The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

Ryan E Aylward; Brian Bieber; Murilo Guedes; Ronald Pisoni; Elliot Koranteng Tannor; Fergus J Caskey

doi:10.1016/j.ekir.2021.12.011

The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

Ryan E Aylward, Brian Bieber, Murilo Guedes, Ronald Pisoni, Elliot Koranteng Tannor, Fergus J Caskey^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

IntroductionTo assess the impact of the COVID-19 pandemic impact on hemodialysis (HD) centers, The Dialysis Outcomes and Practice Patterns Study and ISN collaborated on a web-survey of centers.MethodsA combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centers in 78 countries and all 10 ISN regions.ResultsIn 8 regions, rates of SARS-CoV-2 infection were <20% in most centers, but in North East Asia (NE Asia) and Newly Independent States and Russia (NIS & Russia), rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centers in 8 regions, although lower in North America and Caribbean (N America & Caribbean) and NE Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centers in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centers in NE Asia to ≥50% in 63% of centers in the Middle East and 68% of centers in NIS & Russia. In most centers, <10% of staff died, but in Africa and South Asia (S Asia), 2% and 6% of centers reported ≥50% mortality, respectively.ConclusionThere has been wide global variation in SARS-CoV-2 infection rates among HD patients and staff, personal protective equipment (PPE) availability, and testing, and the ways in which services have been redesigned in response to the pandemic.

Original language	English
Pages (from-to)	397–409
Number of pages	13
Journal	Kidney international reports
Volume	7
Issue number	3
Early online date	13 Dec 2021
DOIs	https://doi.org/10.1016/j.ekir.2021.12.011
Publication status	Published - 1 Mar 2022

Bibliographical note

Funding Information:
RPF has received research grants from Fresenius Medical Care, consulting fees from Astra Zeneca, Bayer, Novo Nordisk, Boeringer-Lilly, and Rethrophin. RPF has also conducted voluntary work for the ISN and KDIGO. VJ has received grants from Baxter Healthcare, GlaxoSmithKline, NephroPlus, and Biocon, received honoraria from AstraZeneca and Baxter healthcare, participated in Zydus and GlaxoSmithKline data safety monitoring boards, and is the past president of the ISN. AL is a member of ISN ExCom, OSEA Regional Board, and Chair of the ISN Disaster Preparedness Working Group. BR has received consultancy fees or travel reimbursement since 2019 from AstraZeneca, GlaxoSmithKline, and Kyowa Kirin Co. All the other authors declared no competing interests.

Funding Information:
The authors would like to thank national Society and Registry country and ISN Regional Board leads who provided lists of dialysis centers that we were then able to contact. Supplementary Appendix S3 lists these contributors and surveyed respondents who wished to be acknowledged (NB we are unable to link respondents with individual responses). We are grateful to Charu Malik and Paul Laffin at ISN for their support, and Silvia Salaro at ISN who assisted with contacting country leads and deploying the survey. We are grateful to staff at Arbor Research Collaborative for Health for supporting survey development and deployment. This research has previously been presented at Kidney Week 2021 (American Society of Nephrology). Global support for the ongoing DOPPS Programs is provided without restriction on publications by a variety of funders. Funding is provided to Arbor Research Collaborative for Health and not to investigators. For details seehttps://www.dopps.org/AboutUs/Support.aspx. BR, RPF, MG, and RP (DOPPS) developed the study idea and initial questionnaire. FC, RA, ET, GD, AL, VL, DS, CP, RE, and VJ adapted the survey. RA and FC disseminated the survey to ISN-members (with the support of ISN). BB performed the analysis. RA wrote a first draft of the manuscript, with edits by FC, RPF, and BR. All authors reviewed the manuscript and approved its final draft.

Publisher Copyright:
© 2021 International Society of Nephrology

Keywords

chronic dialysis
nephrology
advocacy

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title = "The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey",

abstract = "IntroductionTo assess the impact of the COVID-19 pandemic impact on hemodialysis (HD) centers, The Dialysis Outcomes and Practice Patterns Study and ISN collaborated on a web-survey of centers.MethodsA combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centers in 78 countries and all 10 ISN regions.ResultsIn 8 regions, rates of SARS-CoV-2 infection were <20% in most centers, but in North East Asia (NE Asia) and Newly Independent States and Russia (NIS & Russia), rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centers in 8 regions, although lower in North America and Caribbean (N America & Caribbean) and NE Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centers in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centers in NE Asia to ≥50% in 63% of centers in the Middle East and 68% of centers in NIS & Russia. In most centers, <10% of staff died, but in Africa and South Asia (S Asia), 2% and 6% of centers reported ≥50% mortality, respectively.ConclusionThere has been wide global variation in SARS-CoV-2 infection rates among HD patients and staff, personal protective equipment (PPE) availability, and testing, and the ways in which services have been redesigned in response to the pandemic.",

keywords = "chronic dialysis, nephrology, advocacy",

author = "Aylward, {Ryan E} and Brian Bieber and Murilo Guedes and Ronald Pisoni and Tannor, {Elliot Koranteng} and Caskey, {Fergus J}",

note = "Funding Information: RPF has received research grants from Fresenius Medical Care, consulting fees from Astra Zeneca, Bayer, Novo Nordisk, Boeringer-Lilly, and Rethrophin. RPF has also conducted voluntary work for the ISN and KDIGO. VJ has received grants from Baxter Healthcare, GlaxoSmithKline, NephroPlus, and Biocon, received honoraria from AstraZeneca and Baxter healthcare, participated in Zydus and GlaxoSmithKline data safety monitoring boards, and is the past president of the ISN. AL is a member of ISN ExCom, OSEA Regional Board, and Chair of the ISN Disaster Preparedness Working Group. BR has received consultancy fees or travel reimbursement since 2019 from AstraZeneca, GlaxoSmithKline, and Kyowa Kirin Co. All the other authors declared no competing interests. Funding Information: The authors would like to thank national Society and Registry country and ISN Regional Board leads who provided lists of dialysis centers that we were then able to contact. Supplementary Appendix S3 lists these contributors and surveyed respondents who wished to be acknowledged (NB we are unable to link respondents with individual responses). We are grateful to Charu Malik and Paul Laffin at ISN for their support, and Silvia Salaro at ISN who assisted with contacting country leads and deploying the survey. We are grateful to staff at Arbor Research Collaborative for Health for supporting survey development and deployment. This research has previously been presented at Kidney Week 2021 (American Society of Nephrology). Global support for the ongoing DOPPS Programs is provided without restriction on publications by a variety of funders. Funding is provided to Arbor Research Collaborative for Health and not to investigators. For details seehttps://www.dopps.org/AboutUs/Support.aspx. BR, RPF, MG, and RP (DOPPS) developed the study idea and initial questionnaire. FC, RA, ET, GD, AL, VL, DS, CP, RE, and VJ adapted the survey. RA and FC disseminated the survey to ISN-members (with the support of ISN). BB performed the analysis. RA wrote a first draft of the manuscript, with edits by FC, RPF, and BR. All authors reviewed the manuscript and approved its final draft. Publisher Copyright: {\textcopyright} 2021 International Society of Nephrology",

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doi = "10.1016/j.ekir.2021.12.011",

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T1 - The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services

T2 - An ISN-Dialysis Outcomes Practice Patterns Study Survey

AU - Aylward, Ryan E

AU - Bieber, Brian

AU - Guedes, Murilo

AU - Pisoni, Ronald

AU - Tannor, Elliot Koranteng

AU - Caskey, Fergus J

N1 - Funding Information: RPF has received research grants from Fresenius Medical Care, consulting fees from Astra Zeneca, Bayer, Novo Nordisk, Boeringer-Lilly, and Rethrophin. RPF has also conducted voluntary work for the ISN and KDIGO. VJ has received grants from Baxter Healthcare, GlaxoSmithKline, NephroPlus, and Biocon, received honoraria from AstraZeneca and Baxter healthcare, participated in Zydus and GlaxoSmithKline data safety monitoring boards, and is the past president of the ISN. AL is a member of ISN ExCom, OSEA Regional Board, and Chair of the ISN Disaster Preparedness Working Group. BR has received consultancy fees or travel reimbursement since 2019 from AstraZeneca, GlaxoSmithKline, and Kyowa Kirin Co. All the other authors declared no competing interests. Funding Information: The authors would like to thank national Society and Registry country and ISN Regional Board leads who provided lists of dialysis centers that we were then able to contact. Supplementary Appendix S3 lists these contributors and surveyed respondents who wished to be acknowledged (NB we are unable to link respondents with individual responses). We are grateful to Charu Malik and Paul Laffin at ISN for their support, and Silvia Salaro at ISN who assisted with contacting country leads and deploying the survey. We are grateful to staff at Arbor Research Collaborative for Health for supporting survey development and deployment. This research has previously been presented at Kidney Week 2021 (American Society of Nephrology). Global support for the ongoing DOPPS Programs is provided without restriction on publications by a variety of funders. Funding is provided to Arbor Research Collaborative for Health and not to investigators. For details seehttps://www.dopps.org/AboutUs/Support.aspx. BR, RPF, MG, and RP (DOPPS) developed the study idea and initial questionnaire. FC, RA, ET, GD, AL, VL, DS, CP, RE, and VJ adapted the survey. RA and FC disseminated the survey to ISN-members (with the support of ISN). BB performed the analysis. RA wrote a first draft of the manuscript, with edits by FC, RPF, and BR. All authors reviewed the manuscript and approved its final draft. Publisher Copyright: © 2021 International Society of Nephrology

PY - 2022/3/1

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N2 - IntroductionTo assess the impact of the COVID-19 pandemic impact on hemodialysis (HD) centers, The Dialysis Outcomes and Practice Patterns Study and ISN collaborated on a web-survey of centers.MethodsA combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centers in 78 countries and all 10 ISN regions.ResultsIn 8 regions, rates of SARS-CoV-2 infection were <20% in most centers, but in North East Asia (NE Asia) and Newly Independent States and Russia (NIS & Russia), rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centers in 8 regions, although lower in North America and Caribbean (N America & Caribbean) and NE Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centers in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centers in NE Asia to ≥50% in 63% of centers in the Middle East and 68% of centers in NIS & Russia. In most centers, <10% of staff died, but in Africa and South Asia (S Asia), 2% and 6% of centers reported ≥50% mortality, respectively.ConclusionThere has been wide global variation in SARS-CoV-2 infection rates among HD patients and staff, personal protective equipment (PPE) availability, and testing, and the ways in which services have been redesigned in response to the pandemic.

AB - IntroductionTo assess the impact of the COVID-19 pandemic impact on hemodialysis (HD) centers, The Dialysis Outcomes and Practice Patterns Study and ISN collaborated on a web-survey of centers.MethodsA combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centers in 78 countries and all 10 ISN regions.ResultsIn 8 regions, rates of SARS-CoV-2 infection were <20% in most centers, but in North East Asia (NE Asia) and Newly Independent States and Russia (NIS & Russia), rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centers in 8 regions, although lower in North America and Caribbean (N America & Caribbean) and NE Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centers in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centers in NE Asia to ≥50% in 63% of centers in the Middle East and 68% of centers in NIS & Russia. In most centers, <10% of staff died, but in Africa and South Asia (S Asia), 2% and 6% of centers reported ≥50% mortality, respectively.ConclusionThere has been wide global variation in SARS-CoV-2 infection rates among HD patients and staff, personal protective equipment (PPE) availability, and testing, and the ways in which services have been redesigned in response to the pandemic.

KW - chronic dialysis

KW - nephrology

KW - advocacy

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DO - 10.1016/j.ekir.2021.12.011

M3 - Article (Academic Journal)

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SN - 2468-0249

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JO - Kidney international reports

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IS - 3

ER -

The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

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