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case studies

A young man with recurrent kidney stones and renal failure

Jasmeet Gill and Michael R. Wiederkehr

Volume 8 (2020) p. 85 - 90

Original

Association of the COVID-19 pandemic with increased adherence among prevalent hemodialysis patients 

Jasmeet Gill, Stevan A. Gonzalez, Michael R. Wiederkehr, Catalina Hanson, Bernard V. Fischbach, Harold M. Szerlip, and Richard C. Fuquay

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Volume 97 (2022) p. 141 - 148

Abstract

Clinical Nephrology, Vol. 97 – No. 3/2022 (141-149)

Association of the COVID-19 pandemic with increased adherence among prevalent hemodialysis patients 

Jasmeet Gill¹, Stevan A. Gonzalez³, Michael R. Wiederkehr¹#², Catalina Hanson², Bernard V. Fischbach², Harold M. Szerlip¹#², and Richard C. Fuquay²

¹Baylor University Medical Center, Division of Nephrology, Department of Internal Medicine, ²Dallas Nephrology Associates, Dallas, Texas, and ³Baylor Simmons Transplant Institute, Fort Worth, TX, USA
Background: During the COVID-19 pandemic, there has been a reduction in emergency department visits and hospital admissions. We hypothesized that hemodialysis patients were decreasing their hospital visits and increasing their dialysis adherence during the COVID-19 pandemic.
Material and methods: This is a retrospective analysis of hemodialysis patients treated in the seven American Renal Associates (ARA) dialysis centers in the Dallas-Fort Worth metropolitan area. We conducted a “before-and-after” study using existing clinical data to examine patient adherence with hemodialysis between January 1 and March 14, 2020 (pre-COVID) and March 15 to May 18, 2020 (COVID) time periods. Data points included missed treatments, shortened treatments, post-dialysis weight, and hospital visits. Finally, we conducted an anonymous survey in which patients reported their hemodialysis adherence.
Results: Data analysis was performed on 556 patients. Significantly fewer patients missed a single treatment in the COVID vs. pre-COVID time periods (44.1 vs. 58.6%; p < 0.001). Significantly fewer patients finished their treatment with a post-dialysis weight more than 1 kg above their estimated dry weight in the COVID vs. pre-COVID time periods (31.7 vs. 38.9%, p = 0.01). Finally, there was a reduction in total hospital visits during the COVID vs. pre-COVID periods (12.6 vs. 19.4%; p = 0.002). The anonymous survey showed patients reporting increased adherence with hemodialysis and restriction of salt and water intake.
Conclusion: The COVID time period was associated with increased adherence with hemodialysis and decreased hospital visits, and patients were conscious of these changes.Correspondence to:
Harold M. Szerlip, MD , Director
Nephrology Training Program
Baylor University Medical Center
411 N Washington Ave #7000
Dallas, TX 75246, USA
Email: [email protected]

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