Sheffield Teaching Hospitals NHS

ILD105

Dialysis populations are highly vulnerable to respiratory infections including SARS COV2. During the pandemic it was clear that centre-based haemodialysis (HD) faced patients with a very high risk of contracting COVID and that those who were able to dialyse and shield at home were relatively protected. Some centres reduced the number of dialysis sessions or reduced duration of dialysis to reduce exposure to the virus. In addition, the pandemic seriously affected the organisational ability of units to deliver services. Insertion of peritoneal dialysis (PD) catheters was recognised as a high priority service during the pandemic, to allow more patients to dialyse from home and be relatively protected by means of isolation. The home-dialysis population is distinctly different from the centre-based dialysis population demographically, and therefore better understanding of the infection risk and outcome is required. For example, it is known that there is lower access to home dialysis among people from minority ethnic groups, and in the UK the pandemic had a greater impact on such groups. We will compare 2020 data with 2019 data, linking national data on COVID testing with UKRR data on the dialysis population and centre activity. HES data will provide associated mortality and hospitalisation and allow us to examine the factors that influence that risk including demographic, ethnic, comorbidity and socioeconomic factors. We will also explore the changes in dialysis access use from 2019 to 2020. The objective is to examine the impact of the COVID 19 pandemic on dialysis data and modality use including centre variation. Clarifying the impact of COVID on the home-dialysis population will enable policy decisions around supporting home dialysis as well as informing patients around modality choice. The study will also give a better understanding of the impact of COVID on health care processes to better understand which unit practices were associated with greater resilience and enabled home dialysis growth during the pandemic. It is crucial to understand these practice patterns to deliver on targets for growth in home therapies such as home dialysis.