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Submitted: 15 Feb 2022
Accepted: 18 May 2022
ePublished: 31 May 2022
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J Renal Inj Prev. 2023;12(4): e32027.
doi: 10.34172/jrip.2022.32027

Scopus ID: 85174690102
  Abstract View: 1076
  PDF Download: 441

Original

Dialysis practices during the COVID-19 pandemic: a survey from India

Pallavi Prasad 1* ORCID logo, Elumalai Ramprasad 2 ORCID logo, Matcha Jayakumar 2 ORCID logo

1 Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2 Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
*Corresponding Author: Pallavi Prasad, Email: pallaviprasad1986@gmail.com

Abstract

Introduction: The COVID-19 pandemic has been a challenging time for dialysis units worldwide. Nephrologists are faced with the difficult task of providing renal replacement therapy to COVID-19 patients and simultaneously prevent spread of COVID-19 in dialysis units.

Objectives: We aimed to study the dialysis practices being followed during the COVID-19 pandemic.

Patients and Methods: A questionnaire assessing treatment and preventive practices being followed in dialysis units during the COVID-19 pandemic was emailed to nephrologists and nephrology trainees practising in India. Responses were recorded electronically.

Results: We received 173 valid responses. About 83.2% nephrologists were providing dialysis for COVID-19. Hemodialysis/slow low-efficient dialysis was the most common modality (65.2%) of renal replacement therapy (RRT) in COVID-19 acute kidney injury. In dialysis patients with suspicious symptoms, most common test to rule out COVID-19 was RT-PCR (reverse transcriptase polymerase chain reaction) + chest imaging ( 42.2%) followed by RT-PCR alone (34.1%). Around 80.9% nephrologists sought a negative RT-PCR in patients who had recovered from COVID-19 before discontinuation of isolation measures. Adherence to COVID-19 preventive measures varied between 15.2% (portable reverse osmosis disinfection) to 97.1% (mask wearing). Healthcare worker (HCW) training programme was present in 88.4% cases, paid leaves for COVID-19 in 89% and daily HCW symptom screen in 65.3%. The most frequently identified barrier to chronic kidney disease care was a delay in transplantation (66.5%). Accordingly, 20.8% reported a temporary closure of dialysis unit due to COVID-19 outbreak. Moreover, 63% of nephrologists counseled patients to choose peritoneal dialysis above hemodialysis as permanent RRT.

Conclusion: Hemodialysis/slow low efficient dialysis is the preferred modality of RRT in COVID 19-AKI. Many nephrologists are counseling for peritoneal dialysis as superior to hemodialysis during COVID-19 for maintenance RRT. Preventive measure adherence is variable across centers. HCW safety has been addressed in most centers.


Implication for health policy/practice/research/medical education:

This study was conducted to evaluate the practices being followed in dialysis units across the country to prevent spread of COVID-19 and to assess the compliance to guidelines for such prevention in dialysis units.

Please cite this paper as: Prasad P, Ramprasad E, Jayakumar M. Dialysis practices during the COVID-19 pandemic: a survey from India. J Renal Inj Prev. 2023; 12(4): e32027. doi: 10.34172/jrip.2022.32027.

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