Abstract
ABSTRACTIntroduction The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic.Methods Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed.Results We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil.Discussion Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.
Highlights
IntroductionThe pandemic involving the new coronavirus SARS-CoV-2 and its clinical manifestations (COVID19) to the World Health Organization recommending procedures in order to limit the spread as well as minimize the sudden and increasing lethality in distinct population groups
The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, in renal replacement therapies (RRT)
In Brazil, different profiles of children with chronic kidney disease (CKD) were described by Konstantiner et al[1] (2015) emphasizing that areas with lower social and economic indexes have unsatisfactory access to medical facilities, which is corroborated by a higher proportion of patients with undefined etiology for CKD in such areas
Summary
The pandemic involving the new coronavirus SARS-CoV-2 and its clinical manifestations (COVID19) to the World Health Organization recommending procedures in order to limit the spread as well as minimize the sudden and increasing lethality in distinct population groups. The Department of Pediatric Nephrology of the Brazilian Society of Nephrology (SBN in Portuguese) prepared this manuscript regarding recommendations for children and adolescents with kidney diseases and their respective families to mitigate the risk of acquiring and spreading the disease in Brazil. The Brazilian Society of Nephrology is the main medical society involved in the care of this pediatric population on dialysis and nephrology care. The present article summarizes the main recommendations for specific care and management of children and adolescents with chronic kidney disease, dialysis, transplantation, and under immunosuppression during the COVID-19 pandemic. The care for pediatric patients involves many family and social aspects that should be considered by the Nephrology Center, which, in turn, must be a center for continuing education regarding knowledge in all aspects of the COVID-19 pandemic, including isolation, prevention, and waste disposal at home
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