Impact of COVID-19 on Patients Receiving Hemodialysis: The Quebec Renal Network (QRN) COVID-19 Study

There are 24,000 Canadians living with kidney failure who must receive regular hemodialysis treatments to stay alive. This involves coming to the dialysis unit 3 days every week, for 4-5 hours at a time. While this is burdensome at the best of times, the COVID-19 pandemic has made life even more difficult for hemodialysis patients. As they cannot self-isolate, they are at higher risk of infection than others. If they do get infected, this may not be easily identified because they may not have typical symptoms or may deny them for fear of being denied dialysis. Yet, due to their underlying medical illnesses, dialysis patients are at risk of becoming quite ill from COVID-19. The precise risks to their health are uncertain. Finally, widespread application of infection control measures in dialysis units and physical distancing, while needed to control spread of COVID-19, may have unforeseen impacts on all hemodialysis patients. These range from encountering problems with transportation, interfering with their critical need to get to the dialysis unit, to their interactions with the health care team, access to non-dialysis health care, and inability to have their loved ones at their bedside during dialysis. Being the province hardest hit with COVID-19, we have established a province-wide team of kidney doctors and other experts in Quebec to study: (1) the infection control measures implemented in each dialysis unit; (2) how to better identify dialysis patients who have COVID-19; (3) their risk of dying from COVID-19 and the longer-term risk of COVID-19 on their physical and mental health; (4) whether they develop antibodies to this infection; and (5) how all dialysis patients have generally been affected by this pandemic with respect to dialysis and non-dialysis medical care. The results of this comprehensive study will guide our understanding of the impact of COVID-19 on dialysis patients in order to help improve their care both in Canada and globally.