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Abstract: PO0744

Clinical and Psychosocial Impact in Mexican Hemodiafiltration Population During the COVID-19 Pandemic, Twice Weekly Sessions: Is This Safe?

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Lopez Gil, Jose S., Instituto Nacional de Cardiologia Dr Ignacio Chavez, Mexico City, Mexico
  • Garza, Hector Alejandro Perez Grovas, Instituto Nacional de Cardiologia Dr Ignacio Chavez, Mexico City, Mexico
  • Madero, Magdalena, Instituto Nacional de Cardiologia Dr Ignacio Chavez, Mexico City, Mexico
  • Xavier, Daniela, Instituto Nacional de Cardiologia Dr Ignacio Chavez, Mexico City, Mexico

Group or Team Name

  • Division of Nephrology
Background

There is evidence that in patients with residual kidney function (RKF) could benefit switch thrice to twice weekly sessions. In patients without RKF, the evidence is limited. We evaluate the clinical and psychosocial impact of the Covid-19 pandemic in Mexico City.

Methods

At the beginning of the Covid-19 pandemic, the on-line posdilutional hemodiafiltration (OL-HDF) sessions were adjusted from 3 to 2 times per week. 2 months later, we determine hemoglobin, urea, serum creatinine, sodium, potassium, calcium, phosphate, albumin, ferritin and C reactive protein. Likewise psychological evaluation using Hamilton test were carried out and characteristic of sessions were collected. We divide in two groups according to thrice versus twice weekly schedule

Results

25 patients were evaluated, 16 (64%) were female, mean age was 42.04±18.02 years, 21 (84%) did not have RKF. The length session between thrice vs twice were 181.74± 9.94 vs 196 ± 9.19 (p<0.001). When we analyzed the anuric patients we found a significant difference in post-session systolic and diastolic blood pressure when compared between groups (p = 0.014). We did not find difference in dry weight (p = 0.5). We found significance difference between total substitution volume between groups (24.43±10.9 L vs 26.5± 12.48 L, p =0.042) and no difference in Kt/V (1.67 ± 0.25 VS 1.73 ± 0.34, p = 0.35). We found significance difference between groups in serum creatinine (8.68±3.55 vs 10.04±2.94, p=0.03) in the rest of molecules we did not find difference. 32 and 44% of the patients developed depression and anxiety, respectively. 36% of patients lost their jobs and 80% use public transport. There was a moderate correlation between anxiety episodes and economic limitation due to Covid-19 (r = 0.40 p = 0.04). There was no significant inverse correlation between pharmacological adherence and economic limitation (r = -0.29 p = 0.29).

Conclusion

Change of the schedule in patients without RFK did not show significant differences in terms of biochemical parameters, on the other hand, improvement in replacement volumes. We considered a safe strategy to reduce the risk of transmission among our population. Pharmacological and attending adherence to sessions was not modified despite the psychological findings due to the Covid-19 pandemic.