The coronavirus, or COVID-19, pandemic is an unprecedented event that has had many people with chronic conditions and diseases worried about what this means. New information on COVID-19 is constantly coming out as researchers, scientists, and medical professionals learn more. To help address concerns among dialysis patients, the National Kidney Foundation (NKF) answers questions about dialysis and COVID-19.

Should I still go to dialysis if I’m not feeling well?  

Yes, you should. Missing dialysis treatments will only lead you to feel worse—and likely require hospitalization if too much fluid builds up in your body. If you have a confirmed case of COVID-19, have symptoms, or believe you have been exposed to the virus, call your dialysis center before your scheduled appointment. Dialysis clinics are putting special procedures in place to treat potential COVID-19 patients and protect all patients. 

What are dialysis clinics doing to protect patients? 

When it comes to protecting patients, all dialysis clinics are doing three things:

1. performing screenings for every person who enters the building;
2. encouraging each person in the building to wear a mask upon entrance; and
3. cleaning and disinfecting the entire treatment area, including machines and other surfaces.   

If you have COVID-19 or are symptomatic, you will be placed in a separate waiting area and given your dialysis treatment at least six feet away from other patients.

Visitors are also being encouraged to not enter the building. If a visitor or caregiver must enter, they will be screened and encouraged to only stay as long as is necessary. 

Is it safe to reuse surgical masks? 

You should only reuse a surgical mask when there is a shortage of masks. Most dialysis clinics are providing surgical masks to their patients. 

In places experiencing extreme mask shortage, the Centers for Disease Control and Prevention (CDC) has provided recommendations for the re-use of surgical masks:

• Face masks that fasten via ties may not be able to be undone without tearing and should not be re-used.
• Face masks with elastic ear hooks may be more suitable for reuse.
• If face masks are to be reused, the mask should be carefully folded so that the outer surface is held inward and against itself to reduce contact with the outer surface during storage. The folded mask can be stored between uses in a clean, sealable bag or breathable container.
  

Should I wear a mask outside of dialysis treatment?

Outside of dialysis treatment, the CDC also has provided mask recommendations if you have to go in public:

• Always wear a mask in areas where community-based transmission is significant. The mask should be snug, yet comfortable, and cover the bridge of your nose and your whole mouth.
• Keep hand sanitizer with you. Use it often while out in public.
• If you do not have access to surgical masks, masks made of cloth (like a homemade mask crafted out of a t-shirt and a coffee filter, for example) are acceptable.

What are some tips for doing dialysis at home?  

Dialysis at home is much safer because it requires fewer outings and social contact. You still, however, may have opportunities to be exposed to COVID-19.  

Here are some tips for when you need to get dialysis supplies or have lab work done:

1. If the home dialysis company does not bring deliveries into the house and you or another household member are unable to lift the supplies, speak with a dialysis team member. Your dialysis team may be able to work with the company to bring in your supplies or have a patient technician bring them into your house.
2. For your routine bloodwork, your dialysis team may be able to arrange to do blood work at home, either by you or a local lab technician. If that is not an option, speak to your dialysis team on temporarily cutting down on how often you need to get your blood work checked at the clinic. 
3. Have supplies on hand, including surgical masks, hand sanitizer, and disposable gloves. This will give you constant protection, whether you have to go to a medical facility or a technician has to come into your home. Disinfect surfaces that are touched often, such as doorknobs and counters.  

Is it safe to go to restaurants? 

Avoiding public areas where socially distancing is difficult is the safest thing to do. Many restaurants have initiated restrictions to help protect their customers, but it is still recommended to limit outings and follow precautionary guidelines.  

Some tips to limit exposure to COVID-19 when going to a restaurant include:

• Choose to pick up takeout instead of dining at the restaurant.
• Go to restaurants at times when they are less busy.
• Look over the menu online to ensure renal friendly meals are offered, if possible.
• Stay at least six feet away (about two arms’ length) from other people.
• Wear a face mask when not eating or drinking.

What kind of foods should I be eating?

When grocery shopping, stock up on two to three weeks’ worth of healthy, kidney-friendly foods. This will help you cut down on the number of public outings you have to have, thus decreasing your potential exposure to COVID-19. Some supermarkets are offering grocery pick-ups or special shopping hours for senior citizens. Reach out to your local grocery store to find out if either of these is an option for you. 

Your grocery list should have plenty of foods with low potassium, low phosphorus, and low sodium. The NKF has provided a list of kidney-friendly foods with a long-shelf-life, including fruits, vegetables, protein, dairy, grains, fats, and sweets. Many of these items are canned or in a sealed container and are either low-sodium or low-sugar.

How do I deal with stress during the pandemic? 

If you struggle with anxiety and/or depression, whether before the pandemic or because of it, you are not alone. As someone with a chronic disease, your fears are valid, and it’s normal to feel scared or stressed out. If you feel like your mental health is suffering or you are feeling more anxious or depressed than usual, the CDC offers several helpful tips on how to manage stress and anxiety, as well as resources for you to contact when you’re in need.

Can COVID-19 cause kidney failure?

Recent reports show around that 15-20% of hospitalized patients are developing acute kidney injury (AKI) with COVID-19. There have even been findings of people with no history of kidney disease that have developed AKI. While AKI is usually short-term, it can lead to CKD. Depending on the severity of AKI, dialysis may be necessary. 

What is the safest form of transportation if I’m unable to drive?  

Buses, subways, and trains are more difficult to be socially distanced on, and they increase your risk of exposure to COVID-19. A taxi or rideshare service, like Uber or Lyft, would limit your exposure to larger amounts of people—making it a slightly safer option, if possible, than standard public transportation. 

Here are some safety tips for when using a taxi or rideshare service:

• Use a disinfectant wipe to wipe down anything you touch in the vehicle.
• Avoid shaking hands with the driver. 
• Do not touch your face.
• Wash your hands or use hand sanitizer once the ride is over and you’ve paid and left the vehicle.

*National Kidney Foundation. (2020, May 11). COVID-19: Dialysis. https://www.kidney.org/coronavirus/dialysis-covid-19#should-i-go-to-my-dialysis-treatments