The coronavirus has taken a toll on all of us—but the 37 million Americans with chronic kidney disease (CKD) are taking the COVID-19 pandemic especially hard.* People with CKD are used to taking the many precautions that everyone is now practicing amid the virus’ spread, but they’re also feeling more isolated than ever in lockdown. 

Higher risk of mortality leads to isolation

CKD patients are at a higher risk of serious complications from COVID-19, leading many to isolate themselves more than usual. This means that people with CKD are no longer able to see their family and friends as a means to reduce their chances of getting COVID-19. In the process, however, this eliminates the social support system that they would typically use to navigate uncertainty. 

Many CKD patients are especially vulnerable since they typically also have related medical conditions, such as diabetes. “In the U.S., the leading causes of kidney failure are diabetes and high blood pressure, which afflict 34 million and 108 million American adults, respectively,” according to National Geographic. These conditions could compromise the kidney’s ability to balance fluids and electrolytes, and coronavirus can worsen this damage.

In addition, some people do not know they have kidney damage until they end up in the hospital with coronavirus complications. They may arrive at the hospital with a severe headache and nausea and prolonged fatigue, and they may struggle to breathe, due to excess fluid build-up. They often need immediate help via dialysis to keep compromised kidneys from failing.

“For people who are in kidney failure, if they don’t get the care they need, they will die. It’s that dire,” says LaVarne Burton, president and CEO of the American Kidney Fund (AKF). If a patient needs a kidney transplant, they are put on an immunosuppressant afterward to prevent their bodies from rejecting their new kidney, but this also makes them more susceptible to COVID-19.

The financial burden

In addition to isolation, many are being affected financially by the economic downturn. Dealing with unemployment makes access to expensive medications a challenge. One such example is Chika Nwerem, a 47-year-old from Portland, Oregon. 

Nwerem received a kidney transplant in August, and her doctors recommended taking three months off work, due to her high-dose prescription of immunosuppressants. Since her leave is unpaid, she had to look elsewhere for financial help, such as through the AKF. This offers temporary relief, but she knows it won’t last forever.

Can COVID-19 lead to newfound kidney issues?

According to Dr. Girish Nadkarni, a nephrologist in New York City, it was originally thought that COVID-19 was just a respiratory disease, but doctors have found that it’s a systemic disease that can also affect the kidneys. In fact, after reviewing electronic health records of Mount Sinai in East Harlem patients, he found that 46% of the hospital’s COVID-19 patients experienced abrupt kidney failure and that one in five required dialysis. 

“Kidney function still hadn’t returned to normal in 30 percent of the patients who were discharged from the hospital,” said Dr. Nadkarni. “We don’t know the true downstream implications of chronic COVID disease and if it could bring an epidemic of chronic kidney disease.”

Healthy ways to cope

People with CKD can still live healthy lives during the pandemic. Some suggested ways to deal with continued isolation include the following:

• Maintain social connections through safely gathering outdoors or using video chat to connect with friends and family.
• Continue regular medical care, including with a therapist, to manage kidney disease and learn how to cope healthily during the pandemic. 
• Go on a short getaway (or drive) with family or friends for a change of scenery.
• Get takeout from your favorite restaurant.

People with CKD must take the necessary precautions to protect themselves from the virus while still trying to find ways to enjoy life until the pandemic is over.

*Arnold, C. (2020, Oct. 30). Why lockdowns have left kidney patients ‘totally and completely terrified.’ National Geographic. https://www.nationalgeographic.com/science/2020/10/chronic-kidney-disease-patients-millions-need-coronavirus-surges-to-end/