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Kidney Week

Abstract: PO0741

Impact of the COVID-19 Pandemic on In-Center Intermittent Hemodialysis Treatment Adherence

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Gill, Jasmeet, Baylor University Medical Center at Dallas, Dallas, Texas, United States
  • Gonzalez, Stevan A., Baylor Simmons Transplant Institute, Fortworth, Texas, United States
  • Wiederkehr, Michael R., Dallas nephrology associates, Dallas, Texas, United States
  • Szerlip, Harold M., Baylor University Medical Center at Dallas, Dallas, Texas, United States
  • Fuquay, Richard C., Dallas nephrology associates, Dallas, Texas, United States
Background

Studies have shown that 7.9% of patients miss one to two hemodialysis session per month and 35% miss hemodialysis at least once every three months.1 During current COVID-19 pandemic there has been a decrease in utilization of emergency medical services due to fear of contagion. We hypothesized that patients undergoing in-center hemodialysis might have increased compliance with their dialysis prescription to avoid emergency department visits or hospitalizations. We therefore evaluated the effects of the COVID-19 pandemic on patient adherence to their dialysis prescription.

Methods

This is a retrospective analysis of in-center hemodialysis patients treated in the seven American Renal Associates (ARA) dialysis facilities in Dallas, Texas. COVID-19 was declared a pandemic on March 11, 2020 and pandemic related changes were mandated in ARA hemodialysis facilities on March 13, 2020. We used existing clinical data and examined patient compliance with their dialysis prescription between January 1 to March 14, 2020 (pre-COVID) and March 15 to May 18, 2020 (COVID).

Results

The study enrolled 754 eligible patients. Significantly fewer patients missed a single treatment in the COVID vs pre-COVID periods (35.5% vs 49.9%; p<0.001). The percentage of patients who were hospitalized was lower during COVID vs pre-COVID (12.5% vs. 19.6%; p<0.001). The percentage of patients who shortened hemodialysis time was lower during COVID vs pre-COVID (36.2% vs. 40.9%; p=0.06) although not statistically significant. Finally, significantly more patients achieved a weight within1 kg of their estimated dry weight at the end of the dialysis sessions COVID vs. pre-COVID (28.5% vs. 34.5%, p=0.01).

Conclusion

These data suggest that during current COVID-19 pandemic, hemodialysis patients have become more adherent to their dialysis prescription. Retrospective studies have suggested that patients are avoiding seeking medical care due to fear of contacting the SARS-CoV-2 virus1. Our data suggest that similarly, hemodialysis patients have significantly increased their adherence to hemodialysis prescription in order to avoid hospital visits. Additional studies are ongoing to determine the causes for the observed improved compliance.