Protected: Standard procedures in dialysis during the Covid-19 epidemic

Abstract

Scope

The aim of this document has been to define standard procedures for dealing with dialysis patients once the first cases of novel Coronavirus 2019-nCoV (Covid-19) were confirmed among the Italian population.

Applicability

These procedures, that refer exclusively to the hospital’s dialysis rooms, are currently implemented at the ASST Santi Paolo e Carlo in Milan and two smaller centers in the Milan area.

Description

We describe the preemptive measures adopted by the staff at our dialysis unit since 24/02/2020, in order to slow down the transmission of Covid-19. They have allowed us to adopt a uniform approach towards all patients, streamlining the way we identify and deal with suspected, likely and confirmed Coronavirus infections. To start with, all patients coming to the hospital for their dialytic session have been treated as potentially infectious and everybody has been following closely the standard protocols regarding personal protective equipment (PPE).

 

Keywords: Covid-19-positive, dialysis, prevention, personal protective equipment

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Covid-19 in patients on dialysis: infection prevention and control strategies

Abstract

Covid-19 is a disease caused by a new coronavirus presenting a variability of flu-like symptoms including fever, cough, myalgia and fatigue; in severe cases, patients develop pneumonia, acute respiratory distress syndrome, sepsis and septic shock, that can result in their death. This infection, which was declared a global epidemic by the World Health Organization, is particularly dangerous for dialysis patients, as they are frail and more vulnerable to infections due to the overlap of multiple pathologies. In patients with full-blown symptoms, there is a renal impairment of various degrees in 100% of the subjects observed. However, as Covid-19 is an emerging disease, more work is needed to improve prevention, diagnosis and treatment strategies. It is essential to avoid nosocomial spread; in order to control and reduce the rate of infections it is necessary to strengthen the management of medical and nursing personnel through the early diagnosis, isolation and treatment of patients undergoing dialysis treatment. We cover here a series of recommendations for the treatment of dialysis patients who are negative to the virus, and of those who are suspected or confirmed positive.

Keywords: Covid-19, hemodialysis, transmission, prevention

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Introduzione

La malattia da Coronavirus 2019 (Covid-19), appartiene alla grande famiglia di virus a RNA che possono essere isolati in diverse specie di animali [1] e che, per ragioni ancora sconosciute, possono attraversare le barriere della specie e possono causare nell’uomo malattie che vanno dal comune raffreddore a patologie più gravi come la SARSr-CoV1e la MERS. Il 30 gennaio 2020 l’Organizzazione Mondiale della Sanità ha dichiarato ufficialmente l’epidemia Covid-19 un’emergenza di sanità pubblica di interesse internazionale [2].

I sintomi clinici dei pazienti comprendono febbre (44%-98%), tosse secca (68%-76%), mialgia (18%) ed affaticamento (18%); i pazienti in gravi condizioni possono presentare respiro affannoso, rantoli umidi nei polmoni e suoni del respiro indeboliti fino alla polmonite bilaterale, sindrome da distress respiratorio acuto (ARDS), sepsi, shock settico e morte [3]. Sulla base dell’indagine epidemiologica attualmente in corso, il periodo di incubazione della malattia è generalmente compreso tra 3 e 7 giorni, con un massimo di 14 giorni [2] e la trasmissione da uomo a uomo avviene attraverso goccioline di saliva o con contatto diretto; a differenza della SARS, il Covid-2019 è responsabile dell’infezione anche se il paziente è asintomatico [2].

 

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REPORT FOR THE WORLD KIDNEY DAYS IN ITALY 2015-2016

Abstract

World Kidney Day (WKD) is a global campaign, promoted by International Federation of Kidney Foundations (IFKF) and International Society of Nephrology (ISN) aimed at raising awareness among people on importance of our kidneys. This campaign includes many events across the globe. The main purpose of WKD is to create and spread awareness about preventive behaviours and risk factors for renal diseases. In Italy WKD is organized by the Italian Kidney Foundation (FIR) in collaboration with Italian Society of Nephrology (SIN) and the Red Cross of Italy. It takes place in hospitals, public spaces and in schools, where each participant is provided with informative material together with blood pressure and urine dipstick testing. Here, we present the data collected during the 2015 and 2016 WKD campaigns.

KEYWORDS: World Kidney Day, Prevention, Hypertension, Urinalysis

Sorry, this entry is only available in Italian. For the sake of viewer convenience, the content is shown below in the alternative language. You may click the link to switch the active language.

Introduzione

La giornata mondiale del rene (GMR) è un’iniziativa internazionale che mira all’informazione e alla sensibilizzazione dell’opinione pubblica circa le patologie renali, focalizzando l’attenzione sui fattori di rischio e sulle possibilità di cura e trattamento delle stesse (1). In Italia tale evento viene organizzato dalla Fondazione Italiana del Rene (FIR), con la collaborazione della Società Italiana di Nefrologia (SIN) e la Croce Rossa Italiana (CRI). L’iniziativa, che coinvolge numerose Unità di Nefrologia distribuite sul territorio nazionale, si articola su due progetti distinti, quello che si svolge nelle piazze o negli ambulatori di Nefrologia, detto anche “progetto camper” (2, 3), e quello che si tiene nelle scuole, rivolto in particolare a studenti del quarto e quinto anno di scuola superiore.

In questo articolo riportiamo i dati ricavati dai partecipanti alla GMR negli anni 2015 e 2016.
 

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