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Review
. 2020 Apr 4;5(5):580-585.
doi: 10.1016/j.ekir.2020.04.001. eCollection 2020 May.

Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy

Federico Alberici  1   2 , Elisa Delbarba  2 , Chiara Manenti  2 , Laura Econimo  2 , Francesca Valerio  2 , Alessandra Pola  2 , Camilla Maffei  2 , Stefano Possenti  2 , Simone Piva  1   3 , Nicola Latronico  1   3 , Emanuele Focà  4   5 , Francesco Castelli  4   5 , Paola Gaggia  2 , Ezio Movilli  2 , Sergio Bove  6 , Fabio Malberti  7 , Marco Farina  8 , Martina Bracchi  9 , Ester Maria Costantino  10 , Nicola Bossini  2 , Mario Gaggiotti  2 , Francesco Scolari  1   2 ; Brescia Renal COVID Task Force
Collaborators, Affiliations
Review

Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy

Federico Alberici et al. Kidney Int Rep. .

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease (COVID-19), is a major pandemic challenging health care systems around the world. The optimal management of patients infected with COVID-19 is still unclear, although the consensus is moving toward the need of a biphasic approach. During the first phase of the disease (from onset of the symptoms up to 7-10 days) viral-induced effects are prominent, with the opportunity to institute antiviral therapy. In the second inflammatory phase of the disease, immunosuppressive strategies (for example with glucocorticoids or anticytokine drugs) may be considered. This latter stage is characterized by the development of progressive lung involvement with increasing oxygen requirements and occasionally signs of the hemophagocytic syndrome. The management of the disease in patients with kidney disease is even more challenging, especially in those who are immunosuppressed or with severe comorbidities. Here we present the therapeutic approach used in Brescia (Italy) for managing patients infected with COVID-19 who underwent kidney transplantation and are receiving hemodialysis. Furthermore, we provide some clinical and physiopathological background, as well as preliminary outcome data of our cohort, to better clarify the pathogenesis of the disease and clinical management.

Keywords: COVID-19; SARS-CoV-2; dialysis; kidneys; management; patients; transplant.

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Comment in

  • Six Years of KI Reports: Milestones Behind and Ahead.
    McLean R, Mohan S, Radhakrishnan J. McLean R, et al. Kidney Int Rep. 2021 Dec 6;7(1):1-2. doi: 10.1016/j.ekir.2021.11.030. eCollection 2022 Jan. Kidney Int Rep. 2021. PMID: 35005305 Free PMC article. No abstract available.

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