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Abstract: PO0750

Monitoring Trends of COVID-19 Among ESKD Patients in a Large Dialysis Organization

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)


  • Kubisiak, Kristine, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Weinhandl, Eric D., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Ofsthun, Norma J., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Dalrymple, Lorien S., Fresenius Medical Care, Waltham, Massachusetts, United States

Monitoring real-time acceleration, plateaus, and deceleration of infection rates is important for healthcare planning during a pandemic. We implemented methodology to continuously monitor daily cases and changes of COVID-19 case rates among individuals with ESKD receiving care in a large dialysis organization.


We identified patients with ESKD receiving dialysis in a Fresenius Medical Care North America (FMCNA) dialysis facility who tested positive for COVID-19. We fit a loess curve to the daily cumulative number of identified cases and computed the first and second derivative of the fitted curve to assess rate of change and change in rate of change, respectively, over time. We used these visualization techniques to monitor trends in case rates at the national and state levels.


By May 15, 2020, there were 5,513 confirmed COVID-19 cases among patients receiving dialysis in an FMCNA facility. Mean age was 63.6 years, 57% were male, and 71% of confirmed cases had diabetes. Nationally, during the peak infection period in early April, new cases routinely exceeded 150 per day and there was a steady acceleration in growth of cases until the second week of April. As of May 15, 2020, among states with sufficient data, 2 states demonstrated continued acceleration, 10 demonstrated deceleration, and 13 plateaued in rate of growth.


The timing of the acceleration in growth of COVID-19 cases among individuals with ESKD followed national trends in the general population. Varying patterns of plateauing and deceleration of cases at the state level were observed in the ESKD population. Real-time monitoring of disease rates in high-risk populations, such as individuals with ESKD, is needed to plan for continuously changing healthcare demands during a pandemic.


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