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Practice Guideline
. 2020 May-Jun;40(3):258-264.
doi: 10.1016/j.nefro.2020.04.001. Epub 2020 Apr 8.

Management of the SARS-CoV-2 (COVID-19) coronavirus epidemic in hemodialysis units

[Article in English, Spanish]
María Dolores Arenas  1 , Judit Villar  2 , Cristina González  3 , Higinio Cao  4 , Silvia Collado  4 , Marta Crespo  4 , Juan Pablo Horcajada  2 , Julio Pascual  4
Affiliations
Practice Guideline

Management of the SARS-CoV-2 (COVID-19) coronavirus epidemic in hemodialysis units

[Article in English, Spanish]
María Dolores Arenas et al. Nefrologia (Engl Ed). 2020 May-Jun.

Abstract
in English, Spanish

The current outbreak of SARS-CoV-2 represents a special risk for renal patients due to their comorbidities and advanced age. The usual performance of hemodialysis treatments in collective rooms increases the risk. The specific information at this time in this regard is very limited. This manuscript includes a proposal for action to prevent infection in the Nephrology Services, and in particular in Hemodialysis Units, with the objective of early identification of patients who meet the definition of a suspected case of infection by SARS-CoV-2 and propose circuits and mechanisms to carry out hemodialysis treatments. They are recommendations in continuous review and can be modified if the epidemiological situation, the diagnostic and therapeutic options so require.

La epidemia de SARS-CoV-2 representa un riesgo especial para los pacientes renales por su condición de personas con comorbilidades y edad avanzada, y por la realización del tratamiento de hemodiálisis en salas colectivas. La información específica en el momento actual al respecto es muy limitada. El presente manuscrito recoge una propuesta de actuación para prevenir la infección en los Servicios de Nefrología, y en particular en las Unidades de Hemodiálisis, con el objetivo de identificar precozmente aquellos pacientes que cumplan con la definición de caso sospechoso de infección por el SARS-CoV-2 y proponer circuitos y mecanismos para administrarles el tratamiento con hemodiálisis. Son recomendaciones en continua revisión y podrán ser modificadas si la situación epidemiológica y las opciones diagnóstico-terapéuticas así lo requieren.

Keywords: COVID-19; Coronavirus; Hemodialysis; Hemodiálisis; SARS-CoV-2.

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Figures

Fig. 1
Fig. 1
Information poster for users of hemodialysis units.
Fig. 2
Fig. 2
Personal protective equipment (PPE), consisting of a pair of powder-free long-sleeved nitrile gloves, a long waterproof gown, a FFP2 mask, and a full-screen surgical mask. This list of individual protective equipment is under permanent review depending on the evolution and new information available on SARS-CoV-2 disease.
Fig. 3
Fig. 3
If aerosols are to be produced (administration of nebulisations, mechanical ventilation, fiberoptic bronchoscopy, orotracheal intubation, aspiration of secretions, etc.), a FFP3 mask (with exhalation valve) and full protective glasses are required. It is recommended that all material be disposable. If long sleeves are not available, use the isolation gown (green) and add a plastic apron.
See this image and copyright information in PMC

References

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    1. Ma Y., Diao B., Lv X., Zhu J., Liang W., Liu L., et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: report from one HD center in Wuhan, China. medRxiv preprint. 2019 doi: 10.1101/2020.02.24.20027201. - DOI
    1. Documento técnico . Dirección General de Salud Pública, Calidad e Innovación, Ministerio de Sanidad; March 2020. Manejo clínico de pacientes con enfermedad por el nuevo coronavirus (COVID-19). Centro de Coordinación de Alertas y Emergencias Sanitarias.

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