Patients with kidney diseases more likely to contract coronavirus; here's a list of precautions one can take to minimise chances of infection

Does the coronavirus affect the kidneys? The answer unfortunately is yes, it does. A bigger concern, however, is that patients with Chronic Kidney Disease (CKD) are more prone to contract coronavirus infection and worsen kidney damage. This is because they have poor immunity. This also applies to kidney transplant patients as well as those who are on immunosuppressive drugs. Kidney involvement seems to be frequent in this infection, and Acute Kidney Injury (AKI) is an independent predictor of mortality. These patients are at high risk of severe infections. The management of patients on dialysis who are suspected to have been in contact with the novel coronavirus should be carried out according to strict protocols to minimise the risk to other patients and healthcare personnel taking care of them. [caption id=“attachment_8190811” align=“alignleft” width=“380”] Representational image. PTI[/caption] Experience from China and South Korea has shown that the virus can cause protein leakage in urine in about 30-40 percent patients and AKI in 15-20 percent patients. AKI is due to multiple factors like dehydration, sepsis and also the concomitant use of painkillers for indiscriminately reducing fever. The kidney damage has been seen in the advanced stage of the disease when the patient has multi-organ failure. At that stage, treatment is usually supportive in the form of dialysis and, if the general condition of the patient improves, the kidney functions of these patients will get better. It remains to be seen as to how many of these patients will progress to develop chronic irreversible kidney damage called CKD. Kidney disease is a non-communicable disease (NCD) and currently affects around 85 crore people worldwide. One in 10 adults has Chronic Kidney Disease (CKD). Considering the gravity of the situation in the fight against the coronavirus, leading kidney specialists worldwide have launched the world’s first multilingual online educational resource ( KidneyEducation.com) to provide all the vital information needed to fight against the dreaded disease and the extra precautions kidney patients should take for their protection, and how, etc. The ‘Know Corona to Defeat Corona’ information has been launched in 12 languages. Currently, the information is available in seven international languages, English, Hindi, Bengali, Arabic, French, Vietnamese, and Serbian, and five Indian languages, Gujarati, Tamil, Telugu, Malayalam and Punjabi. The work of translation in many more languages is under progress. International Society of Nephrology president Dr Vivekanand Jha has dedicated to society this free multilingual online educational resource while American Society of Nephrology president Dr Anupam Agarwal said this was an innovative and free way to educate people online in their native language. Dr Sanjeev Gulati, director, Nephrology and Kidney Transplant, Fortis Group of Hospitals, NCR, is the project-in-charge of the Fight Against Corona on the KidneyEducation.com website. What patients with kidney diseases should know The following guidelines should be adhered to by patients with kidney disease to protect themselves and minimise the risk of contracting coronavirus infection: - Wash your hands frequently or use an alcohol-based sanitiser. This is the single most important step in protecting yourself as the virus is often transmitted by large droplets. - Stop smoking and avoid alcohol intake as this weakens your immune system further and increases the chances of a fulminant infection if you contract the novel coronavirus. - Control your blood sugar meticulously as poor blood sugar will increase your chances of developing infection because of a weak immunity. - Practise social distancing. Avoid meeting people and if necessary to meet them, keep the meeting short and maintain a safe distance. - Keep yourself physically active and do regular workouts at home or in an open park but away from crowds. Physical activity gives a boost to our immune system. Do regular breathing exercises of the chest or yoga as this bolsters the immunity of the lung. - Eat a healthy diet rich in antioxidants (in consultation with your nephrologist and nutritionist). We should use natural foods rich in probiotics and antioxidants like yoghurt, ginger, turmeric and cabbage. - Drink plenty of water, preferably warm water. If you sip water, you may swallow the viruses into your gut and prevent them from getting into your lungs. The human stomach has acidic PH which destroys bacteria and viruses. - Make sure you are vaccinated against pneumococcal infections as this will help minimise the chances of secondary infection - Do not miss your dialysis treatments for fear of contracting coronavirus. If visiting hospitals for consultation or those visiting dialysis units, please wear masks along with protective eye glasses. Routine wearing of masks by everyone all the time is not advisable. Try asking your physician for a teleconsultation to avoid/minimise hospital visits. - Maintain an extra reserve supply of your medications during this pandemic. If the same brand is not available, it is better to go for any generic brand rather than stopping the medication altogether. Hoping that all of you would follow these precautions and stay safe and healthy. Steps to be taken by family members and caregivers - All family members living with patients on dialysis must follow the precautions and regulations given to patients to prevent person-to-person and within-family transmission of the COVID-19 disease, which includes body temperature measurement, good personal hygiene, washing hands, and prompt reporting of potentially sick people. - Patients on dialysis who have a family member or caregiver subject to basic quarantine can have dialysis as usual in accordance during the 14-day period. Dr Gulati can be reached via email at sgulati2002@gmail.com or on the phone at 9871600885