As the second wave of COVID-19 grips the country with a dangerously alarming rise in COVID-19 infections, a lot remains unknown about the impact of COVID-19 on patients suffering kidney ailments or those who are on dialysis. Republic Media Network posed some of the common questions on kidney ailments amid COVID-19 with leading experts and medical practitioners: Dr. Zaheer Virani - nephrologist from DNB Nephrology and also a member of Maharashtra's COVID-19 task force. Dr. Gaurav Sagar - Senior consultant Nephrology, Indraprastha Apollo Hospitals.
Q1. What are the core guidelines for patients with dialysis during this second wave? Are they more susceptible? Dr Zaheer Virani answers:
"Dialysis patients are as susceptible as anybody in the general population. The difference is that dialysis patients visit dialysis centres twice-thrice a week and some of these centres are in hospitals that also treat COVID patients. So they cannot be home quarantined and they are more exposed. But we are better prepared this time as compared to the first wave, we have a program covidialysis.in where no dialysis patient who has turned COVID positive will ever be denied dialysis."
Q2. What are the blood parameters and other symptoms to look out for if someone is COVID positive and under dialysis? Dr. Zaheer Virani
"Very similar to what you would have in the general population. Some of our dialysis patients are also breathless because they accumulate fluid in the lungs. So when a patient on dialysis gets breathless, it might be a little difficult to differentiate whether they are COVID positive and the breathlessness is because of that or because of fluid connection which can be deducted by a good history. As far as treatment is concerned, they have to continue dialysis even if they turn COVID positive. Discontinuing dialysis might lead to more complications."
Q3. When does a patient under dialysis have to go to the hospital after testing COVID positive? Dr. Zaheer Virani answers:
"If you have a high-grade fever which is not subsiding with Paracetamol, if a patient is breathless with oxygen saturation less than 95, if he has any untoward symptoms like persistent diarrhea or vomiting or his mental status is deteriorated like he is feeling drowsy or sleepy all the time, then he should immediately to the hospital. However, he should first consult a doctor and his doctor should decide on hospitalization on the basis of the parameters such as temperature, heart rate, blood pressure, oxygen saturation."
Q4. If I am COVID positive and undergoing dialysis then how does it impact my sessions? Dr. Zaheer Virani answers:
It does not impact your sessions and one must continue with his dialysis. If he has any issues with the dialysis then he should consult his nephrologist.
Q5. What is the recovery timeline from post-COVID for patients undergoing dialysis? What helps in the recovery phase? Dr. Zaheer Virani answers:
"Good nutrition and physiotherapy is the best treatment as far as recovery is concerned. One will have a lot of fatigue, weakness respiratory discomfort, so one has to gradually undergo physiotherapy session with good nutrition. But do not discontinue dialysis. Those discontinuing dialyses are the ones who are suffering and ending up in the ICUs with unfortunate events."
Q6. Are the medicines available for patients under dialysis more restrictive vis-a-vis COVID? Dr. Zaheer Virani answers:
"Three of four medications which are found to be useful by WHO - one is Betamethasone which is a steroid given for dialysis patients. The second one is Oxygen given to dialysis patients. Even Remdisivir can be given as a life-saving drug if required if a physician thinks it is necessary."
Q7. Can a COVID vaccine be taken by patients on dialysis? Dr. Gaurav Sagar answers:
Absolutely, all dialysis patients and kidney transplant patients should be advised to take the vaccine as soon as they are eligible for it and they should take the vaccines like I mentioned they are more exposed because they have to leave their homes and visit dialysis centres.
Q8. What are the general precautions to be advised for patients on dialysis? Dr. Gaurav Sagar answers:
Not to miss dialysis. They are more prone to infections, cardiac issues, they have fluctuations in blood pressures, so if they do regular dialysis, the non-COVID issues will be minimised. And maintain a healthy nutritional diet.