Home dialysis trend grows amid pandemic

Via @InquirerUSA Home dialysis trend grows amid pandemic

9/24/2020 1:29:00 AM

Via InquirerUSA Home dialysis trend grows amid pandemic

NIPOMO, California — After Maria Duenas was diagnosed with Type 2 diabetes about a decade ago, she managed the disease with diet and medication. But Duenas’ kidneys started to fail just as the novel coronavirus established its lethal foothold in the U.S. On March 19, three days after Duenas, 60, was rushed to the emergency …

of them travel to a clinic for their treatments.Dialysis patients are at higher risk of contracting Covid-19 and getting seriously ill with it, said Dr. Anjay Rastogi, director of the UCLA CORE Kidney Program, where Duenas is a patient.In an analysis of more than 10,000 deaths in 15 states and New York City, the Centers for Disease Control and Prevention found about

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40% of peoplekilled by Covid -19 had diabetes. That percentage rose to half among people under 65.But people on dialysis are also vulnerable to Covid -19 because they usually visit dialysis clinics two to three times a week for an average of four hours at a time, exposing themselves to other patients and, potentially, the virus, Rastogi said.

“Now even more so, we are strongly urging our patients to consider home dialysis,” he said.Although patients on home dialysis reduce their exposure to COVID-19 by avoiding clinics, they face other challenges. Home dialysis requires supplies such as dialysis fluid, drain bags, tubing, disinfectant and personal protective equipment. According to a recent study, patients may have problems obtaining dialysis supplies because supply chains are strained.

(Heidi de Marco/California Healthline)Duenas uses her bedroom mirror to make sure her catheter is properly covered with gauze before she goes to bed. She will be tethered to the machine overnight.(Heidi de Marco/California Healthline)hemodialysis, which is administered in a hospital or clinic, or sometimes at home, a dialysis machine pumps blood out of the body and through a special filter called a dialyzer, which clears waste and extra fluid from the blood before it is returned to the body.

Dialysis treatment centers that offer hemodialysis have intensified their infection-control procedures in response to COVID-19, said Dr. Kevin Stiles, a nephrologist at Kaiser Permanente in Bakersfield. Visitors are no longer allowed to accompany patients, and patients get temperature checks and must wear masks during treatment, he said. (KHN, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Inperitoneal dialysis, which is the more popular home option because it is less cumbersome and restrictive, the inside lining of the stomach acts as a natural filter. Dialysis solution cleanses waste from the body as it is washed into and out of the stomach through a catheter in the abdomen.

It takes Duenas about 45 minutes to prepare her overnight treatment. Her tubing allows her to get as far as her bathroom, but she sometimes gets tangled in it at night.(Heidi de Marco/California Healthline)Not everyone is eligible for home dialysis, which comes with its own challenges.

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Home dialysis requires patients or their caregivers to lift bags of dialysis solution that weigh 5 to 10 pounds, Stiles said. Good eyesight and hand dexterity are also critical because patients must be able to maintain sterile environments.Home patients need dialysis equipment and regular deliveries of supplies such as dialysis fluid, drain bags, tubing, disinfectant and personal protective equipment. In response to Covid-19,

some clinicshave arranged courier services and contracted with labs to deliver supplies to patients.Duenas vigorously washes her hands before she cleans the area around the catheter in her abdomen. She also sterilizes the dialysis equipment before hooking herself up for the night.(Heidi de Marco/California Healthline)

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