ABSTRACT
Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.
Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Patient Education as Topic/standards , Pneumonia, Viral/prevention & control , Renal Insufficiency, Chronic/complications , Activities of Daily Living , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Elective Surgical Procedures , Hand Hygiene/methods , Hand Hygiene/standards , Health Facilities , Health Personnel , Humans , Nephrology/standards , Personal Space , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Renal Dialysis , Risk Factors , SARS-CoV-2 , Symptom AssessmentABSTRACT
ABSTRACT We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available. RESUMO Este documento foi desenvolvido para trazer informações pertinentes à prática nefrológica em relação ao conhecimento sobre o acometimento renal da COVID-19, conduta frente aos casos de injúria renal aguda e orientações práticas sobre a provisão do suporte dialítico.Como as informações sobre a COVID-19 evoluem a uma velocidade jamais vista na ciência médica, as orientações apresentadas, embora baseadas em evidências científicas recentes, referem-se ao momento presente. Essas orientaços poderão ser atualizadas à medida que dados publicados e outras informações relevantes venham a ser disponibilizadas.
ABSTRACT
ABSTRACT The Covid-19 pandemic brought several challenges to the healthcare system: diagnosis, treatment and measures to prevent the spread of the disease. With the greater availability and variety of diagnostic tests, it is essential to properly interpret them. This paper intends to help dialysis units concerning the use of clinical criteria and diagnostic tests for decision making regarding the discontinuation of isolation of patients with suspected or confirmed Covid-19, as well as the return to work activities for employees with suspected or confirmed Covid-19. RESUMO A pandemia da Covid-19 trouxe desafios ao sistema de saúde em diversas esferas: diagnóstico, tratamento e medidas para evitar a disseminação da doença. Com a maior disponibilização e variedades de testes diagnósticos, torna-se fundamental sua adequada interpretação. Este posicionamento pretende orientar unidades de diálise em relação ao uso de critérios clínicos e testes diagnósticos para a tomada de decisão referente à descontinuação do isolamento de pacientes com suspeita ou confirmação de Covid-19, assim como para o retorno às atividades laborais de colaboradores com suspeita ou confirmação de Covid-19.
ABSTRACT
ABSTRACT Chloroquine and hydroxychloroquine have shown promising preliminary results and have been discussed as therapeutic options for patients with Covid-19. Despite the lack of robust evidence demonstrating the benefits and justifying the use of one of these drugs, the final decision is the responsibility of the attending physician and should be individualized and shared, whenever possible. This position statement recommends dosage adjustment for these drugs in the context of renal impairment. RESUMO Em razão de resultados preliminares promissores, a hidroxicloroquina e a cloroquina têm sido discutidas como opção terapêutica para pacientes com Covid-19. Apesar da ausência de estudos robustos que evidenciem o benefício e justifiquem o uso de uma dessas drogas, a decisão final compete ao médico assistente, devendo ser individualizada e, sempre que possível, compartilhada. A presente nota pretende orientar o ajuste posológico dessas drogas no contexto da disfunção renal.
ABSTRACT
ABSTRACT Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population. RESUMO Pacientes com Doença Renal Crônica estão entre os indivíduos de risco aumentado para desenvolvimento de formas mais sérias de Covid-19. Esse risco aumentado inicia-se já na fase pré-dialítica da doença. Fornecer informações úteis para esses pacientes, em linguagem que facilite o entendimento da doença, pode ajudar nefrologistas e outros profissionais de saúde a estabelecerem uma comunicação mais efetiva com esses pacientes e ajudar a minimizar o contágio e os riscos de doença grave nessa população.
ABSTRACT
ABSTRACT Considering the new coronavirus epidemic (Covid-19), the Brazilian Society of Nephrology, represented by the Peritoneal Steering Committee, in agreement with the and the Dialysis Department, developed a series of recommendations for good clinical practices for peritoneal dialysis (PD) clinics, to be considered during the period of the Covid-19 epidemic. We aim to minimize the disease spread, protecting patients and staff, and ensuring the quality of the treatment provided and adequate follow-up for PD patients. The recommendations suggested at this moment must be adapted to each clinic's reality and the conditions of the structural and human resources, dependent on the adequate financial provision of the public health system for its full implementation. RESUMO Considerando a nova epidemia de coronavírus (Covid-19), a Sociedade Brasileira de Nefrologia, representada pelo Comitê de Diálise Peritoneal, em concordância com a diretoria e o Departamento de Diálise, desenvolveu uma série de recomendações de boas práticas clínicas para os serviços de diálise peritoneal a serem consideradas durante o período da epidemia de Covid-19, com o objetivo de minimizar a disseminação da doença, proteger pacientes e funcionários e garantir a qualidade do tratamento prestado e acompanhamento adequado para os pacientes em DP. As recomendações aqui sugeridas devem ser adaptadas a cada realidade de serviço e às condições estruturais e de recursos humanos e dependem da provisão financeira adequada do sistema público de saúde para sua plena implementação.
ABSTRACT
ABSTRACT These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted. These recommendations may change, at any time, in the light of new evidence. RESUMO As presentes recomendações foram elaboradas após a publicação da Nota Informativa nº 3/2020 CGGAP/DESF/SAPS/MS, em 4 de abril de 2020, na qual o Ministério da Saúde recomenda o uso de máscara de pano por toda a população, em locais públicos. Levando-se em consideração a necessária priorização do fornecimento de Equipamentos de Proteção Individual (EPIs) para pacientes com suspeita ou confirmação da doença, assim como para profissionais de saúde, a Sociedade Brasileira de Nefrologia (SBN) posicionou-se favoravelmente ao uso de máscaras de pano por pacientes renais crônicos em diálise, em ambientes públicos, exceto no ambiente da diálise. As presentes recomendações englobam onze itens relativos ao que é racional para posicionamento, procedimentos, indicações, contraindicações, assim como tecidos apropriados para confecção e os cuidados de higiene a serem adotados. Essas recomendações poderão ser modificadas a qualquer momento, à luz de novas evidências.
ABSTRACT
The Covid-19 pandemic brought several challenges to the healthcare system: diagnosis, treatment and measures to prevent the spread of the disease. With the greater availability and variety of diagnostic tests, it is essential to properly interpret them. This paper intends to help dialysis units concerning the use of clinical criteria and diagnostic tests for decision making regarding the discontinuation of isolation of patients with suspected or confirmed Covid-19, as well as the return to work activities for employees with suspected or confirmed Covid-19.
Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Nephrology/standards , Pneumonia, Viral/diagnosis , Renal Dialysis , Return to Work , Algorithms , Brazil , COVID-19 , COVID-19 Testing , Checklist , Clinical Decision-Making , Clinical Laboratory Techniques/methods , Coronavirus Infections/epidemiology , Humans , Occupational Diseases/diagnosis , Pandemics , Patient Isolation , Pneumonia, Viral/epidemiology , Real-Time Polymerase Chain Reaction/methods , Real-Time Polymerase Chain Reaction/standards , SARS-CoV-2 , Societies, Medical/standards , Urology Department, Hospital/standardsABSTRACT
Chloroquine and hydroxychloroquine have shown promising preliminary results and have been discussed as therapeutic options for patients with Covid-19. Despite the lack of robust evidence demonstrating the benefits and justifying the use of one of these drugs, the final decision is the responsibility of the attending physician and should be individualized and shared, whenever possible. This position statement recommends dosage adjustment for these drugs in the context of renal impairment.
Subject(s)
Antimalarials/administration & dosage , Chloroquine/administration & dosage , Coronavirus Infections/drug therapy , Hydroxychloroquine/administration & dosage , Pneumonia, Viral/drug therapy , Renal Insufficiency , Brazil , COVID-19 , Humans , Nephrology , Pandemics , Societies, Medical , COVID-19 Drug TreatmentABSTRACT
We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.
Subject(s)
Acute Kidney Injury/therapy , Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Renal Replacement Therapy/standards , Vascular Access Devices/standards , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Brazil/epidemiology , COVID-19 , Clinical Decision-Making , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Critical Care , Humans , Kidney/drug effects , Nephrology/standards , Occupational Diseases/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Recovery of Function , Renal Replacement Therapy/methods , Respiration, Artificial/adverse effects , SARS-CoV-2 , Societies, MedicalABSTRACT
Considering the new coronavirus epidemic (Covid-19), the Brazilian Society of Nephrology, represented by the Peritoneal Steering Committee, in agreement with the and the Dialysis Department, developed a series of recommendations for good clinical practices for peritoneal dialysis (PD) clinics, to be considered during the period of the Covid-19 epidemic. We aim to minimize the disease spread, protecting patients and staff, and ensuring the quality of the treatment provided and adequate follow-up for PD patients. The recommendations suggested at this moment must be adapted to each clinic's reality and the conditions of the structural and human resources, dependent on the adequate financial provision of the public health system for its full implementation.
Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Kidney Failure, Chronic/therapy , Pandemics/prevention & control , Peritoneal Dialysis/standards , Pneumonia, Viral/prevention & control , Brazil , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Disinfection/methods , Disinfection/standards , Humans , Kidney Failure, Chronic/complications , Masks , Nephrology/standards , Occupational Diseases/prevention & control , Patient Care Team , Patient Education as Topic , Patient Isolation/methods , Patient Isolation/standards , Peritoneal Dialysis/instrumentation , Peritoneal Dialysis/methods , Personal Protective Equipment , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Societies, Medical , Telemedicine/legislation & jurisprudence , Telemedicine/methods , Telemedicine/standards , Urology Department, Hospital/organization & administration , Urology Department, Hospital/standardsABSTRACT
Dialysis units are environments potentially prone to the spread of Covid-19. Patients cannot suspend treatment, and they often have comorbidities, which assigns them a higher risk and worse prognosis. The Brazilian Society of Nephrology prepared this document of good practices, whose technical recommendations deal with general measures that can be implemented to reduce the risk of transmission and prevent the spread of the disease in the unit.
Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Renal Dialysis/standards , Urology Department, Hospital/standards , Brazil , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Disinfection/methods , Disinfection/standards , Humans , Masks , Nephrology/standards , Patient Isolation/methods , Patient Isolation/standards , Personal Protective Equipment , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Renal Insufficiency, Chronic , SARS-CoV-2 , Societies, Medical/standards , Symptom AssessmentABSTRACT
These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted. These recommendations may change, at any time, in the light of new evidence.