COVID-19 and Kidney Failure in the Acute Care Setting: Our Experience From Seattle

Published:April 07, 2020DOI:
      For weeks we watched as Wuhan, China, was ravaged by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), wondering what the future had in store for us. On January 21, 2020, the first known case of coronavirus disease 2019 (COVID-19) on US soil was identified 20 miles north of Seattle in the town of Everett, WA. On Friday, February 28, the nation's first reported death due to COVID-19 infection was disclosed, followed by the second mortality case a mere 48 hours later. Both were patients with kidney failure dialyzing with Northwest Kidney Centers in our ambulatory clinics and subsequently under the care of our Hospital Services team. During the course of that weekend, our organization was brought to the forefront of the COVID-19 pandemic, mandating an immediate and coordinated response. Our approach to managing the threat in our outpatient facilities has been summarized elsewhere.
      • Watnick S.
      • McNamara E.
      On the frontline of the COVID-19 outbreak: keeping patients on long-term dialysis safe.
      This editorial focuses on the acute care setting by considering 3 key questions.
      To read this article in full you will need to make a payment


      Subscribe to American Journal of Kidney Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Watnick S.
        • McNamara E.
        On the frontline of the COVID-19 outbreak: keeping patients on long-term dialysis safe.
        Clin J Am Soc Nephrol. 2020; 15: 710-713
        • Huang C.
        • Wang Y.
        • Li X.
        • et al.
        Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.
        Lancet. 2020; 395: 497-506
        • International Society of Nephrology Academy Online Learning
        Webinar: COVID19 for the nephrologist: real-life experience from Italy.
        • Cheng Y.
        • Luo R.
        • Wang K.
        • et al.
        Kidney disease is associated with in-hospital death of patients with COVID-19.
        Kidney Int. 2020; 97: 829-838
        • Naicker S.
        • Yang C.-W.
        • Hwang S.-J.
        • Liu B.-C.
        • Chen J.-H.
        • Jha V.
        The novel coronavirus 2019 epidemic and kidneys.
        Kidney Int. 2020; 97: 824-828
        • Xu D.
        • Zhang H.
        • Gong H.
        • et al.
        Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis.
        (Preprint at)
        • Li Z.
        • Wu M.
        • Yao J.
        • et al.
        • Anti -2019-nCoV Volunteers
        Caution on kidney dysfunctions of COVID-19 patients.
        (Preprint at)
        • Kupferschmidt K.
        • Cohen J.
        Race to find COVID-19 treatments accelerates.
        Science. 2020; 367: 1412-1413
        • Guan W.
        • Ni Z.
        • Hu Y.
        • et al.
        Clinical characteristics of coronavirus disease 2019 in China.
        N Engl J Med. 2020; 382: 1708-1720
        • Honore P.M.
        • Hoste E.
        • Molnár Z.
        • et al.
        Cytokine removal in human septic shock: where are we and where are we going?.
        Ann Intensive Care. 2019; 9: 56
      1. Klein D, Hagedorn B, Kerr C, Hu H, Bedford T, Famulare M. Working paper – model-based estimates of COVID-19 burden in King and Snohomish counties through April 7, 2020.–%20model-based%20estimates%20of%20COVID-19%20burden%20in%20King%20and%20Snohomish%20counties%20through%20April%207.pdf. Accessed March 30, 2020.

        • Fink S.
        Worst-case estimates for U.S. coronavirus deaths. The New York Times.
        • Committee on Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, Institute of Medicine
        Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response.
        National Academies Press (US), Washington, DC2012
      2. American Society of Nephrology. Recommendations on the care of hospitalized patients with COVID-19 and kidney failure requiring renal replacement therapy. Accessed March 30, 2020.