Dear doctor/ Dr Chandan Chaudhari, Nephrologist, Wockhardt hospital, Mumbai
Any infection occurring anywhere in the human body can put pressure on the kidneys. The precautions to be taken by a patient suffering from kidney disease will be the same as in the case of any other Covid-19 patient except for two things: patients with chronic kidney disease (CKD) must regularly check their blood pressure at home and monitor their creatinine levels at least once every month. A high-protein diet is not recommended for CKD patients who are not on dialysis and for transplant patients.
CKD patients who are not on dialysis
Get a renal function test done every month. Also, do not consume too many Vitamin C tablets, which is otherwise used as prophylaxis for Covid-19, as it might increase potassium levels.
CKD patients who are on dialysis
It is often difficult for doctors to convince patients on dialysis that the shortness of breath could be because of Covid-19 and not necessarily because of complications from dialysis. Also, such patients need to regularly visit hospitals for dialysis. This increases their chances of catching an infection. Hence, it is important to wear masks at all times and keep oneself sanitised.
Depending on the situation, a Covid-positive or pneumonia patient might have to undergo dialysis three to four times a week, up from two to three times a week, to remove excess water from the lungs.
Kidney transplant patients
The immunity levels of a patient who has undergone a kidney transplant is already suppressed to a large extent—such patients are prescribed immunosuppressants so that their body does not reject a transplanted kidney. It is, therefore, easier for them to catch Covid-19. If found to be Covid-positive, they can have severe manifestations of the disease—prolonged pneumonia and low oxygen saturation levels. So, striking a balance between reducing their dosage of immunosuppressants and ensuring that the body does not reject the transplant is challenging. Also, those who have recently undergone a kidney transplant, say, in the last five years, must monitor their creatinine levels at least once in two months.
—As told to Pooja Biraia Jaiswal