ABSTRACT
Background: The COVID-19 pandemic caused unprecedented disruption to dialysis patients care globally. Facility surveys were distributed to assess the impact of COVID-19 pandemic on hemodialysis (HD) and peritoneal dialysis (PD) practices. Methods: Medical Director (MD) and Nurse Manager (NM) Surveys (MDS, NMS) are being distributed in May/June 2020 to 723 clinics enrolled in the Dialysis (in-center HD, DOPPS) or Peritoneal (PDOPPS) Dialysis Outcomes and Practice Patterns Study in Canada, China, Japan, the United States, 7 European countries, 5 Gulf Cooperative Council countries, and China metropolitan areas (Beijing, Guangzhou, Shanghai). Surveys content includes the number of COVID-19 cases, testing, and clinical management, screening, infection control, staffing, patient transportation, and psychological support. Results: As of 27 May 2020, we have 80 MDS (China, Europe, US = 33, 38, 5) and 101 NMS (45, 46, 9) responses from DOPPS sites. The following percentages are presented sequentially for China, Europe, and US. Among MDs, 0%, 67%, 67% reported at least one confirmed COVID-19 case among dialysis patients, and 85%, 70%, 66% reported being on the late phase of the COVID-19 curve. 40%, 23%, 100% of MDs were more likely to recommend home dialysis;19%, 5%, 29% reported an increase in missed dialysis treatments;30%, 24%, 50% were more likely to prescribe potassium binders;and 75%, 68%, 43% had greater challenges obtaining vascular access interventions. Among NMs, 30%, 9%, 40% reported current limitations in access to COVID-19 testing;and 61%, 51%, 29% reported having, or risk of, shortage in staffing. Conclusions: Early results indicate many clinics in Europe and US have had COVID-19 cases, but sites in the three DOPPS-China cities have avoided COVID-19 to date. In all regions, shortages of human and medical resources were common, as were changes to dialysis delivery/practice including more skipped sessions, greater use of potassium binders, and preferentially recommending home dialysis. Over the next month, we expect hundreds more responses, and will compare approaches in PD and HD clinics. These data will inform guidance for dialysis care as the COVID-19 pandemic ensues.