COVID-19 Outbreak and Management Approach for Families with Children on Long-Term Kidney Replacement Therapy

Clin J Am Soc Nephrol. 2020 Sep 7;15(9):1259-1266. doi: 10.2215/CJN.03630320. Epub 2020 Jul 14.

Abstract

Background and objectives: During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT.

Design, setting, participants, & measurements: A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively.

Results: Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported.

Conclusions: The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.

Keywords: COVID-19; Caregivers; Children; End-stage kidney disease; Families; Mainland China; Renal replacement therapy; SARS-CoV-2.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Age Factors
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Caregivers / psychology
  • Child
  • China / epidemiology
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / psychology
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Cost of Illness
  • Family / psychology*
  • Family Relations
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Host Microbial Interactions
  • Humans
  • Kidney Diseases / psychology
  • Kidney Diseases / therapy*
  • Male
  • Mental Health
  • Middle Aged
  • Pandemics / prevention & control*
  • Patient Safety
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / psychology
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Renal Replacement Therapy* / adverse effects
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2
  • Time Factors
  • Treatment Outcome