Policy and Pandemic: The Changing Practice of Nephrology During the COVID-19 Outbreak

Truong, Tiffany; Dittmar, Michael; Ghaffari, Arshia; Lin, Eugene

ABSTRACT The coronavirus (COVID-19) pandemic has changed care delivery for patients with end-stage kidney disease (ESKD). We explore the United States healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the COVID-19 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and following the COVID-19 pandemic can bolster our ability to optimize care for patients with ESKD. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.