THE IMPLEMENTATION OF NATIONAL DIALYSIS PROTOCOL FOR END-STAGE KIDNEY DISEASE PATIENTS WITH COVID-19 AMONG RENAL UNITS IN WEST JAVA, INDONESIA

Andhika R1, Makmun A1

1Division   of   Nephrology   and   Hypertension,  Department   of   Internal   Medicine,   Faculty   of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia

Aim: We investigated the implementation of our National Dialysis Protocol for End-Stage Kidney Disease (ESKD) patients with COVID-19 in renal unit in West Java, Indonesia.

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pandemic and brought significant challenges to health care systems worldwide. End-stage kidney disease (ESKD) patients on regular hemodialysis are considered to be at high risk for SARS-CoV-2 infection. This special population is vulnerable because they usually have several comorbidities, suppressed immunity, and inevitable frequent visits to the dialysis unit. Specific protocols are essential to prevent COVID-19 transmission among ESKD patients on regular hemodialysis. Indonesian Society of Nephrology has published a National Dialysis Protocol for End-Stage Kidney Disease (ESKD) patients with COVID-19. Ideally, patients with COVID-19 should be dialyze in a separate isolation room with dedicated health care personnel staff. However, it is not frequently achievable in developing countries with limited resources.

Methods: Data was retrospectively collected from Renal Units in West Java, Indonesia, from January 1st, until December 31th, 2020.

Results: The overall prevalence of COVID-19 patients among 86 Renal Units in West Java, Indonesia was 10.1% (1,022/10,127). Only 39.5% (35/86) of all Renal Units used a separate isolation room for dialyzing ESKD patients with COVID-19. While the other 60.5% (52/86) still dialyze in the same room, with specific time and/or place modification. There were 13.9% (12/86) dialysis unit with designated health care personnel staff for COVID-19 patients.

Conclusions: Although specific protocol has been established to prevent COVID-19 transmission among ESKD patients on regular hemodialysis, its implementation in developing country is still a challenge.


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