Dialysis patients are ambiguous about getting infected during this pandemic. The best way to prevent infection and reduce transmission is to be well informed about the Covid-19 virus, the disease symptoms and method of pandemic proliferation.
Covid-19 has emerged as a global pandemic and has challenged the entire healthcare system. Dialysis Patients are ambiguous about getting infected, testing methods, preventive mechanisms, ponder on myths about the vaccination safety and manage commutation issues to hospital for routine dialysis during lockdown.
Worries and concerns being faced by dialysis patients during Covid-19:
Q1: How can a CKD/dialysis patient prevent himself/herself against Covid-19?
A1: Follow standard hand washing and social distancing practices at all times. High protein diet is advisable to enhance immune system to fight against infections. Keep the carb diet on lower side & do not compromise with your sleep. Vitamin D and Vitamin C supplementation can be used as they have protective effects on respiratory tract, thus preventing infections.
Q2: Is CT/HRCT Chest, an alternative to RT-PCR for Covid-19 detection?
A2: To detect the presence of Covid-19 infection, RT-PCR is considered as gold standard. CT chest is done at later stage to understand the level of infection in lungs. It is to be noted that a CT scan is not required if the patient has mild illness and has maintained saturation because CT scan increases the risk of cancer in later stages of life. Symptomatic patients who are not maintaining saturation may go for CT chest. However frequent CT scans are not suggested as the radiation from CT scan is several times more harmful as compared to the radiation of single X-Ray chest.
Q3: Should CKD patients; those on dialysis or living with a renal transplant, take Covid-19 vaccination?
A3: Yes, they must take the vaccine. End Stage Renal Disease or Dialysis is not a contraindication for vaccine. It is recommended to take the vaccine after a dialysis session or on a non-dialysis day. The transplant patients take immunosuppressive medicine which hampers the immunity and makes the immune conversion slower, hence they should get themselves vaccinated at earliest.
Q4: Is home hemodialysis beneficial during Covid-19?
A4: The home hemodialysis is a solution to commutation problem and frequent hospital visit faced by hemodialysis patients. In a home dialysis program there are very few visits to the hospital. The other major benefits of home hemodialysis are dialysis in an infection free environment, comfort of home, flexibility in dialysis scheduling, less recovery period, no work leaves, improved quality of life, personal attention & better time management. Clinical studies indicate that home based dialysis offers more control on patient outcomes like better control on BP, phosphate control, better mineral metabolism, better quality of sleep and decreased load on heart.
Q5: Can we use Oxygen Concentrator in place of oxygen cylinder?
A5: Oxygen Cylinders (LMO – Liquid Medical Oxygen) provide up to 99% pure oxygen, however Oxygen Concentrators gives only 90 -95% pure oxygen to the patients. It is advisable, to use oxygen concentrators for patients with oxygen saturation level above 85%. Oxygen Concentrators are not that effective for critical patients having oxygen saturation below 85%. For such critical patients (oxygen saturation below 85%) liquid medical oxygen should be used.
In a nutshell, I suggest all patients to follow standard social distancing norms. In case of any Covid-19 symptoms inform your dialysis center prior to your schedule. Never miss a dialysis session in any circumstance. Protect yourself and others from infection by washing your hands or using an alcohol based sanitizers frequently.
Stay Healthy, Stay Safe.
Dr. Deepak Agarwal
Vice President Clinical Excellence
DCDC Health Services Private Limited, New Delhi
