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More than one-third of patients hospitalized for COVID-19 in a large metropolitan New York heath system developed acute kidney injury (AKI), according to a study published in
The largest study to date on the incidence of AKI in the United States, the study included 5449 adults admitted with COVID-19 to one of 13 hospitals in the Northwell Health system and found that 36.6% of the patients experienced a kidney injury. There was also a strong relationship between kidney injury and respiratory failure, noted study co-author Jia Hwei Ng, MD, Assistant Professor of Medicine
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For diabetic patients in high-deductible health plans (HDHPs), the introduction of preventive drug lists (PDLs)—with no copayments for preventive medications—is associated with lower out-of-pocket costs and increased use of essential medications, reports a study in
The researchers evaluated a natural experiment using data on commercially insured patients with diabetes enrolled in HDHPs (individual deductible at least $1000) linked to health savings accounts. Approximately 1750 patients in an intervention group were switched by their employers to PDL coverage. This meant that essential medications and supplies for preventing adverse outcomes of diabetes—including antidiabetic drugs, insulin, test strips, and
Many professional societies staked out the early position that COVID-19 patients should continue their blood pressure medications in the absence of a clear reason to stop them. And the early evidence to date has reinforced those recommendations.
It will take at least several months for more definitive answers from clinical trials, but the three largest observational studies to date found no signals of harm among patients taking inhibitors of the renin-angiotensin system (RAS) pathway.
Published in the May 1, 2020,
SARS-CoV-2 infection, the causative agent of coronavirus disease 2019 (COVID-19), was declared a pandemic on March 11, 2020, with more than 1.4 million people afflicted by April 8, 2020, and more than 80,000 deaths (
As the first wave of survivors of severe COVID-19 begin to leave hospitals, many face a new challenge—dialysis.
Acute kidney injury (AKI) is recognized as a common complication in patients who develop severe COVID-19 infections requiring intensive care. Among those who recover enough to be discharged from the hospital, between 20% and 90% may require dialysis, according to reports from around the country, said Jeffrey Silberzweig, MD, co-chair of the ASN COVID-19 Response team, during a recent ASN webinar (
“We need to anticipate a surge of these patients,” Silberzweig said.
The Dialysis After Discharge: Transitions of Care
As New York City hospitals braced for a potentially overwhelming surge of COVID-19 cases, Columbia University Medical Center nephrologist Sumit Mohan, MD, MPH, and his colleagues had to transform the way they provided kidney transplant care.
“We put a pause on nearly all kidney transplants,” said Mohan, an associate professor of epidemiology and medicine at Columbia University. All elective procedures were put on hold to free up space and ventilators for a surge of COVID-19 patients. For kidney transplant patients with living donors, they decided it was safer to postpone surgeries to prevent donors or immune-suppressed recipients from becoming infected
As COVID-19 started to take hold in countries like China and Italy, Marian Michaels, MD, MPH, thought the transplant community in the United States and Canada would benefit from having information about the then-rising epidemic so they could establish solid plans for their patients and programs. She had no idea how prescient that decision would be.
Michaels, a pediatric infectious diseases physician at UPMC Children’s Hospital of Pittsburgh, gathered fellow infectious disease transplant experts to publish a framework for keeping patients and hospital staffs safe during an outbreak of COVID-19 (
The American Association of Kidney Patients (AAKP) recently held a webinar about coronavirus and kidney patients in partnership with the Centers for Disease Control and Prevention (CDC). Shannon Novosad, MD, MPH, a medical officer with the CDC’s dialysis safety team, discussed tips for kidney patients to protect themselves at home, in the community, or in healthcare facilities, including general advice on handwashing and social distancing. She also suggested that patients have a plan in case they become ill and that they have several weeks’ worth of medications and supplies. It is important, she added, that they not postpone dialysis treatment.
The world is struggling with the new and uncertain realities of the COVID-19 pandemic, which has challenged all facets of the healthcare system in unprecedented ways. As the initial experience in the United States has taught us, none are more vulnerable to COVID-19–related morbidity and mortality than the ESRD population (
