Doctors call to vaccinate those on dialysis or chronic kidney disease as soon as possible against Covid
About 50,000 people in Italy today are on dialysis. But nearly four and a half million men and women suffer from chronic kidney disease in an advanced form, considering this condition from what doctors call the third stage and up, in terms of severity. For them, doctors are asking for the possibility of vaccination for Covid-19 soon.
This is the appeal of the Italian Society of Nephrology (SIN) to the institutions, to ensure that these patients are urgently included among the subjects to whom the first doses of the vaccine will be given priority.
Because those on dialysis risk
The effects of the epidemic on people undergoing dialysis treatment, according to a survey by the Italian Society of Nephrology itself, were extremely heavy. Among dialysis patients there was in fact a mortality ten times higher than that estimated to date in the general population during the second phase of the pandemic (26% vs 2.4%).
"The high frequency with which dialysis patients have to go to hospital, from 2 to 3 times a week, increases the likelihood of contagion – says SIN President Piergiorgio Messa. And in fact, among patients on chronic dialysis there was a very high frequency of contagion from Sars-Cov-19, and unfortunately also a simultaneous and dramatic rise in the lethality rate, equal to over a third of those infected ".
The greater risk of contagion is associated with frequent visits to dialysis centers that involve continuous travel, prolonged contact (4-5 hours) with other patients in common environments while waiting and during dialysis treatment for patients on hemodialysis: this explains the higher incidence of infections in patients on hospital dialysis than in those on home dialysis (peritoneal dialysis).
In any case, all patients on dialysis, both carried out in dialysis centers and at home, when infected, showed a very high mortality, also due to the high number of associated diseases (cardiovascular, metabolic, neoplastic, etc.) increase fragility.
Furthermore "Dialysis patients are characterized by a reduced immune response which, in addition to contributing to a greater susceptibility to contracting the infection, could be associated with a reduced efficacy of the COVID-19 vaccination – underlines the expert". In order to better assess the situation, SIN, in collaboration with the Istituto Superiore di Sanità, has designed a cohort study in dialysis patients in Italy, to evaluate the clinical efficacy in terms of protection from infection and the safety of the various vaccines. used, also measuring the immunological response of these patients to standard vaccine doses.
More attention to the kidneys
We need to pay more attention to the kidneys, even if they lose "bumps", they do not show any signs of suffering. It is an important factor to consider. If the heart goes into trouble because little blood arrives, pain appears. When the brain is unable to manage movements correctly, one immediately realizes that there has been a problem. But if these organs, which weigh about 200 grams each, do not work well, their fatigue is "silent".
Unless there is a reduction in function of about 50 percent, the two organs do not send any alarm signals. Or rather, they warn us with nuanced signs: a slight tiredness, a swelling under the eyes. But in the meantime, the body suffers.
In short, the kidneys are the ideal addicts for the body. They always work, all the time, never complaining. And perhaps also for this reason we do not realize the importance of their activity, which is not limited to "washing" the blood (about 180 liters is the quantity filtered every day) but helps us to regulate the pressure, to control any anemia and even to preserve bone health.
For this reason, there is a profound underestimation of the risks that the kidneys run and the diseases that can affect them, so much so that even today there are people who as soon as they come to the attention of the specialist must undergo dialysis.
Unfortunately, when the kidney does not work well, we often don't even notice and adapt to the rhythm that they impose on the body. So we find ourselves with tired organs that are unable to carry out their activity normally. With these precedents we can understand why chronic kidney disease is so widespread, albeit with different forms of severity: seven to ten out of a hundred people in Italy have to deal with this condition. And many, unfortunately, do not know this.