Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team
Purpose: To collate best practice recommendations on the management of patients receiving in-center hemodialysis during the COVID-19 pandemic, based on published reports and current public health advice, while considering ethical principles and the unique circumstances of Canadian hemodialysis units...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-09-01
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| Series: | Canadian Journal of Kidney Health and Disease |
| Online Access: | https://doi.org/10.1177/2054358120938564 |
| _version_ | 1819242884387307520 |
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| author | Rita S. Suri John E. Antonsen Cheryl A. Banks David A. Clark Sara N. Davison Charles H. Frenette Joanne E. Kappel Jennifer M. MacRae Fabrice Mac-Way Anna Mathew Louise M. Moist Elena Qirjazi Karthik K. Tennankore Hans Vorster |
| author_facet | Rita S. Suri John E. Antonsen Cheryl A. Banks David A. Clark Sara N. Davison Charles H. Frenette Joanne E. Kappel Jennifer M. MacRae Fabrice Mac-Way Anna Mathew Louise M. Moist Elena Qirjazi Karthik K. Tennankore Hans Vorster |
| author_sort | Rita S. Suri |
| collection | DOAJ |
| description | Purpose: To collate best practice recommendations on the management of patients receiving in-center hemodialysis during the COVID-19 pandemic, based on published reports and current public health advice, while considering ethical principles and the unique circumstances of Canadian hemodialysis units across the country. Sources of information: The workgroup members used Internet search engines to retrieve documents from provincial and local hemodialysis programs; provincial public health agencies; the Centers for Disease Control and Prevention; webinars and slides from other kidney agencies; and nonreviewed preprints. PubMed was used to search for peer-reviewed published articles. Informal input was sought from knowledge users during a webinar. Methods: Challenges in the care of hemodialysis patients during the COVID-19 pandemic were highlighted within the Canadian Senior Renal Leaders Forum discussion group. The Canadian Society of Nephrology (CSN) developed the COVID-19 rapid response team (RRT) to address these challenges. They identified a pan-Canadian team of clinicians and administrators with expertise in hemodialysis to form the workgroup. One lead was chosen who drafted the initial document. Members of the workgroup reviewed and discussed all recommendations in detail during 2 virtual meetings on April 7 and April 9. Disagreements were resolved by consensus. The document was reviewed by the CSN COVID-19 RRT, an ethicist, an infection control expert, a community nephrologist, and a patient partner. Content was presented during an interactive webinar on April 11, 2020 attended by 269 kidney health professionals, and the webinar and first draft of the document were posted online. Final revisions were made based on feedback received until April 13, 2020. CJKHD editors reviewed the parallel process peer review and edited the manuscript for clarity. Key findings: Recommendations were made under the following themes: (1) Identification of patients with COVID-19 in the dialysis unit, (2) hemodialysis of patients with confirmed COVID-19, (3) hemodialysis of patients not yet known to have COVID-19, (4) visitors; (5) testing for COVID-19 in the dialysis unit; (6) resuscitation, (6) routine hemodialysis care, (7) hemodialysis care under fixed dialysis resources. Limitations: Because of limitations of time and resources, and the large number of questions, formal systematic review was not undertaken. The recommendations are based on expert opinion and subject to bias. The parallel review process that was created may not be as robust as the standard peer review process. Implications: We hope that these recommendations provide guidance for dialysis unit directors, clinicians, and administrators on how to limit risk from infection and adverse outcomes, while providing necessary dialysis care in a setting of finite resources. We also identify a number of resource allocation priorities, which we hope will inform decisions at provincial funding agencies. |
| first_indexed | 2024-12-23T14:46:54Z |
| format | Article |
| id | doaj.art-881e2a7d8b1d44378e9fe20e6447040b |
| institution | Directory Open Access Journal |
| issn | 2054-3581 |
| language | English |
| last_indexed | 2024-12-23T14:46:54Z |
| publishDate | 2020-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Canadian Journal of Kidney Health and Disease |
| spelling | doaj.art-881e2a7d8b1d44378e9fe20e6447040b2022-12-21T17:43:05ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812020-09-01710.1177/2054358120938564Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response TeamRita S. Suri0John E. Antonsen1Cheryl A. Banks2David A. Clark3Sara N. Davison4Charles H. Frenette5Joanne E. Kappel6Jennifer M. MacRae7Fabrice Mac-Way8Anna Mathew9Louise M. Moist10Elena Qirjazi11Karthik K. Tennankore12Hans Vorster13 Centre de recherche de l’Université de Montréal, Montreal, QC, CanadaHemodialysis Committee, British Columbia Renal Agency, Vancouver, CanadaPrince Edward Island Provincial Renal Program, Summerside, CanadaDivision of Nephrology, Department of Medicine, Dalhousie University & Nova Scotia Health Authority, Halifax, CanadaDivision of Nephrology, Department of Medicine, University of Alberta, Edmonton, CanadaDivision of Infectious Diseases, Department of Medicine, McGill University, Montreal, QC, CanadaDivision of Nephrology, Department of Medicine, University of Saskatchewan, Saskatoon, CanadaDivision of Nephrology, Department of Medicine, University of Calgary/Alberta Health Services, CanadaCHU de Québec Research Center, L’Hôtel-Dieu de Québec Hospital, Division of Nephrology, Department of Medicine, Université Laval, QC, CanadaDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, CanadaDivision of Nephrology, Department of Medicine, Western University, London, ON, CanadaDivision of Nephrology, Department of Medicine, University of Calgary/Alberta Health Services, CanadaDivision of Nephrology, Department of Medicine, Dalhousie University & Nova Scotia Health Authority, Halifax, CanadaOntario Renal Network, Toronto, CanadaPurpose: To collate best practice recommendations on the management of patients receiving in-center hemodialysis during the COVID-19 pandemic, based on published reports and current public health advice, while considering ethical principles and the unique circumstances of Canadian hemodialysis units across the country. Sources of information: The workgroup members used Internet search engines to retrieve documents from provincial and local hemodialysis programs; provincial public health agencies; the Centers for Disease Control and Prevention; webinars and slides from other kidney agencies; and nonreviewed preprints. PubMed was used to search for peer-reviewed published articles. Informal input was sought from knowledge users during a webinar. Methods: Challenges in the care of hemodialysis patients during the COVID-19 pandemic were highlighted within the Canadian Senior Renal Leaders Forum discussion group. The Canadian Society of Nephrology (CSN) developed the COVID-19 rapid response team (RRT) to address these challenges. They identified a pan-Canadian team of clinicians and administrators with expertise in hemodialysis to form the workgroup. One lead was chosen who drafted the initial document. Members of the workgroup reviewed and discussed all recommendations in detail during 2 virtual meetings on April 7 and April 9. Disagreements were resolved by consensus. The document was reviewed by the CSN COVID-19 RRT, an ethicist, an infection control expert, a community nephrologist, and a patient partner. Content was presented during an interactive webinar on April 11, 2020 attended by 269 kidney health professionals, and the webinar and first draft of the document were posted online. Final revisions were made based on feedback received until April 13, 2020. CJKHD editors reviewed the parallel process peer review and edited the manuscript for clarity. Key findings: Recommendations were made under the following themes: (1) Identification of patients with COVID-19 in the dialysis unit, (2) hemodialysis of patients with confirmed COVID-19, (3) hemodialysis of patients not yet known to have COVID-19, (4) visitors; (5) testing for COVID-19 in the dialysis unit; (6) resuscitation, (6) routine hemodialysis care, (7) hemodialysis care under fixed dialysis resources. Limitations: Because of limitations of time and resources, and the large number of questions, formal systematic review was not undertaken. The recommendations are based on expert opinion and subject to bias. The parallel review process that was created may not be as robust as the standard peer review process. Implications: We hope that these recommendations provide guidance for dialysis unit directors, clinicians, and administrators on how to limit risk from infection and adverse outcomes, while providing necessary dialysis care in a setting of finite resources. We also identify a number of resource allocation priorities, which we hope will inform decisions at provincial funding agencies.https://doi.org/10.1177/2054358120938564 |
| spellingShingle | Rita S. Suri John E. Antonsen Cheryl A. Banks David A. Clark Sara N. Davison Charles H. Frenette Joanne E. Kappel Jennifer M. MacRae Fabrice Mac-Way Anna Mathew Louise M. Moist Elena Qirjazi Karthik K. Tennankore Hans Vorster Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team Canadian Journal of Kidney Health and Disease |
| title | Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team |
| title_full | Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team |
| title_fullStr | Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team |
| title_full_unstemmed | Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team |
| title_short | Management of Outpatient Hemodialysis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team |
| title_sort | management of outpatient hemodialysis during the covid 19 pandemic recommendations from the canadian society of nephrology covid 19 rapid response team |
| url | https://doi.org/10.1177/2054358120938564 |
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