Hybrid dialysis: a promising strategy to reduce hospital acc
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A pandemic sustained by a novel coronavirus, SARS-CoV-2, rose between December 2019 and January 2020. Starting in Hubei Province in China, it soon spread worldwide. Italy has been one of the first non-Asian countries to be severely affected. Lockdown measures were quickly implemented, but the COVID-19 outbreak could not be avoided.

In March 2020, a 74-year-old man affected by end-stage renal disease and on peritoneal dialysis was referred to an emergency room in Modena, Northern Italy, due to fever and respiratory symptoms. After ruling out COVID-19 infection, a diagnosis of chronic obstructive pulmonary disease exacerbation was confirmed and he was thus transferred to the nephrology division.

Physical examination and blood tests revealed a positive fluid balance and insufficient correction of the uraemic syndrome, although peritoneal dialysis prescription was maximized. After discussion with the patient and his family, the staff decided to start hybrid dialysis, consisting of once-weekly in-hospital hemodialysis and home peritoneal dialysis for the remaining days.

He was discharged at the end of the antibiotic course, after an internal jugular vein central venous catheter placement and the first hemodialysis session. This strategy allowed improvement of depuration parameters and avoidance of frequent access to the hospital, which is crucial in limiting exposure to SARS-CoV-2 in an endemic setting.

Source: https://casereports.bmj.com/content/13/10/e236411?rss=1
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