Article Text

Download PDFPDF

Case report
Hybrid dialysis: a promising strategy to reduce hospital access during the SARS-CoV-2 pandemic
Free
  1. Giacomo Mori1,
  2. Gaetano Alfano1,2,
  3. Francesco Fontana1 and
  4. Riccardo Magistroni2
  1. 1Struttura Complessa di Nefrologia Dialisi e Trapianto Renale, University Hospital Modena, Modena, Italy
  2. 2Università degli Studi di Modena e Reggio Emilia, Modena, Italy
  1. Correspondence to Dr Giacomo Mori; morigiacomo{at}hotmail.it

Abstract

In March 2020, a 74-year-old man affected by end-stage renal disease and on peritoneal dialysis was referred to an emergency room in Modena, Northern Italy, due to fever and respiratory symptoms. After ruling out COVID-19 infection, a diagnosis of chronic obstructive pulmonary disease exacerbation was confirmed and he was thus transferred to the nephrology division. Physical examination and blood tests revealed a positive fluid balance and insufficient correction of the uraemic syndrome, although peritoneal dialysis prescription was maximised. After discussion with the patient and his family, the staff decided to start hybrid dialysis, consisting of once-weekly in-hospital haemodialysis and home peritoneal dialysis for the remaining days. He was discharged at the end of the antibiotic course, after an internal jugular vein central venous catheter placement and the first haemodialysis session. This strategy allowed improvement of depuration parameters and avoidance of frequent access to the hospital, which is crucial in limiting exposure to SARS-CoV-2 in an endemic setting.

  • dialysis
  • infectious diseases
  • TB and other respiratory infections

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors GM made substantial contribution to the concept design of the work, or acquisition, analysis or interpretation of data, and drafted the article. GA, FF and RM revised it critically for important intellectual content and approved the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.