In some New York hospitals, 30 percent of severe coronavirus patients need dialysis, a much larger proportion than is typical in ICUs, said Alan Kliger, chairman of the American Society of Nephrology’s task force for dialysis and Covid-19. “I’ve never seen anything remotely like this,” said Kliger, who has been in calls with hospitals and suppliers. “It’s stressing the whole system.”
A spokesperson for the city’s public hospital system, NYC Health + Hospitals, said it has enough supplies for now but is monitoring the situation closely.
Baxter, a major manufacturer of dialysis supplies, is seeing up to five times the normal demand for dialysis fluids like continuous renal replacement therapy in the U.S. and Europe, said spokesperson Lauren Russ. The company’s plants are “running at maximum production levels” to meet the unprecedented demand, she added. Baxter is working with FDA and CMS to send more supplies to New York hospitals without disrupting supply for facilities elsewhere.
That means placing an upper limit on what New York hospitals can order right now, further pressuring stocks in hospitals flooded with patients. Meanwhile other hot spots such as Chicago, New Orleans and Seattle are increasingly worried about their own supply as coronavirus cases mount, Kliger said.
FDA spokesperson Jeremy Kahn said the agency had no information to share regarding an interagency meeting and that there are no shortages of dialysis drugs listed on the FDA’s webpage.
“It is possible that there are distribution challenges leading to shortages of these products in certain regional areas,” he added.
About 30 million Americans already suffer from some form of kidney disease, which often requires dialysis or transplant. Kidney problems were the nation’s ninth leading cause of death in 2017.
If the severe coronavirus patients put on dialysis recover, the kidney disease symptoms usually dissipate too, a doctor treating them said. But the demand now has pressured even regular stocks that hospitals buy to help kidney failure patients without the coronavirus, and providers worry that standard dialysis equipment such as machines and infusion pumps and could be next. At the same time, few hospitals have the trained nursing staff available to administer dialysis, a time-consuming treatment, to a surge of new patients — and those nurses are falling ill with the virus.
A New York-based nurse with more than two decades of experience, who requested anonymity for fear of retaliation, said she is one of eight nurses in her dialysis unit who is out sick with the coronavirus due to a lack of personal protective equipment and close, prolonged contact with patients.