The ubiquitous impact and disruption of COVID-19 has been an omnipresent and near universal fact of life for the past year. While we have shared in a generational narrative globally, at a human level we each have a personal story relating to the virus. These experiences range from boredom, to feelings of isolation, to the tremendous loss of a loved one. However, for our most vulnerable populations the pandemic has truly been a looming threat, and a matter of survival.
This has been the reality for patients on dialysis, people living with chronic kidney disease (CKD), and transplant recipients, which can be attributed to a number of factors, including the following: kidney disease is commonly caused or accompanied by comorbidities such as hypertension, diabetes, heart failure, or coronary disease; all risk factors for COVID-19. Kidney disease patients may have compromised immune systems while transplant recipients must take immunosuppressant medications. Those patients on dialysis who cannot access home treatment must attend treatments at dialysis centres, exposing themselves to potential risk at each point of contact before, during, and after treatment. Compounding these and more medical factors converging to put kidney disease patients at risk, there are the socioeconomic disparities that disproportionately and negatively impact outcomes for both kidney disease and COVID-19 patients. Such is the case for racial and ethnic minorities, and people with lower incomes.
Initial reports in early 2020 did not include chronic kidney disease as a severe risk factor for COVID-19. As the pandemic has descended on health care facilities research into subsequent data in the interim has drawn dire conclusions. A study published in the Canadian Medical Association Journal (CMAJ) found that among a group of dialysis patients in Ontario between March and August 2020, 62.6% of those infected required hospitalization, and 28.3% of cases were fatal. Not only does this fatality rate outpace the general population by nearly four times, but it is even higher than the rates of mortality for those over 80 years of age. The European Renal Association COVID-19 Database (ERACODA) working group has published a call to action in the Nephrology Dialysis Transplantation (NDT) medical journal stating that chronic kidney disease is the most prevalent risk factor for severe COVID-19, and is associated with a high rate of mortality. The group calls for more targeted COVID-19 research and testing into CKD, higher levels of care upon diagnosis, and the inclusion of CKD patients in vaccine and drug trials.
As a Canadian company in the hemodialysis industry, NephroCan has committed itself to putting patients first and improving their quality of life. As such we feel compelled to add our support behind calls for action by the nephrology community to support patient outcomes under the threat of COVID-19. Furthermore, in solidarity with the Canadian Society of Nephrology (CSN) and The Kidney Foundation of Canada we call upon health authorities to prioritize and grant access to vaccinations for patients living with chronic kidney disease.