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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