WE view with great concern the rising prevalence of Covid-19 in the country over the past few weeks.
We are particularly concerned about the impact of Covid-19 infection in patients with chronic kidney disease (CKD), especially those with CKD stage five who are receiving treatment with dialysis or kidney transplantation.
Experience worldwide shows this group of patients are very vulnerable to serious complications from Covid-19 infection and there is a significant mortality among those infected.
Similarly, there is increased risk of healthcare workers, who attend to these patients, acquiring the infection due to frequent encounters.
There are now about 50,000 patients living on dialysis or with a functioning kidney transplant in the country, the vast majority of whom are on haemodialysis.
These patients have impaired immunity either inherently from their illness or induced by medication, making them eminently vulnerable to complications should they be infected with Covid-19.
The financial impact on a patient and his/her family, the staff and on the haemodialysis centre’s management once a Covid-19 infection occurs is huge.
There are tests for the virus to be done, personal protective equipment to be donned, and the affected centre has to be sanitised.
The emotional strain on patients and staff once a centre has an infected patient is immeasurable.
We thank the Health Ministry’s nephrologists and its haemodialysis units for accepting most infected patients from the private and NGO centres.
Currently, all haemodialysis centres follow stringent guidelines set by national and international bodies to prevent cross-infection.
Haemodialysis staff are specialised nurses and not readily replaceable. If they are infected, they would have to be quarantined, reducing the centre’s capability to look after patients.
The government is rolling out the Covid-19 vaccination plan tomorrow, and we hope the Health Ministry will give special priority to patients with CKD. This will reduce overcrowding in the government’s haemodialysis centres and help return some normalcy in the private and NGO-run haemodialysis centres.
We urge that priority be given to the following groups:
> Patients on haemodialysis and peritoneal dialysis.
> Patients with functioning kidney transplants.
> Healthcare workers directly attending to haemodialysis and peritoneal dialysis patients.
> Family members of haemodialysis/peritoneal dialysis/kidney transplant patients.
> Patients with CKD stages three and four (pre-dialysis).
We are happy to assist the vaccination programme.
The National Renal Registry of the Malaysian Society of Nephrology and the National Kidney Foundation of Malaysia can assist in disseminating information as well as in scheduling vaccinations.
DATUK DR ZAKI MORAD
Chairman, National Kidney Foundation
PROF DR ABDUL HALIM ABDUL GAFOR
President, Malaysian Society of Nephrology
DR ROSNAWATI YAHYA
President, Malaysian Society of Transplantation