Living Donors Online Message Board
Living Donation Discussion and News => Living Donation Forum => Topic started by: Fr Pat on April 22, 2020, 07:15:57 AM
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Some may be interested to know that the National Kidney Foundation website has a section about COVID-19 virus as to how it relates to kidney patients, transplant recipients, and living donation. www.kidney.org/coronavirus
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Fr. Pat,
This is a great resource. Thanks for sharing.
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As kidney failure and dialysis have been noted in critical care for Covid-19 since the earliest reports in Wuhan, I find the NKF report not just disingenuous but blatantly false.
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John, which part do you find objectionable? Have you notified NKF?
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I did not find much useful information on the website for donors. it was mostly for recipients. the speaker in this short video basically said "we don't know". If you have normal kidney function then your risk is similar to others that did not donate "
but there is not data". if you developed hypertension or diabetes after donation you are at higher risk but "not so much because of the donation as much as it is the diseases". ?? As kidney donors we have a higher risk of developing hypertension so logically:
increased risk of hypertension if you donate a kidney
hypertension increased risk of COVID
therefore hypertension which may be associated with kidney donation puts you at greater risk from COVID
Now there are those who will say, we don't know if you would have developed hypertension regardless of the kidney donation. Especially for related donors who are donating to a first degree relative with hypertension, familial hypertension is/was a risk for all of us just because we share similar genetic make up. So in the end, the "why" doesn't really matter.
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We have half the nephron mass we did. Our function may be unimpaired, but the hazard is of both direct viral attack of our remaining kidney, no spare, or blood clot induced damage. A physician friend analogizes blood clots like being shot at by bullets. They can strike anywhere, and where they strike is badly damaged. Again, we have no spare. Our odds of getting infected are the same as anyone’s. Our risk of serious complications, explicitly due to our lack of a second kidney, is elevated compared to someone just like us who still has two. The NKF should acknowledge this, as we each had to when we signed our consent.
https://www.nytimes.com/2020/05/01/health/coronavirus-dialysis-death.html (https://www.nytimes.com/2020/05/01/health/coronavirus-dialysis-death.html)
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Discussion with Dr. Alan Klinger about Covid and kidneys, PBS News Hour (April 20, 2020): https://www.pbs.org/newshour/show/why-doctors-are-worried-about-severe-kidney-damage-in-some-covid-19-patients (https://www.pbs.org/newshour/show/why-doctors-are-worried-about-severe-kidney-damage-in-some-covid-19-patients)
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Study shows about a third of Covid-19 patients had kidney failure. Percent jumps to 90% for those requiring a ventilator.
From the article: “It’s not specific to COVID-19. It’s more related to how sick you are,” he [Dr. Kenar Jhaveri] said. Nevertheless, knowing the proportion of patients at risk for this condition could help hospitals as they plan equipment and staffing needed for future coronavirus surges, he said.
https://www.reuters.com/article/us-health-coronavirus-kidney/kidney-injury-seen-in-more-than-a-third-of-hospitalized-covid-19-patients-us-study-idUSKBN22Q0U7
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I understand the urgency if a donation is directed to a loved one. In this current situation I would think seriously about being a non-directed donor which is what I am. For me personally, I always understood it would be a sacrifice of some sort. You don't take an organ out of your body with no ramifications. Still I'm not sitting here fearful that the virus is going to sneak up and get me. I do take reasonable precautions given my age and condition. But I figure when the Lord wants me, he'll know where to find me. :)
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This is not specific to living donors, but I found this blog post by Erin Bromage to be a science-based, understandable description of the risks of infection and how to manage them: https://www.erinbromage.com/post/the-risks-know-them-avoid-them (https://www.erinbromage.com/post/the-risks-know-them-avoid-them)
FYI.
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There appear to be longer-term effects of Covid on some patients: https://www.reuters.com/article/us-health-coronavirus-effects/scientists-just-beginning-to-understand-the-many-health-problems-caused-by-covid-19-idUSKBN23X1BZ (https://www.reuters.com/article/us-health-coronavirus-effects/scientists-just-beginning-to-understand-the-many-health-problems-caused-by-covid-19-idUSKBN23X1BZ)
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“We thought this was only a respiratory virus. Turns out, it goes after the pancreas. It goes after the heart. It goes after the liver, the brain, the kidney and other organs. We didn’t appreciate that in the beginning,” said Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute in La Jolla, California.
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I do hope people take the virus seriously. I hear too many people equate it to "just like the flu".
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High rates of long-term renal recovery in survivors of COVID-19-associated acute kidney injury requiring kidney replacement therapy
"These findings indicate that kidney recovery is common in COVID-19 survivors even after long periods of KRT [kidney replacement therapy aka dialysis] requirement during AKI [acute kidney injury]. This information may be of value for patients with COVID-19 and their clinicians when it comes to deciding about the initiation or continuation of KRT."
https://www.kidney-international.org/article/S0085-2538(21)00069-7/fulltext (https://www.kidney-international.org/article/S0085-2538(21)00069-7/fulltext)
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Thanks to our local hospital where I am a volunteer chaplain, I got vaccinated with the Pfizer vaccine. Just had my second shot and the side-effects have been minimal. Haven't grown any extra appendages. My nephrologist thought it would be a good idea since he considers me at higher risk at CKD3. I'm looking forward to getting back to visiting patients when they permit.
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As I'm an active Blood Services volunteer for the ARC, I, too, have been fortunate enough to get the Pfizer vaccine. No side effects other than being slightly sore at the injection site for either the first or the second. Full potency reportedly at fourteen days, tomorrow. I anticipate slightly increased activity out in the world, but still double masked, at a distance, washing hands, and avoiding crowds, especially indoors. Best wishes all!