Dialysis patients are at risk of contracting covid

The COVID-19 pandemic in Indonesia requires people to do something psychical distancing and don't leave the house. However, for dialysis patients, leaving the house is a must, especially to go to a clinic or hospital which is a location with a high risk of COVID-19 infection.

Patients with end-stage renal failure must routinely undergo hemodialysis or routine dialysis at least twice a week. Even though every time you leave the house, the potential risk of contracting is getting bigger, dialysis cannot be postponed because that's how they survive.

Even though the effects of COVID-19 can be more dangerous if it infects patients with previous comorbidities. So, how do dialysis patients in Indonesia face the risk of COVID-19?

The risks of contracting COVID-19 faced by dialysis patients

The SARS-CoV-2 virus that causes COVID-19 is a challenge for the health system. This is because of its novelty, the speed at which it spreads, and the severity of the symptoms.

The initial symptoms of COVID-19 are similar to those of the flu, namely fever, sore throat and shortness of breath. However, if this virus attacks the vital organs of the body, the damage will be serious.

The scale of the severity of the effects of infection is very wide, from asymptomatic, experiencing critical respiratory failure, failure to function in several organs at once, to death.

Most cases of death due to COVID-19 infection occur in patients with comorbidities or patients with comorbidities, namely cardiovascular disease, chronic lung disease, immunosuppression (decreased immunity), diabetes, liver disease, and chronic kidney disease.

There are no specific studies on the extent of the risk of the effects of COVID-19 in chronic kidney failure patients who need regular dialysis.

However, several studies have shown that dialysis patients may have a risk of more serious effects when infected with the SARS-CoV-2 virus.

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1. Low body resistance is a risk factor

The majority of dialysis patients have immune defenses below average. This makes the risk of being infected with COVID-19 more likely to be.

This is because high levels of urea in the blood cannot be excreted through urine. Ureum is the waste of protein and amino acids in the liver. Excessive urea levels can poison the blood and reduce endurance.

"If traced like this, it means that this virus infection will be heavier. The possibility of achieving respiratory failure in dialysis patients is higher than healthy people, ”explained Akbarbudhi Antoro, a doctor of internal medicine at Cipto Mangunkusumo Hospital (RSCM).

2. COVID-19 infection attacks the kidneys

In China, there have been several cases of COVID-19 patients who have experienced kidney failure and need transplants. Even though the patient did not have a previous history of kidney disease.

This condition is likely triggered by choked oxygen circulation in people with COVID-19 who experience pneumonia. As a result, damage to the kidneys cannot be avoided.

Similar cases have occurred in several patients who contracted SARS. In the past, experts found that the viruses that cause SARS and MERS cause infections in the tubules or tubes of the kidneys.

Journal JAMA Network said, with these facts, the risk of worsening conditions in kidney failure patients who must dialysis when infected with COVID-19 should be watched out for.

3. Dialysis patients are prone to complications from other organ disorders

Kidney failure patients who depend on dialysis usually have other comorbidities. Along with malfunctioning of both kidneys, dialysis patients are prone to damage to other organs of the body.

The risk of the disorder includes susceptibility to the patient's lung and heart conditions.

"When the kidneys are not functioning, the patient is prone to experience complications of heart and lung problems. Even if they miss one session, there will be a buildup of fluid in their lungs that threatens their lives, ”said dr. Akbar.

Stories of dialysis patients maintaining their health amid the COVID-19 pandemic

Since the outbreak of the COVID-19 outbreak in Indonesia, hospitals and clinics that provide dialysis have started to do so screening medical examination of patients before admission.

Patients will be checked for body temperature and asked about any COVID-19 symptoms they feel such as sore throat and shortness of breath. Those with symptoms will be transferred to a COVID-19 referral hospital for further examination.

Meanwhile, the referral hospital cannot carry out the dialysis process at once. This situation puts dialysis patients at risk not only at the risk of COVID-19 infection.

Tony Samosir, chairman of the Indonesian Dialysis Community (KPCDI), said that this regulation requires patients to postpone dialysis schedules and it endangers their lives.

"Kidney failure is often coughing, shortness of breath, and high body temperature. This is because when you drink too much, water will accumulate in your lungs, ”explained Tony.

"We agree that patients with COVID-19-like symptoms should be tested and isolated, in case it is really positive. But there must be parallel action, providing a special isolation room that provides dialysis facilities, "continued Tony.

Tony asked the government to develop procedures for handling dialysis patients in the midst of the COVID-19 pandemic. The Indonesian Nephrology Association has discussed the handling standard because it is deemed absolutely necessary.