{"id":48443,"date":"2020-08-28T08:37:33","date_gmt":"2020-08-28T07:37:33","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48443"},"modified":"2020-08-28T13:40:44","modified_gmt":"2020-08-28T12:40:44","slug":"covid-19-and-chronic-kidney-disease-it-is-time-to-listen-to-patients-experiences","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/08\/28\/covid-19-and-chronic-kidney-disease-it-is-time-to-listen-to-patients-experiences\/","title":{"rendered":"Covid-19 and chronic kidney disease: It is time to listen to patients\u2019 experiences\u00a0"},"content":{"rendered":"

Delayed treatment has been a crucial issue<\/span><\/i><\/p>\n

As of 24 August 2020, <\/span>242,899<\/span> people in France, roughl<\/span>y 3\u2030 <\/span>of the population, had tested positive for SARS-Cov-2. [1] The real number has been estimated to potentially be as high as 5% by the Pasteur Institute. [2] The death toll of<\/span> 30,496 <\/span>patients represents an unadjusted mortality rate of <\/span>12.6<\/span>%. [1]<\/span><\/p>\n

The government implemented lockdown policies from 17 March to 11 May, and all schools and universities closed. [3] As patients with a chronic kidney disease (CKD), we were immediately identified as vulnerable by health authorities and advised to apply strict isolation measures. [4] Where remote working was impossible, sick leave was granted and extended to patients’ immediate carers. Furloughing enabled us to earn at least 84% of our net salary during the acute phase of the pandemic.\u00a0<\/span><\/p>\n

Currently, it is thought that<\/span> 1.3% of kidney recipients and 4% of dialysis <\/span>patients have been infected with covid-19 in France. [5] At first sight these numbers look good, when one considers the risk of infection in immunocompromised patients and the need for them to attend dialysis units at a time when most healthcare departments were full with covid-19 patients, and personal protective equipment was limited. But a large online survey undertaken between 22 June 12 July carried out by Renaloo [<\/span>http:\/\/www.renaloo.com<\/span><\/a>, an association for patients with kidney disease], suggests <\/span>otherwise<\/span>. Two thousand and thirty patients with a renal condition, living in all the French regions, including overseas territories, answered questions on their social and medical status, their perception of risk to themselves, and their behavior. Of these, 100 (5%) had been either diagnosed with covid-19 (1.7%) or were suspected to have contracted the disease (3.3%). Twenty-five had been hospitalized, of which six who needed intensive care (all survived the virus since they replied after returning home).<\/span><\/p>\n

Most of the respondents had end-stage renal disease [ESRD]: of these, two thirds were living with a functioning graft compared to 45% in the whole French ESRD population. Fifty-seven percent of ESRD-free respondents had stage 4\/5 CKD. When compared to the typical renal patient, respondents were\u00a0 younger, more likely to be female, and had a higher level of education. Half were employed and of these most were able to follow the official guidelines to work from home or reduced working hours. This was not the case for people who are self-employed or healthcare professionals.\u00a0\u00a0<\/span><\/p>\n

The survey data indicate some key learning points:<\/span><\/p>\n