DIALYSIS PRACTICES DURING THE COVID -19 PANDEMIC: A SURVEY FROM INDIA

Abstract

INTRODUCTION: We aimed to study the practices being followed in dialysis units across the country during the COVID-19 pandemic. METHODS: A questionnaire assessing treatment and preventive practices being followed in dialysis units during the COVID-19 pandemic was emailed to nephrologists and nephrology trainees practising in India. Responses were recorded electronically. RESULTS: We received 173 valid responses. 83.2% nephrologists were providing dialysis for COVID-19. Hemodialysis/Slow low efficient dialysis was the most common modality (65.2%) of renal replacement therapy (RRT) in COVID-19 acute kidney injury. In dialysis patients with suspicious symptoms, most common test to rule out COVID-19 was RTPCR(reverse transcriptase polymerase chain reaction) +chest imaging ( 42.2%)followed by RT-PCR alone (34.1%). 80.9% nephrologists sought a negative RT-PCR in patients who had recovered from COVID-19 before discontinuation of isolation measures. Adherence to COVID-19 preventive measures varied between 15.2% (portable reverse osmosis disinfection) to 97.1% (mask wearing). Healthcare worker (HCW) training programme was present in 88.4% cases, paid leaves for COVID-19 in 89% and daily HCW symptom screen in 65.3%. The most frequently identified barrier to chronic kidney disease care was a delay in transplantation (66.5%).20.8% reported a temporary closure of dialysis unit due to COVID-19 outbreak. 63% nephrologists counseled patients to choose peritoneal dialysis above hemodialysis as permanent RRT. CONCLUSION: Hemodialysis/SLED is the preferred modality of RRT in COVID 19-AKI.Many nephrologists are counseling for peritoneal dialysis as superior to hemodialysis during COVID-19 for maintenance RRT. Preventive measure adherence is variable across centres. Healthcare worker safety has been addressed in most centres.