In a detailed letter sent to the U.S. Department of Health and Human Services, the nation’s largest kidney patient and professional organizations urged the Administration to address the unique needs of kidney patients as the country reopens. The National Kidney Foundation (NKF) and the American Society of Nephrology (ASN), who together represent 37 million Americans affected by kidney disease and the physicians who care for them, called upon the Administration to implement a set of recommendations regarding COVID-19 testing, supplies and vaccination, dialysis, elective surgeries, organ donation, transplantation, and drug supplies.
Specifically, the organizations advocated that as states start to implement the “Guidelines for Opening Up America Again”, that the Administration adopt policies and procedures to ensure kidney patients, their families and clinicians have adequate access to personal protective equipment, priority access to COVID-19 testing, and early access to a vaccine once it is developed; support end-stage renal disease (ESRD) patients’ ability to safely access dialysis services and other related care; prioritize the safe resumption of organ transplantation, which has significantly declined as a result of COVID-19; extend and build upon temporary policy changes that may be required to meet the ongoing needs of kidney patients; and address the needs of patients who develop acute kidney injury (AKI) as a result of COVID-19 infection.
“Kidney patients continue to be extremely vulnerable to severe COVID-19 infection and we must take every precaution to help protect them as the country reopens,” said Kevin Longino, CEO of National Kidney Foundation and a kidney transplant patient. “While kidney patients should continue to shelter in place during reopening; they also need access to a healthcare system which can support their need to isolate and socially distance. Prioritizing the protection of dialysis and transplant patients will help mitigate the risk of resurgence for COVID-19, protect the most susceptible patients, and assist states with achieving a balance between reopening their economies and ensuring the health of the public.”
“COVID-19 has made an indelible impact on the process of care for patients with kidney diseases,” said Anupam Agarwal, MD, FASN, President of the American Society of Nephrology. “The Administration moved quickly and decisively to address the safe continuity of care for people with kidney diseases. Now we must take the long view to prioritize and expand access to safe and effective treatments and therapies while also addressing the vast clinical consequences of COVID-19 infection on kidney health. We welcome the continued support, partnership, and leadership of the Administration to address this particularly vulnerable patient population.”
Kidney patients are especially vulnerable to COVID-19 infection due to compromised immune systems, multiple comorbid conditions such as diabetes, high blood pressure and heart disease among others, which increase their risk for COVID-19 complications, and because nearly 90% of patients with kidney failure use in-center dialysis treatments, which require frequent visits to dialysis centers.
Early data from New York City indicate that 20 to 40 percent of COVID-19 intensive care unit patients develop kidney failure and need emergency dialysis. New data suggests that the mortality rate for patients on chronic dialysis who develop COVID-19 is in the range of 10-20% and for kidney transplant patients the mortality associated with COVID-19 may be as high as a staggering 30%.
Support for government intervention to help address supply shortages and acute kidney injury as a result of COVID-19 is strong. A recent National Kidney Foundation—Harris Poll Survey on COVID-19 and Kidney Health found that two-thirds (65%) of Americans are concerned over potential shortages of dialysis equipment from COVID-19. And the majority of Americans, (87%), support the federal government stepping in to address any shortages found in hot spots and to provide funding for equipment, supplies, and staff needed to care for patients with complications caused by the virus, such as acute kidney injury. Support is also high (87%) for the federal government devoting more resources towards the diagnosis, prevention, and treatment of kidney disease and significantly increasing funding for kidney research at the National Institutes of Health (NIH) as a result of kidney-related illness resulting from COVID-19.
“It is our hope and intention that the recommendations NKF and ASN have put forward will best advance the critical needs facing kidney patients during COVID-19, and offer an opportunity for safely reintegrating into their communities during the reopening phases taking place nationwide,” added Longino. “We sincerely thank the Administration for their efforts thus far to protect kidney patients and look forward to working closely with them to implement our recommendations.”