COVID-19: Renal service guide

April 2020

Scope

This information provides guidance on the management of Renal patients across Eastern & Northern Devon during the Covid-19 pandemic. The information is based on advice from Public Health England, NHS England, the Renal Association, the British Transplantation Society and Kidney Care UK.

National guidance

Kidney Care UK: Coronavirus (COVID-19) guidance for patients with kidney disease

British Transplantation Society: COVID-19 Information for Transplant Professionals

Public Health England: Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19

The Renal Association: COVID- 19 useful information and resources

Conditions with specific guidance

Transplant, significantly immunosuppressed and dialysis patients have been given Vulnerable Patient Shielding letters.

Urgent referrals

Appropriate referrals include the following. If unsure please use Advice and Guidance to ask if referral is needed.

  • Acute Kidney Injury
  • Rapidly declining chronic kidney disease (CKD)
  • Nephrotic Syndrome
  • Renal dysfunction with significant blood and protein in urine

Routine referrals

Routine new referrals already made will be offered a postponed slot, or referred back to GP with advice. All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given via our e-RS Advice and Guidance service.

Follow up clinic lists still stand and will be reviewed as follows:

  • General nephrology: Stable patients postponed, phone consultations where required, face to face reviews when needed.
  • CKD nurse: postponed
  • Low Clearance: phone consultations, face-to-face reviews where required
  • Transplant: phone consultations, face-to-face review where required
  • Vasculitis: phone consultations, face-to-face review where required
  • Other specialist clinics: Stable patients postponed, phone consultations where required, face-to-face reviews when needed
  • Anaemia service: intravenous (IV) iron infusions postponed, blood monitoring reduced to bimonthly

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

Urgent advice

e-RS Advice and Guidance will be turned around within 24-48 hours, Monday-Friday.

If more urgent advice is required telephone the switchboard on 01392 411611 and ask to speak to the Renal Registrar 9am-5pm, or the Renal Consultant out of hours.

Advice & Guidance

e-RS Advice and Guidance will be turned around within 24-48 hours, Monday-Friday.

COVID-19 high risk patient advice

Transplant, significantly immunosuppressed and dialysis patients have been given Vulnerable Patient Shielding letters.

Patients in high risk groups (transplant, immunosuppression) have been asked to let us know if they have symptoms so that we can monitor, review immunosuppression and assess whether review required.

Blood monitoring for stable patients on immunosuppression (non-transplant) can be reduced according to CCG temporary revisions to monitoring schedules for prescribing and monitoring, under the NHS Devon CCG Specialised Medicines Service (SMS) shared care prescribing guidelines.

Haemodialysis patients have been asked to let their dialysis unit know if they have symptoms before they arrive for their session so that we can plan appropriate isolation and testing in the dialysis units.

NICE Covid19 guidance for Dialysis patients

Supporting information

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Last updated: 04-05-2020

 

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