a development that many providers did not see coming. FEMA held a call Monday with FDA and CMS to discuss the possibility of issuing emergency use authorizations to import more dialysis fluids, according to a document obtained by POLITICO.
...
"Gov. Andrew Cuomo recently said that New York’s ventilator needs are beginning to plateau, and he has begun diverting the equipment to states in greater need. But hospital staff say that the extended nature of dialysis treatment means that shortages of fluids, trained personnel and even equipment there could just be starting."
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And here's a NY Times story on dialysis patients and clinics:

 Dialysis Patients Face Close-Up Risk From Coronavirus
As the pandemic sweeps the United States, patients needing kidney dialysis and employees of the clinics worry about keeping the virus at bay in such tight spaces.

"As the coronavirus rages from state to state, the 500,000 people whose failing kidneys require them to get dialysis are among the most vulnerable. Each clinic may have dozens of patients during a single shift, often sitting less than the recommended six feet apart for hours.
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"Infection has traditionally been one of the industry’s biggest problems.

“The second leading cause of death among hemodialysis patients is infections,” said Dr. Alan Kliger, a Yale nephrologist who is leading efforts to control the spread of coronavirus among dialysis patients. As many as one in 10 patients die from complications from an infection, often at the site where a patient has a catheter.


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