Ethics of kidney care in the era of COVID-19

The COVID-19 pandemic presents significant challenges for health systems globally, including substantive ethical dilemmas that may pose specific concerns in the context of care for people with kidney disease. Ethical concerns may arise as changes to policy and practice impact on the ability of all health professionals to fulfil their ethical duties towards their patients in providing best practice care. In this paper we briefly describe such concerns and elaborate on issues of particular ethical complexity in kidney care: equitable access to dialysis during pandemic surges; balancing the risks and benefits of different kidney failure treatments, specifically with regards to suspending kidney transplantation programs and prioritizing home dialysis, and barriers to shared-decision making; and ensuring ethical practice when using unproven interventions.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: review Source Type: research

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We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. METHODS: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. RESULTS: We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the CO...
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
This guideline covers children, young people and adults who need or who have had a kidney transplant, and people who are donating a kidney (live donors). It also advises transplant and referring centres on how to run their services, while keeping them safe for patients, donors and staff during the COVID ‑19 pandemic. Kidney transplants improve life expectancy and quality of life, and cost less than dialysis in the long term, so providing effective and safe services will benefit patients and make the best use of resources.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
AbstractAimsHeart transplantation may represent a particular risk factor for severe coronavirus infectious disease 2019 (COVID-19) due to chronic immunosuppression and frequent comorbidities. We conducted a nation-wide survey of all heart transplant centers in Germany presenting the clinical characteristics of heart transplant recipients with COVID-19 during the first months of the pandemic in Germany.Methods and resultsA multicenter survey of all heart transplant centers in Germany evaluating the current status of COVID-19 among adult heart transplant recipients was performed. A total of 21 heart transplant patients with ...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
By RICHARD HOEHN, MD Experts claim we could have been better prepared when the COVID-19 pandemic struck in early 2020. With an annual budget of $400-700 million, the Strategic National Stockpile (SNS) is designed to respond to chemical, biological, and other disasters. Its $8 billion inventory included 13,000 ventilators and a limited supply of personal protective equipment, N95 masks, and medical supplies. This left state and local governments scrambling as the COVID-19 pandemic accelerated and the capacity of many hospitals was overwhelmed. Faced with immediate and visible death and suffering, leaders took drastic...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Economics Health Policy Healthcare spending Richard Hoen Source Type: blogs
Authors: Ulu S, Gungor O, Gok Oguz E, Hasbal NB, Turgut D, Arici M Abstract Coronavirus disease 19 (COVID-19) became a nightmare for the world since December 2019. Although the disease affects people at any age; elderly patients and those with comorbidities were more affected. Everyday nephrologists see patients with hypertension, chronic kidney disease, maintenance dialysis treatment or kidney transplant who are also high-risk groups for the COVID-19. Beyond that, COVID-19 or severe acute respiratory syndrome (SARS) due to infection may directly affect kidney functions. This broad spectrum of COVID-19 influence on...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Abstract The evolving pandemic of Coronavirus Disease 2019 has posed a substantial health risk worldwide. However, there is a paucity of data regarding the clinical course and the therapeutic management of patients with chronic kidney disease and COVID-19 infection. To date, most evidence has come from renal transplantation, with about 45 patients reported thus far, and the current data from the ERA-EDTA (ERACODA) registry for transplanted patients and patients on Renal Replacement Therapy (RRT); as for those with glomerular diseases, data are lacking. Herein, we report the case of a 62-year-old patient with sever...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
(Terasaki Institute for Biomedical Innovation) The Transplant Research and Education Center (TREC), housed at the Terasaki Research Institute for Biomedical Innovation (TIBI), launched the COVID-19 Kidney / Transplant Listening&Resource Center (KTLRC) on June 17, 2020. The KTLRC is a vital new service created in direct response to the unique and unmet needs of the dialysis and organ transplant community during the COVID-19 Pandemic.
Source: EurekAlert! - Infectious and Emerging Diseases - Category: Infectious Diseases Source Type: news
This guideline covers children, young people and adults who need or who have had a kidney transplant, and people who are donating a kidney (live donors). It also advises transplant and referring centres on how to run their services, while keeping them safe for patients, donors and staff during the COVID ‑19 pandemic. Kidney transplants improve life expectancy and quality of life, and cost less than dialysis in the long term, so providing effective and safe services will benefit patients and make the best use of resources.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
We report a case series of six kidney and pancreas transplant recipients who presented in an unusually short time frame during the COVID-19 pandemic with transplant organ dysfunction and rejection (Table 1). Mean time from the time of transplant to the current presentation was 7.3 ± 4 years. Of these six patients, three had severe allograft dysfunction requiring initiation of dialysis or insulin therapy.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: letters to the editor Source Type: research
While most people are familiar with the hallmark symptoms of COVID-19 by now—cough, fever, muscle aches, headaches and difficulty breathing—a new crop of medical conditions are emerging from the more than 4 million confirmed cases of the disease around the world. These include skin rashes, diarrhea, kidney abnormalities and potentially life-threatening blood clots. It’s not unusual for viruses to directly infect and affect different tissues and organs in the body, but it is a bit unusual for a primarily respiratory virus like SARS-CoV-2, which is responsible for COVID-19, to have such a wide-ranging reach...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Source Type: news
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