COVID-19 and care for patients with chronic kidney disease: challenges and lessons

Abstract The COVID-19 pandemic has blurred the traditional distinction between communicable diseases (CD) and noncommunicable diseases (NCDs) The manifestations of COVID-19 range from an asymptomatic carrier state to fatal multiorgan failure While initial reports did not report significant effects on the kidneys, it is now well established that kidney involvement (acute kidney injury, urinary abnormalities, tubular function defects) in COVID-19 is common and also associated with poorer outcomes At the same time, care for patients with existing chronic kidney disease (CKD) has suffered during this pandemic and those with CKD are considered higher risk for severity of COVID-19 symptoms Widespread lockdowns have affected the delivery of health care to patients with CKD, including those on dialysis or on transplant wait-lists The pandemic has reinforced the need for accessible home-based therapies and highlighted the value of teleconsultation and remote monitoring technologies COVID-19 has revealed the poor emergency preparedness by health systems around the world It has underscored glaring inequities in availability of diagnostic tests and essential medications in different countries, including for dialysis In response, there has been increasing recognition of the necessity of universal health coverage and in prioritizing vaccine distribution to serve the most vulnerable, including those with renal failure The COVID-19 pandemic has also reaffirmed the role of the environment and eco-systems contributing to both CDs and NCDs Attention to universal health coverage through a One Health approach is needed to prevent global health crises and prevent furtherkidney dysfunction and failure