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Original

Going to war with COVID-19: Strategies for SARS-CoV-2 management in the Padua Nephrology and Dialysis Unit’s hemodialysis facility 

Silvia Dian, Monica Simeone, Barbara Rossi, Giuseppe Scaparrotta, Antonio Fragasso, Giovanni Carretta, Alfio Capizzi, Daniele Donato, Vito Cianci, Anna Maria Cattelan, and Lorenzo A. Calò

Volume 95 (2021) p. 151 - 156

Abstract

Clinical Nephrology, Vol. 95 – No. 3/2021 (151-155)

Going to war with COVID-19: Strategies for SARS-CoV-2 management in the Padua Nephrology and Dialysis Unit’s hemodialysis facility 

Silvia Dian¹*, Monica Simeone¹*, Barbara Rossi¹, Giuseppe Scaparrotta¹, Antonio Fragasso¹, Giovanni Carretta², Alfio Capizzi², Daniele Donato², Vito Cianci³, Anna Maria Cattelan⁴, and Lorenzo A. Calò¹

¹Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padua, ²Department of Directional Hospital Management, Medical Directorate, Padua University Hospital, and ³Emergency Unit Padua University Hospital, ⁴Infectious Disease Unit, Padua University Hospital, Italy
Background: The recent SARS-CoV-2 outbreak represents a global health emergency, and dialysis patients are a high-risk population. Patients with end-stage renal disease (ESRD) in hemodialysis facilities require specific protocols to be planned and promptly executed for the management of suspected/confirmed cases of COVID-19 with respect to prevention, protection, screening, and isolation.
Materials and methods: In order to prevent the spread of SARS-CoV-2 in our Hemodialysis Unit, we adopted individual protection measures accompanied by measures to minimize contacts among hemodialysis patients with suspicious symptoms as well as other patients and medical staff. We provided our patients detailed instructions to be followed in the event of their having symptoms compatible with SARS-CoV-2 infection or having contacts with SARS-CoV-2-positive subjects. Ultimately, four possible scenarios and care paths were developed and implemented in collaboration with the Infectious Diseases and Emergency Units at the Padua University Hospital.
Results: The application of this strategy has resulted in the nearly 200 patients treated in our hemodialysis facilities while there were only 2 cases of COVID-19 (1% incidence rate) with no deaths.
Conclusion: We attribute the low COVID-19 incidence noted so far for patients in our hemodialysis facilities to the early detection and prompt isolation of suspected patients per our specific plan along with the prompt application of preventive measures.

*These authors contributed equally.Correspondence to:
 Prof. Lorenzo A. Calò, MD, PhD 
Nephrology, Dialysis and Transplantation Unit
Department of Medicine – DIMED
University of Padova
Via Giustiniani 2, 35128 Padova, Italy
Email: [email protected]

Letter to the Editor

Padova University nephrology unit’s peritoneal dialysis management during the COVID-19 pandemic

Laila Qassim, Irene Cirella, Gresa Baboci, Barbara Rossi, Luciana Bonfante, and Lorenzo A. Calò

Volume 96 (2021) p. 60 - 62

Original

Fatigue in hemodialysis patients:  A single-center cross-sectional study 

Laura Gobbi, Enrico Baruzzo, Luca Iodice, Giuseppe Comunian, Franco Martinello, Maximiliano Marigo, Giovanni Carretta, Barbara Rossi, and Lorenzo A. Calò

Volume 96 (2021) p. 281 - 288

Abstract

Clinical Nephrology, Vol. 96 – No. 5/2021 (281-288)

Fatigue in hemodialysis patients:  A single-center cross-sectional study 

Laura Gobbi¹, Enrico Baruzzo¹, Luca Iodice¹, Giuseppe Comunian¹, Franco Martinello¹, Maximiliano Marigo¹, Giovanni Carretta², Barbara Rossi¹, and Lorenzo A. Calò¹

¹Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, and ²Department of Directional Hospital Management, Medical Directorate, Padova University Hospital, Padova, Italy
Background: Fatigue is a highly prevalent condition among people affected by chronic disease, with consequent poor health-related quality of life and lower survival rates. Fatigue is one of the most common and debilitating symptoms also experienced by hemodialysis (HD) patients after HD sessions, and given the non-specific manifestations and its invisible nature, it is under-recognized and under-treated by healthcare professionals. The complexity of fatigue’s pathogenesis and the lack of measurement tools make the development of nursing interventions and practices specifically targeted at its recognition and therapy difficult. We aimed to investigate the prevalence and severity of fatigue, identify predictor variables in HD patients, and promote healthcare professionals’ awareness and recognition of fatigue.
Materials and methods: A single-center, cross-sectional study was conducted among 140 patients treated at the HD unit between August 2019 and March 2020 at the Nephrology, Dialysis, and Transplantation Unit of Padova University Hospital. We assessed patient’s fatigue by Chalder’s Fatigue Questionnaire, pain by Numeric Rating Scale and activities of daily living by Barthel Index. Demographic and clinical characteristics were taken from medical records.
Results: The findings of this study indicate that age, dialysis vintage, inter-dialysis weight gain, and ultra-filtration rate are proportionally related to reported levels of fatigue. Hemoglobin, iron, ferritin, and number of sleep hours before HD session present a significant inverse correlation to fatigue.
Conclusion: The complexity of fatigue’s pathogenesis makes a better understanding of this phenomenon difficult, nevertheless, healthcare professionals should develop interventions and practices targeted at its identification and management.Correspondence to:
 Prof. Lorenzo A. Calò, MD, PhD
 Nephrology, Dialysis and Transplantation Unit
Department of Medicine, University of Padova
Via Giustiniani 2,  35128 Padova, Italy
Email: [email protected]

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