Kidney International Reports, Journal Year: 2022, Volume and Issue: 7(10), P. 2119 - 2121

Published: Aug. 3, 2022

See Clinical Research on Page 2196 Since the World Health Organization announced emergence of several cases pneumonia in Wuhan City, Hubei Province, China, a debate efficiency health care systems has captured attention broad audience worldwide. Early reports COVID-19 infection focused much immediate febrile respiratory symptoms. Further developments revealed complex multisystem disease with wide range clinical manifestations. Therefore, initially, few could foresee changes pandemic would impose kidney globally.1Zhu N. Zhang D. Wang W. et al.A novel coronavirus from patients 2019.N Engl J Med. 2020; 382: 727-733https://doi.org/10.1056/NEJMoa2001017Crossref PubMed Scopus (17405) Google Scholar With numerous countries instituting nationwide lockdowns, many individuals became suddenly deprived elective primary and specialized assistance, thus imposing great burden those uncontrolled comorbidities. Patients chronic were particularly vulnerable presenting an increased risk for progression to later stages disease, hospitalization, mortality. Among hospitalized patients, pathophysiology hypotheses speculated trying uncover causes high incidence acute injury. In this context, one most impactful chapters be written by need renal replacement therapy (RRT).2Hilbrands L.B. Duivenvoorden R. Vart P. al.COVID-19-related mortality transplant dialysis patients: results ERACODA collaboration.Nephrol Dial Transplant. 35: 1973-1983https://doi.org/10.1093/ndt/gfaa261Crossref (264) Scholar,3Duivenvoorden Noordzij M. al.Clinical, functional, mental outcomes recipients 3 months after diagnosis COVID-19.Transplantation. 2022; 106: 1012-1023https://doi.org/10.1097/TP.0000000000004075Crossref (5) Changes major social economic determinants led global shift morbidity noncommunicable diseases. Though diseases are currently believed affect about 850 million people worldwide, these lack access proper prevention, detection, or treatment strategies.4Jager K.J. Kovesdy C. Langham Rosenberg Jha V. Zoccali A single number advocacy communication—worldwide more than have diseases.Kidney Int. 2019; 96: 1048-1050https://doi.org/10.1016/j.kint.2019.07.012Abstract Full Text PDF (181) Consequently, systems, which already challenged increase RRT, further confronted effects pandemic. The additional increments either due rate injury at intensive units resulting exposed worldwide fragilities preventing, detecting, treating diseases.5Soares dos Santos Junior A.C. Brazil pandemic.Kidney Int Rep. 2021; 6: 2017-2018https://doi.org/10.1016/j.ekir.2021.06.021Abstract To better understand how shaped globally, Dialysis Outcomes Practice Patterns Study (DOPPS) International Society Nephrology (ISN) collaborated unprecedented venture, surveyed centers across globe, Figure 1. Using combination sampling approaches, guaranteeing anonymized reporting, DOPPS ISN collaboration effort 78 all 10 regions (Africa, Eastern Central Europe, Western Middle East, Newly Independent States Russia, Northeast Asia, South Southeast Asia Oceania, North America Caribbean, Latin America). effect hemodialysis (HD) was depicted Aylward al.6Aylward Bieber B. Guedes al.The impact in-center services: ISN-dialysis practice patterns study survey.Kidney 7: 397-409https://doi.org/10.1016/j.ekir.2021.12.011Abstract (11) surveyed, especially Africa (37%) (33%), diagnostic testing not widely available. Limited might explain why isolation policies difficult implement reduce spread SARS-CoV-2 infection. availability personal protective equipment nephrology workforce also concern. Personal shortages commonly reported only demand but because interruptions supply chains. Some half their staff being infected SARS-CoV-2, resulted overload, places where capacity provide RRT its limit. Globally, 29% respondents redeployment center other areas during Overall, wellbeing services made available 48% HD centers. Because procedures suspended locations, transplantation seriously affected. inequities delivery pandemic, developed Tannor al.7Tannor E.K. identifies significant low lower-middle income countries—an ISN/DOPPS 971-982https://doi.org/10.1016/j.ekir.2022.02.027Abstract (12) Access effective sustainable remains highly unbalanced reflecting fact that is still priority countries. Socioeconomic factors analyzed emphasis provided regions, low-income (LICs) lower-middle-income (LMICs). Data comparing LICs/LMICs upper-middle-income high-income suggested imbalances become even worse authors higher missed sessions among living LICs LMICs. Similarly, unit mechanical ventilation reportedly limited identified as critical issues During peritoneal (PD) method renewed special interest. it conceptually home-based therapy, suspected confirmed isolated home without occupying ward dialysis. addition, compared HD, patients' chances getting into contact going facilities reduced, thereby minimizing These benefits counterbalanced monitoring strategy. paper published issue KI Reports, Albakr al.8Albakr R.B. R.E. al.An ISN-DOPPS survey 2019 services.Clin Res. 2196-2206https://doi.org/10.1016/j.ekir.2022.07.013Abstract (4) describe introduced challenges related PD routine patient care. study, Peritoneal (PDOPPS) administered web-based 165 51 disruptions Asia. use masks, occurred routinely exchanges, reinforced throughout Reductions laparoscopic surgical catheters 9 whereas nonsurgical percutaneous 6 regions. Surprisingly, training new declined each region. Increased remote technology communicate clinics observed prepandemic levels. Measuring, important steps toward rapidly improving generating value regard, publications greatly contributed understanding providing evidence deficiencies resource allocation, infrastructure, human resources. able capture variation rates who, under pressure, lacked psychological support. Striking disproportionally affecting LLMICs. This mismatch between medical resources echoed current dominant model ineffective chains fragmented validated measuring wrong things way.9Porter M.E. What care?.N 2010; 363: 2477-2481https://doi.org/10.1056/NEJMp1011024Crossref (3480) conclusion, benchmark, pointing out clear opportunities governments policymakers should focus efforts improve Reaching sustainable, equitable high-value environment must overarching goal ecosystem. achieve this, investments locally produced supplies vital, Telemedicine modes communication larger scale fostered leverage improvements RRT. Providing education seen part strategic plan offer integrated Taken together constitute some key ingredients building filling gaps globally. author declared no conflicts Pandemic Identifies Significant Global Inequities Hemodialysis Care Low Lower-Middle Income Countries—An SurveyKidney ReportsVol. 7Issue 5PreviewIt unknown affected (LLMICs). We aimed identify Full-Text Open AccessAn Survey Impact ServicesKidney 10PreviewHome may minimize SARS-CoV2 exposure risks center-based explored availability, care, facility practices changed time. AccessThe In-Center Services: An ISN-Dialysis 3PreviewTo assess centers, web-survey AccessCardiovascular Kidney Transplant Recipients ADPKDKidney 9PreviewCardiovascular leads failure. Autosomal Dominant Polycystic Disease (ADPKD) systemic various cardiac abnormalities. Details cardiovascular profile ADPKD who undergoing (KT) limited.

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