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La Covid-19 a-t-elle réduit la prise en charge de la maladie rénale terminale en 2020?

par Jacobs, Lucas ;Collart, Frédéric ;Baudoux, Thomas ;Bonvoisin, Catherine;Smet, Jm J.M.D.;Devresse, Arnaud;Mbaba, J.;Radermacher, L.;Grottes, JM des
Référence Bulletin de la Dialyse à Domicile, 4, 1, page (53-54)
Publication Publié, 2021-04-07

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Résumé :

The SARS-CoV-2 pandemic has been associated with a drop in diagnoses of several diseases in 2020, including cancers. Using data from the “Groupement des Néphrologues Francophones de Belgique” (GNFB), we assessed whether there was a similar effect with regards to end-stage renal disease (ESRD). We collected data from incident patients with ESRD from 25 of the 26 centers participating to the GNFB registry. Thus, we were able to assess the annual and monthly incidence observed in 2018, 2019 and 2020. In 2018, 971 patients started their treatment for ESRD, 970 in 2019 and 892 in 2020 - a decrease of 8% in 2020. This drop in incidence is observed in 18 of the 25 centers analyzed. Monthly comparisons show that this decrease starts in March 2020. This decrease is observed for each age group, regardless of primary renal disease, and was particularly important for the activity of preemptive transplants: 14 patients (1.4%) in 2019 and only 8 patients (0.9%) in 2020. In particular, fewer patients started a peritoneal dialysis (PD) program: 105 patients (10.7%) in 2018, 99 patients (9.9%) in 2019 but only 67 patients (6.7%) in 2020. So, between the years 2019 and 2020, we observe a 33.3% drop in the number of patients starting a peritoneal dialysis program across French-speaking Belgium. In addition, we are seeing a 50% drop in the number of patients who started home hemodialysis (HDD) since the COVID-19 pandemic: 10 patients in 2019 compared to 5 patients in 2020. In conclusion, the year 2020 was marked by an 8% incidence drop of overall treatments for ESRD with a particularly marked decline in the home dialysis initiation programs (PD and HDD). In addition, the interruption of transplant programs in academic centers as well as the closure of ambulatory patient clinics in a majority of hospitals has been associated with a delay in nephrological management. This could, at least partially, explain these observations. Thus, several centers have lost patients with pre-terminal renal failure due to sudden deaths at home. At present, we still do not know if a rebound effect will be observed in 2021.