Management of chronic kidney disease patients during the COVID-19 pandemic: Adapted clinical guidelines of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists

Abstract

During the global COVID-19 pandemic, there was an urgent need to make complex clinical decisions about the management of chronic kidney disease (CKD)patients. Since a significant number of CKD patients have impaired renal function or receive immunosuppressive (IS) therapy, they belong to a high-risk group for adverse effects of COVID-19 infection. In addition, the overwhelming majority of CKD patients have co-morbidities, which not only increases the risk of SARS-CoV-2 infection, but also the formation of life-threatening complications of COVID-19. Currently, there are no data on the best practices for the management of CKD patients during the COVID-19 pandemic. However, based on the existing research presented by leading renal associations (ERA-EDTA, Kidney Care UK, The Renal Association), NICE Rapid Guidelines on this topic, and our own experience, the expert group of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists has created the Adapted Clinical Recommendations for the Management Of Patients with CKD stages 1-4 during the COVID-19 pandemic. The proposed clinical guidelines aimed to classify all CKD patients at risk for SARS-CoV-2 infection and hospitalization. The key characteristics of each class of kidney disease are the kidney functional level, determined by the glomerular filtration rate (GFR), daily urinary protein excretion, hypertension, medication intake and other additional characteristics. All of the following clinical guidelines have a level of evidence of 2C.

Keywords

• COVID-19 pandemic, chronic kidney disease, patients, immunosuppressive therapy, glomerulonephritis, anti-epidemic measures, treatment.