The Health Ministry has issued guidelines for dialysis of Covid 19 patients asking states and Uts to earmark at least one dialysis facility in case of rise of COVID-19 epidemic.
The guidelines issued on Wednesday say that the states and UTs should identify and earmark at-least one hemodialysis facility with adequate number of dialysis machines, trained staff, reverse osmosis (RO) water system and other support equipment as preparatory fixed-point dialysis unit in case of rise of COVID-19 epidemic.
Health departments have to issue directives to the district administrations allowing easy movements of these patients (with one attendant) to dialysis facility.
Patients who do not have private vehicles, government run transport system should be organised for facilitating transport of these patients. Patients should use their hospital papers as pass to commute to the dialysis unit.
The district administration should ensure that service providers for the dialysis consumables, should be allowed to deliver the material to the hospital or home as the case may be.
COVID-19, a disease caused by a novel coronavirus (SARS CoV-2), is currently a pandemic, which produces high morbidity in the elderly and in patients with associated comorbidities.
Chronic kidney disease stage-5 (CKD-5) patients on dialysis [maintenance hemodialysis (MHD)or continuous ambulatory peritoneal dialysis (CAPD)] are also vulnerable group because of their existing comorbidities, repeated unavoidable exposure to hospital environment and immunosuppressed state due to CKD-5.
These patients are therefore not only more prone to acquire infection but also develop severe diseases as compared to general population.
Patients on regular dialysis should adhere to prescribed schedule and not miss their dialysis sessions to avoid any emergency dialysis. There will be three situations of patients who require dialysis, patients already on maintenance dialysis, patients requiring dialysis due to acute kidney injury (AKI) and patients critically ill requiring continuous renal replacement therapy (CRRT).
The dialysis units have been informed that a sign board should be posted prominently in the local understandable language as well as Hindi and English asking patients to report any fever, coughing or breathing problem in dialysis unit and waiting area.
All hemodialysis units should educate their personnel in hemodialysis units; including nephrologists, nurses, technicians, other staff and all patients undergoing MHD along with their care givers about COVID-19.