The reliability and success of peritoneal dialysis during the COVID-19 pandemic.

Hasan H Yeter,Galip Guz,Refika Karaer,Mehmet D Ayli,Emre Yasar,Murat Duranay,Ebru Gok Oguz,Omer F Akcay

doi:10.1111/sdi.12940

Abstract

We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID‐19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross‐sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID‐19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ferritin levels significantly elevated at the end of 97 ± 31 days. PTH and phosphorus levels remained stable in remote monitoring automated PD (RM‐APD) group (p = 0.4 and p = 0.5), they tended to increase in continuous ambulatory PD group and significantly increased in automated PD group (p = 0.09 and p = 0.01 for PTH and p = 0.06 and p = 0.001 for phosphorus, respectively). Moderate to severe depression was associated with dyspnoea, weight gain more than 5 kg, fatigue, palpitation and increased anxiety. PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. Also, RM‐APD may be a better choice because of providing more stable bone‐mineral metabolism. Moreover, evaluating depression and anxiety is essential for the accurate clinical assessment.

Highlights

Novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was accepted as a pandemic on 11 March 2020 by the World Health Organization (WHO)[1]
The need for travel thrice weekly to the dialysis center, clustering of patients in dialysis units, and contact of dialysis staff members for more than one patient restricts the physical isolation of hemodialysis patients, which is necessary for protection from the virus
When we compared the peritoneal dialysis (PD) modalities, we found that serum BUN and albumin levels were significantly higher in patients with Continuous ambulatory PD (CAPD) (p=0.002 and p=0.007) at baseline

Summary

Introduction

Novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was accepted as a pandemic on 11 March 2020 by the World Health Organization (WHO)[1]. The disease, which primarily manifests as an acute upper and lower respiratory tract infection, could affect multiple organs and systems, including the heart, intestine, kidneys, blood, and nervous system[1,2]. The patient population with chronic disease was the most affected group by this pandemic. One of these frail groups consisted of patients with end-stage kidney disease (ESRD). Frequency and mortality are detected as 16% and 16.2%, respectively, in this patient population[5]

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