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A message from a Kidney Specialist about COVID-19


Avantika Chenna, MD  |  Phoebe Nephrologist

Coronavirus pneumonia epidemic raged in Wuhan, China and swept through that country in December before becoming one of the most serious pandemics affecting the entire world. The disease caused by its pathogenic virus was named "COVID-19" by the World Health Organization (WHO) on February 11, 2020. As of March 26, the total number of COVID-19 cases in the U.S. was more than 75,000 with more than 1,000 deaths.  The virus can cause damage to body organs, especially the kidneys and lungs.  COVID- 19 in kidneys can cause acute kidney injury (AKI) as well as mild to severe proteinuria. According to three recently published studies, patients with AKI and COVID-19 infection, around 1.5% to 9% of patients required dialysis. The proportion of patients needing dialysis increased to 5.6-23% in critically ill patients with severe COVID-19 infection.

As of March 26, Phoebe had confirmed 217 positive COVID-19 cases and 16 deaths, and the numbers are rising by the day.  Phoebe has been doing a great job serving patients with COVID-19, and I want to share my experience so far with COVID-19 and kidney failure among our patient population and explain how we are keeping up with growing demands. Phoebe Putney Hospital has risen to the occasion and has not fallen short of any university hospital during this critical time in serving this community.  

I have been practicing nephrology in this community, which I have grown to love as my own, for three years.  I consider it my responsibility to educate everyone in the community, who I consider my friends and family, in this time of need.  I am proud to be a part of the Phoebe family and to help in taking care of the kidney failure patients.

Last week, I witnessed my first COVID-19 patient who had respiratory failure requiring mechanical ventilation.  The patient then developed kidney failure and eventually needed dialysis. Since then, the number of COVID-19 admissions and patients in kidney failure has steadily increased. We have continuously been updating ourselves and using all the available medical treatments to combat COVID-19.

Phoebe CEO Scott Steiner has publicly discussed the shortage of personal protective equipment and the innovative ways Phoebe has developed to prolong the life of an N95 respirator mask. Phoebe has created an entirely new intensive care unit to care for the increasing number critically ill patients.  Our ER physicians, hospitalists and intensivists are no less than the soldiers who are protecting this nation.

I’ve seen Chief medical officer Steve Kitchen making rounds in the isolation floors distributing treats in appreciation of the efforts of various staff members and to encourage them. Our nurses are also being very brave and spending long hours one on one with the COVID- 19 patients. My heart is full of respect for the Phoebe team members who are doing such an admirable job. Other hospitals in the region are also pitching in by accepting patients without COVID-19 to help us create space for the COVID patients.

With the rising incidence of kidney failure and need for dialysis, we are using innovative measures like dialyzing patients at night for prolonged periods and trying to provide aggressive short daily treatments in other patients.  DCI is also helping Phoebe by procuring more dialysis machines to accommodate the growing dialysis needs. During this time, our dialysis nurses are pulling extra hours and working on their off days too to keep up with the growing patient needs in the hospital.

We know that our community has a high prevalence of kidney disease and a huge population of dialysis patients. I urge my friends to please take care of themselves so that they do not fall sick. Until we find either a treatment or a vaccine, we have to take extra care to avoid contracting this infection

Measures to avoid COVID-19 infection.

  • Frequent hand washing or use hand sanitizers.
  • Avoid social gatherings
  • Please turn away and cover your mouth while coughing or sneezing.
  • Avoid unnecessary travel
  • Try to eat fresh fruits and vegetables as they have high antioxidant content in them which is necessary for boosting immunity.
  • Try to eat at home.
  • Stock up on groceries and avoid frequent visits to the grocery stores if possible.
  • Daily shower is a must
  • Drink plenty of water to help prevent kidney failure.
  • Maintain at least 6 feet distance from other people.
  • If coughing or short of breath, seek a COVID-19 test.
  • If on dialysis, please go to your dialysis unit regularly. Avoid ER visits if possible.
  • If on peritoneal dialysis, you and your caregiver would need to take good care of yourselves and avoid contact with sick people. Your PD nurse is your best friend.
  • This is not the time to watch movies in a movie theater. This is the time to watch your favorite movies on Netflix or Amazon. Use this time for family bonding.
  • If you are a patient with a kidney transplant or cancer patient on chemotherapy you need to take extra precautions. Please try to wear a mask when going outside. You might not develop the usual symptoms like fever due to being on immunosuppression, so be extra observant.
  • COVID-19 is not just a disease of the elderly.  This is not the time for a pool party or a birthday party.
  • Keep up to date on developments from reliable news sources.
  • If you are on Lisinopril or losartan, be extra cautious when sick and always take care that you remain hydrated.
  • Please notice little things like drop in your urine output, blood or bubbles in urine if suspecting COVID-19.
  • If you are in healthcare, please take care of yourself too since we are not invincible.

Current evidence suggests that it is not unusual to see acute kidney injury with COVID -19. It is essential you take care of yourself by maintaining good hydration, stable blood pressure, stable blood glucose and avoiding kidney toxic medicines.

I want to recognize the efforts of everyone working in the community in healthcare and help to educate our the community about the seriousness of the disease. I really feel for the families whose members are sick and in the hospital. The families have been so cooperative and understanding during this time, even though patient visitation has been suspended. My deep condolences to those who have lost their near and dear ones due to COVID-19.

I encourage you to take care of yourself and not to panic. The city is in good hands. I know that we as a community are stronger than the coronavirus, and together, we can defeat it.