New Delhi: Health experts have warned that people living with certain chronic health conditions such as chronic kidney (CKD) disease, chronic obstructive pulmonary disease (COPD), type 2 diabetes, cancer are at an increased risk of severe illness due to COVID-19, the disease caused by the novel coronavirus or SARS-CoV-2. Current available data suggest that people living with kidney disease, particularly those on dialysis and transplant recipients might be at risk of severe infection and mortality from COVID-19.

As the coronavirus pandemic persists all over the world, doctors, health agencies and governments are engaging in several activities to educate, inform the public with kidney disease and other chronic health issues to reduce their exposure to this dreaded virus and how to respond to a potential infection. Yet, before we list some COVID-19 guidance for patients with chronic kidney disease, let us try to understand what happens to the body when a person with CKD reaches the end-stage of renal disease.

What happens in the end-stage of renal disease and how is it treated?

When a person with chronic kidney disease reaches the end-stage (stage V) of renal disease, the kidneys no longer essay the role or function as healthy kidneys do. The kidneys are unable to remove the toxins, metabolic wastes and excess fluid from the bloodstream effectively. At this point, one of the treatment modality is dialysis, which flushes out unwanted toxins, excess fluid and waste products by filtering the blood.

“Dialysis is one of the treatment methods for these patients, apart from preventing the accumulation of excess waste in the body, the purpose of dialysis is also to help control blood pressure and regulate levels of chemical elements in the blood, including sodium and potassium. Without dialysis, salts and other waste products continue to accumulate in the blood which eventually damages other important organs of the body,” said Dr A S Mathur, Nephrologist, NephroPlus Dialysis Center.

Do’s and Don’ts for patients on dialysis during COVID-19 pandemic

As we pass through the tough times of a pandemic and have been isolated due to intermittent lockdown restrictions in many parts of the country, dialysis patients need to grapple with certain unique challenges with regards to their diet, medication as well as mental health. Below are a few tips suggested by the nephrologist that will help kidney patients, especially those on dialysis, stay healthy amid the pandemic:

Food and Nutrition

Diet is fundamental and, therefore, dialysis patients must make note of their dietary needs:

• Consume less salt or salty foods. Sodium tends to increase thirst and the tendency of drinking more fluid. Use fresh herbs and whole spices or lemon juice/vinegar to add flavour to the food.
• Potassium should be regulated at safe levels in the blood, when levels are too high or too low it can result in cardiac arrest.
• Avoid high phosphate foods such as dairy products, processed food, bone-based soups, beans and cocoa based products.
• Eat a high protein meal that includes foods like eggs, soy, poultry/ meat, lentils and fish.
• Dialysis patients have reduced urine output and therefore excess fluid retained in the body causes shortness of breath, swelling in the legs and high BP.
• Consult your nephrologist on the daily fluid allowance per day that includes tea, coffee, water or any liquid at room temperature.

Medication

People with chronic kidney disease undergoing dialysis face unique health challenges and, thus, it is important to manage all their medication and take them as prescribed. Here are a few tips for managing medication at home:

• Maintain sufficient stock of regular medicines – with current restrictions it would be a good idea to keep a stock of medication (for 2-3 weeks) that is required regularly. It also saves you or your caretaker from having to go and buy them often, avoiding interaction with crowds.
• Understand each medication – do not just blindly ingest medicines from the prescription. Make sure you know what each medication does and its benefits, as advised by your doctor.
• Create a checklist – use a pill organiser and a daily checklist to track your daily regime of medication. Set an alarm so you don’t miss your dose.
• Always keep in touch with your nephrologist on a regular basis.

Mental Health

Your mental health affects your physical health, it is, therefore, common for chronic kidney disease patients and their caretakers to experience mental health issues caused by lifestyle changes especially when living in isolation nowadays.

• Do something you enjoy every day. Pick on your hobbies such as art, music, reading, etc.
• Enjoy a daily walk, get enough sleep and take your medication on time.
• Meditation is also a viable option, focusing on your breathing will help.
• It is best to avoid any unnecessary stress – listen to the advice of your doctor, should you have any apprehensions talk to a family member or your physician – have an open line of communication.

As a kidney patient, you may feel overwhelmed making decisions surrounding your treatments in these difficult times. However, it’s important to realise the fact that you have many rights and options when it comes to your care, helping you live a longer and healthier life.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.