In connection with the prevailing coronavirus pandemic, Prof. dr hab. Ryszard Gellert, a national consultant in the field of nephrology, out of concern for the welfare and health of both doctors and patients with chronic kidney disease, has prepared special recommendations for the care of patients treated with peritoneal dialysis.
We remind you that dialysis is a life-saving procedure. If for medical reasons it is indicated to start dialysis during this period, this cannot be postponed. Due to the CODIV-19 epidemic, particular consideration should be given to initiating peritoneal dialysis, which will allow the patient to undergo home dialysis and reduce the number of hospital visits.
The first step in this case is to insert the catheter by the surgeon. A short stay in hospital is therefore required. This should not be a barrier, however, as the benefits of home dialysis are not to be underestimated. The benefits should be weighed against the risks in this case. Patients with COVID19 and in quarantine will receive treatment.
Recommendations (selected recommendations from the national consultant’s communication):
• Visits to the peritoneal dialysis center / hospital should be limited to emergency cases (eg suspected peritonitis, severe catheter orifice).
• Patients and their families should communicate with dialysis center staff primarily by means of ICT.
• I recommend that you frequently contact patients remotely in order to recognize their health problems early and treat them appropriately. Remote monitoring of patients appears to be a particularly advantageous method of managing peritoneal dialysis patients in large peritoneal dialysis centers.
• Peritoneal dialysis can be an excellent alternative to hemodialysis. Much of the patient and caregiver training can be performed remotely, and peritoneal catheter placement can be performed in accordance with required procedures, including testing the patient for the presence of SARS-Cov-2 genetic material.
• The management of COVID-19 infection in peritoneal dialysis patients is the same as for all other dialysis patients.
• Establish a rapid, one-way flow of people and procedures during the center visit, including completion of clinical questionnaires, examination of the external catheter outlet, medical consultation and adjustment of further treatment recommendations along with prescribing / dispensing medications
Developed for medical personnel of dialysis centers, “Special recommendations for the care of patients treated with peritoneal dialysis” were developed to improve and provide care for dialysis patients during epidemics. We must remember that both patients with confirmed COVID-19 and those in quarantine still need to be treated. The most important thing is to ensure the continuity of therapy, while maintaining maximum safety and protection for medical personnel.
In the communiqué, I recommend, first and foremost, that dialysis patients stay at home. There are centers that use remote monitoring of patients treated at home and this is currently a particularly advantageous method of therapeutic management, both for doctors and patients. Frequent, but remote contact of dialysis station personnel with patients will also allow to identify possible health problems earlier and develop a therapeutic strategy – informs prof. Ryszard Gellert, national consultant in the field of nephrology.
Due to the current situation and the need to self-isolate, home peritoneal dialysis should be the method of choice for a certain group of patients. The use of this method is for the benefit of the patient who protects his health, but also for the benefit of dialysis stations, which are today even more overcrowded due to the reorganization of healthcare facilities related to the coronavirus pandemic. Peritoneal dialysis is the preferred choice for patients who are self-service and have the potential to learn dialysis quickly.
Of course, home dialysis can be offered by facilities that have constant contact with the patient through telemetry systems or that have constant 24-hour nursing care. Thanks to this, while staying at home, patients can contact the dialysis center and consult medical staff in case of any doubts. I believe that, as nephrologists, we should make every effort to ensure that in times of a pandemic, as many patients as possible could benefit from peritoneal dialysis as a method of dialysis therapy – prof. Beata Naumnik, voivodship nephrology consultant, Head of the First Clinic of Nephrology and Transplantology with the Dialysis Center.
Help fight the virus and share information with others. Together we can do more!