The COVID-19 pandemic disrupted health care for millions of Americans, and could have had a particularly devastating impact on people suffering from kidney failure, a new study finds.
Researchers from Brown University in Providence, Rhode Island, gathered nationwide data on kidney failure treatment, with a specific focus on patients beginning new treatment.
They found the overall initiation of kidney failure treatment declined by 30 percent during the first wave of the pandemic.
Black people and people who live in counties harder struck by Covid accounted for the largest portion of the decline.
Patients who initiated treatment often did so at later points, by which time their kidneys were in worse condition.
The research shows how the pandemic prevented many Americans from seeking care or made them fearful of doing so, with potentially deadly consequences.
Researchers found a sharp, 30%, decline in Americans seeking out treatment for kidney failure early in the pandemic, with a particularly sharp drop in April
Americans waited longer to get transplants or begin dialysis for kidney failure last year, leading to them initiating treatment at points where they were in worse health. Pictured: a dialysis machine, used to treat kidney failure
Researchers gathered data from 2018, 2019 and 2020 for the study, which was published Thursday in JAMA Network Open.
During the first four months of the pandemic, from March 2020 to June 2020, 551 Americans received a preemptive transplant.
In 2018 and 2019, around 900 initiated treatment over that same time span.
This means that the rate of the transplants occurring fell by around 38 percent during the early stages of the pandemic.
The rate of patients initiating dialysis treatment fell by around 25 percent during the early months of the pandemic, from around 1,200 in each of 2018 and 2019 to 914 in 2020.
Researchers found that a majority of the decline occurred in April, weeks after most states issued lockdowns and stay-at-home orders..
Among black Americans, rates of kidney failure reporting fell by more than ten percent during that month, from around 2,800 cases to just under 2,500.
People who live in counties that were in the top 20 percent of Covid deaths per capita had the steepest drop in kidney failure reporting.
Around 4,700 cases were recorded in April 2018 and 2019, before falling nearly 30 percent down to around 3,400 reported cases.
The people who did start treatment were also in worse condition when they attempted to seek out medical care, meaning they were at an increased risk of dying from their ailment.
Black Americans were the race with the sharpest decline in initiation of kidney treatment, with the largest drop taking place in April, where there was a 10% drop. The blue line is representative of 2020, the black is 2018, the gold in 2019
People who lived in areas in the top quintile of Covid deaths per capita were by far the least likely to seek out treatment for kidney disease, especially in April, where the drop was nearly 30%. The blue line is representative of 2020, the black is 2018, the gold in 2019
Researchers believe these declines are not because people had suddenly healthier kidneys, but instead because people chose not to seek out care.
‘The significant decline in the number of patients with incident kidney failure in the early months of the COVID-19 pandemic…may be due to several factors,’ researchers wrote.
‘Some patients may have delayed treatment initiation, but others may have died before being able to initiate treatment.’
Previous studies have confirmed the findings of the Brown University researchers, showing a decline in kidney care during the pandemic.
Separate studies that the overall kidney health of people declined as well, with regular treatment being disrupted by the pandemic.
The phenomena is not exclusive to kidney disease patients.
Another recent study from the UK finds that thousands of patients skipped potentially life-saving surgery for cancer during the pandemic, fearing they would contract the virus.
Some experts believe the true death toll of the pandemic in 2020 may be more than double official numbers not just because of undercounting of Covid figures, but also because disruptions of treatment and limited medical resources.
