ABSTRACT
The coronavirus (coronavirus disease-2019) pandemic has changed care delivery for patients with end-stage kidney disease. We explore the US healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the coronavirus disease-2019 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and after the coronavirus disease-2019 pandemic can bolster our ability to optimize care for patients with end-stage kidney disease. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.
Subject(s)
COVID-19 , Health Policy , Kidney Failure, Chronic/therapy , Nephrology , Renal Dialysis/methods , Telemedicine/methods , Ambulatory Care Facilities , Anastomosis, Surgical , Arteries/surgery , Blood Vessel Prosthesis Implantation , Centers for Medicare and Medicaid Services, U.S. , Computer Security , Delivery of Health Care/methods , Delivery of Health Care/standards , Disaster Planning , Health Services Accessibility , Hemodialysis Solutions/supply & distribution , Hemodialysis, Home/methods , Hemodialysis, Home/standards , Humans , Organization and Administration/standards , Personal Autonomy , Personal Protective Equipment , Quality Assurance, Health Care , Reimbursement Mechanisms , Renal Dialysis/instrumentation , Renal Dialysis/standards , SARS-CoV-2 , Telemedicine/standards , United States , Veins/surgeryABSTRACT
Coronavirus disease-2019 (COVID-19) has caused a pandemic that has affected millions of people worldwide. COVID-19 is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is spread by close contact and by respiratory droplets. It has also impacted different aspects of caring for people with kidney disease, including those with acute kidney injury (AKI), chronic kidney disease (CKD), those requiring kidney replacement therapy (KRT), and those with a kidney transplant. All of these patients are considered high risk. The lessons learned from the COVID-19 pandemic will hopefully serve to protect patients with kidney disease in a similar situation in the future.