Know your options

• Tell us a little about yourself and your history in the kidney community

I have been a nephrologist for over 30 years. First I was in an academic setting, taking care of patients, teaching and doing research. Then I moved to industry where I felt I could have an impact on design and implementation of new, sorely needed products for patients with kidney disease.

• What will change about dialysis patient care because of COVID‑19?

As in the community at large, wearing masks and keeping a safe distance from others will also be expected in health care settings. If you are a dialysis patient, you will probably see a lot more use of telehealth medicine to help keep the number of patients in clinics at a minimum.

• What should I be prepared for?

You should be prepared for a different experience at dialysis clinics. There will be much more scrutiny around illness. Patients will likely be checked for fever and other symptoms each time they enter health care centers to ensure they are not contagious. Hospital visits for care will have similar procedures in place.

• How can I best manage my health if I don’t go to the clinic?

Telehealth is an excellent way to manage minor health problems. Not missing any dialysis treatments is also key as that contributes to all kinds of poor health outcomes. 

• When is it a good time to go back to my clinic?

You should keep in close contact with your health care provider to determine that. The number of COVID patients and risk of infection is widely different in various geographies. Your health care provider is the best resource for that information.

• Can I delay dialysis until after the pandemic is over?

It is not a good idea to do that. If you delay dialysis too long you could become extremely ill and require emergency treatment. Starting dialysis on an emergency basis is much more risky than starting in a planned fashion.

• If I need to have a catheter placed, what should I consider regarding the surgery?

Whether you choose hemodialysis or peritoneal dialysis you will need a procedure to have a catheter placed. For HD it will be in a blood vessel and for PD it will be in your abdomen. The most important thing to do when going to the health center to have a catheter placed is to follow the instructions of your nephrologist/surgeon. Different centers will have different policies and procedures. Some will require COVID testing before a procedure, others will just check to see that you feel okay and do not have a fever. There will also be rules around visitors. The best advice is to check with your doctor and follow the recommendations.

• How can I prepare for a conversation about my treatment choices?

There are many sources for information about dialysis choices. Under pdempowers.com "Knowledge Center" you will find multiple resources that may be helpful in learning more about kidney disease and your treatment options at home in between your appointments.  The National Kidney Foundation website is also an excellent resource. Again, talk to your healthcare team. They have been through this many times and will be an excellent source to answer all your questions.