ABSTRACT
As the rate of natural disasters and other devastating events caused by human activities increases, the burden on the health and well-being of those affected by kidney disease has been immeasurable. Health system preparedness, which involves creating a resilient system that is able to deal with the health needs of the entire community during times of unexpected disruptions to usual care, has become globally important. In the wake of the COVID-19 pandemic, there is a heightened awareness of the amplification of negative effects on the renal community. Paradoxically, the complex medical needs of those who have kidney diseases are not met by systems handling crises, often compounded by an acute increase in burden via new patients as a result of the crisis itself. Disruptions in kidney care as a result of unexpected events are becoming more prevalent and likely to increase in the years to come. It is therefore only appropriate that the theme for this year's World Kidney Day will focus on Kidney Health for All: preparedness for the unexpected in supporting the vulnerable. © 2023 JSC Vidal Rus. All rights reserved.
ABSTRACT
BACKGROUND AND AIMS: During the coronavirus disease-2019 (COVID-19) pandemic, the National Healthcare System of Greece was reorganized in order to cover the expected rise in hospitalizations of critically ill patients with COVID-19 infection. Accordingly, the aim of the present study was to explore whether the onset of the pandemic influenced the hospitalization rate of patients with end-stage kidney disease (ESKD) in a large tertiary university hospital in the metropolitan region of Thessaloniki, Greece. METHOD: In this observational study, we retrospectively collected data regarding the hospitalizations of ESKD patients in the section of Nephrology of the first Department of Internal Medicine at the AHEPA University Hospital of Thessaloniki. We provide a comparative evaluation of the number of hospitalizations, demographic characteristics of patients and in-hospital outcomes between the 1-year-long period before (1 March 2019-29 February 2020) and the corresponding period after the onset of the COVID-19 pandemic (1 March 2020-28 February 2021). RESULTS: Over the 1-year period before the onset of the pandemic, 149 ESKD patients with various complications were hospitalized in our department. During the control period, we recorded only 90 non-COVID-19 hospitalizations of ESKD patients (Table 1). There was no significant difference in the age and gender of patients who were hospitalized before and after the onset of the pandemic. Furthermore, the median duration of hospitalizations and the in-hospital mortality rate were comparable between the two periods. Over the 1-year-long period after the onset of the pandemic, our department provided care to 50 ESKD patients (32 males and 18 females) with COVID-19 infection who had a mean age of 66.3 ± 16.1 years. Of these, 33 patients (66%) were given discharge from the hospital, and the remaining 17 patients (34%) died. CONCLUSION: This single-centre observational study shows a significant reduction in non-COVID-19 hospitalizations of ESKD patients in a tertiary University Hospital of Thessaloniki after the onset of the pandemic. However, the demographic characteristics of patients who were hospitalized, the duration of in-hospital care and clinical outcomes were comparable between the pandemic and control periods.