Prioritise renal patients for COVID-19 vaccine, says doctorSunday, March 07, 2021
BY KASEY WILLIAMS
MANDEVILLE, Manchester — Consultant nephrologist at the Mandeville Regional Hospital here, Dr Racquel Lowe-Jones, is appealing for individuals suffering from renal (kidney) disease to be prioritised for the roll-out of novel coronavirus vaccines due to the high vulnerability of the group.
“Because our patients are vulnerable, we would like them to be prioritised for COVID vaccination, when the vaccines arrive. This is not new; it is in keeping with international standards. In other dialysis centres around the world, dialysis patients are prioritised for vaccination,” she told the Jamaica Observer last week.
“We hope that our patients will be on that priority list, because chronic kidney disease is a non-communicable disease and it is a killer, if not treated,” she added.
On average, 70 patients receive dialysis treatment weekly at the hospital's renal unit.
The life-saving procedure, which can take hours, is badly needed for more than 140 patients now on the hospital's waiting list.
“We have over 140 patients waiting for dialysis, so what happens is that in order for somebody to come onto our system, the current patient(s) has to transfer or migrate,” Marika Davis, nurse manager at the renal unit, told the Sunday Observer.
The current curfew measures have also taken a toll on patients who have to travel late at night and early morning.
“Letters have to be written for our patients, because some of their treatments finish in the night, and the curfew is at 8:00 pm, so these patients have to have special permission to travel back home and to come to the unit. This is a life-saving procedure and they are a vulnerable population. Their immune system is not as strong as well, so they are vulnerable to COVID,” said Dr Lowe Jones.
With March 11 being celebrated as World Kidney Day under the theme 'Kidney Health for Everyone Everywhere: Living Well with Kidney Disease', staff from the hospital's renal unit are focused on spreading awareness about the disease. The week of activities begins today with a virtual church service.
“We want to focus on our patients, so we want people to know that although they have kidney failure, they can still live a near normal life… We don't want to focus on the dismal aspect of it...,” Davis said.
“There must also be an implementation of preventative measures, because we don't want a lot of people to come down with renal failure, so we will be having educational activities on World Kidney Day where our physiotherapist will come into our nephrology clinic, and will teach our patients about the benefits and types of exercise that they can do,” she added.
A nephrology clinic caters for the study and preservation of kidney health and the treatment of related disease.
The hospital's renal unit offers hemodialysis — involving the purifying of blood — for patients who live in six parishes.
“We only offer for now hemodialysis… The patients that we cater for are from Manchester, St Elizabeth, Clarendon and sometimes we have patients as far as Trelawny, St Ann and Westmoreland,” said Davis.
“Including our emergencies [the number of patients] can take us up to 70 [per week] … if they don't get dialysis, they are going to die,” she stressed.
Davis alluded to the importance of maintaining a healthy diet to avoid the end stage of kidney failure.
“You have patients who have kidney failure, but they don't reach the end stage, which is the last stage, so they don't need dialysis as yet, but if they continue with their diet exercise and medication, then they won't reach that stage,” she said.
There will be a week of activities to educate renal patients on diet and exercise and promote kidney health.
“We will also include our dietician to educate about healthy foods for people who have kidney failure, and the foods they should avoid,” said Davis.
“The leading cause of renal failure is uncontrolled diabetes and hypertension, you will find that people tend not to take their medication how they should, and that's what cause it to be uncontrolled and leads to renal failure,” she added.
The renal unit has outgrown its space and there is hope that it will be expanded soon.
“We started on December 16, 2010. We started out with dialysis for four patients. We only had four stations. We [expanded] in 2013 to 12 stations. We dialyze patients who have end-stage renal disease, that's stage 5, where their kidneys are not functioning anymore,” said Davis.
“We try our best to maintain them and our maintenance system is very good… If we were to get more machines, we would need the space for it and staff. We would need a bigger unit… We would want a nephrology centre of excellence in Mandeville,” she declared.
“This would entail kidney transplant, peritoneal dialysis (involving the removal of excess fluids and toxins) and hemodialysis, that's what we would want to aim for,” she added.
When asked about the impact of COVID-19 on the renal unit, Davis pointed to safety protocols.
“Because of how we would normally operate, it does not affect us as much, because we work in a sterile environment and our patients have been adhering,” she said.
Dr Lowe-Jones is reminding persons that being on a kidney machine is not a death sentence.
“What we find is there are a lot of patients, who have 'pressure' and 'sugar', but don't know they have kidney disease, because it's silent until it becomes very bad, and then they [patient] start to have symptoms,” she said.
“Being on the kidney machine is not a death sentence. There is also something called a kidney transplant, and we would like for the public to know that kidney transplant has been going on in Jamaica since the 1970s,” she said.
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