Confirmed Drop in Treatment of Patients with Incident End-Stage Kidney Disease During the Novel Coronavirus Disease 2019 Pandemic

We read with great interest the study by Wetmore et al.¹ showing a drop in the number of patients starting hemodialysis (HD), peritoneal dialysis (PD), or being transplanted preemptively in the context of the coronavirus disease 2019 pandemic.

Similar results emerged from the Belgian Registry (Brussels-Capital and Wallonia regions) that aims to annually collect data regarding incident patients with ESKD in the 26 centers participating to the “Groupement des Néphrologues Francophones de Belgique.”

In 2018, 971 patients started their treatment for ESKD (dialysis initiation or preemptive transplantation), 970 in 2019 but only 892 in 2020,showing an 8% drop. Monthly comparisons showed that this decrease started in March 2020, when the coronavirus disease 2019 pandemic peaked in Belgium. The same trend was observed for each age group, regardless of primary kidney disease. In addition, contrasting with the Wetmore et al. data,¹ incident number and percentage of patients starting peritoneal dialysis, home HD, or receiving a preemptive kidney transplantation also decreased in 2020 compared with 2019 (a 33%, 50%, and 36% drop, respectively, compared with 2019) suggesting that home techniques were not favored in the context of the pandemic.

In conclusion, the year 2020 was marked by an 8% incidence drop of patients who started a treatment for ESKD, with a particularly marked decline in home dialysis programs (PD and HD) and preemptive kidney transplantation.

Disclosures

T. Baudoux serves as a consultant for Astra-Zeneca. F. Collart has received honoraria from Astrazeneca and Vifor, and is a member of advisory boards for Vifor. A. Devresse is a member of advisory boards for Alnylam Pharmaceuticals.

Funding

This study received support from the Belgian federal government.