Study: Early Months of COVID-19 Pandemic Saw Fewer Patients Looking for Kidney Failure Treatment

Regular dialysis or kidney transplants are common treatment options that were disrupted after the beginning of COVID-19.

A new study found that in the 4 months following the COVID-19 pandemic, the number of patients initiating treatment for kidney failure declined by 30%. Further, black patients and those living in counties with high numbers of COVID-19 deaths initiated treatment with significantly worse levels of kidney function compared to prior years, according to a Brown University press release.

Even with these new results, it does not necessarily mean that patients with chronic kidney disease had fewer incidents of failure or had healthier kidneys, according to lead study author Kevin Nguyen. Instead, this decline in patients with kidney failure most likely reflects decisions to delay treatment or changes in how health care was delivered early in the pandemic. Regular dialysis or kidney transplants are common treatment options that were disrupted after the beginning of COVID-19.

“Treatment in the form of dialysis or a transplant is essential for the survival of people with chronic kidney disease,” Nguyen said in a press release. “Missed routine care could be potentially catastrophic. So, understanding whether and how these initiations of treatment changed with respect to the pandemic is really important.”

The objective of the study was to analyze the number and characteristics of patients initiating treatment for newly diagnosed kidney failure during the pandemic. The researchers also wanted to examine the changes specifically within people of color and members of low-income families due to the disproportional impact of the pandemic.

Data were taken from the Renal Management Information System Medical Evidence Form, which is a national census of all patients with kidney failure who initiate long-term dialysis or receive a preemptive kidney transplant. The team studied the changes in the number of patients with kidney failure initiating treatment and in estimated glomerular filtration rate (eGFR) for the period between March 1 and June 30, 2020, and compared them to the corresponding periods in 2018 and 2019.

This data were segmented by race/ethnicity, county-level COVID-19 mortality, and neighborhood socioeconomic characteristics.

Between March and June 2020, there was a significant decrease in the percentage of patients with kidney failure who received preemptive transplants or who initiated dialysis treatment compared to pre-COVID-19. Additionally, in April 2020, the number of patients initiating treatment for kidney failure was approximately 30% lower than trends in prior years.

There were declines in the measurement of kidney function observed exclusively among non-Hispanic Black patients and declines in eGFR for patients residing in counties with the highest number of deaths from COVID-19, but not for patients residing in other countries, according to the study.

“In the early months of the pandemic, not only were there declines in the number of people initiating treatment for kidney failure, but for some groups, when they did initiate treatment, it was when they had lower kidney function,” Nguyen said in the press release.

Although there is a gradual rebound in treatment initiation that occurred in the later months, it still did not reach pre-pandemic levels, according to Nguyen. Further, the findings still underscore the importance of maintaining continuity of care and improving care for people with chronic kidney disease, both throughout the COVID-19 pandemic and after it diminishes.

“Any disruption in care can have grave consequences for these patients,” Nguyen said in the press release.

REFERENCE

Fewer patients sought treatment for kidney failure in early months of COVID-19 pandemic. Brown University. October 13, 2021. Accessed October 15, 2021. https://www.brown.edu/news/2021-10-13/kidney