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Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease?

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1174 (Published 25 March 2020) Cite this as: BMJ 2020;368:m1174

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  1. Andy Extance
  1. Exeter, UK
  1. andy{at}exeterempirical.com

Chronic kidney disease

When the UK prime minister, live on national TV with the chief medical officer Chris Whitty, advised vulnerable patients—including those with chronic kidney disease—to minimise their social contact, it should have been a welcome surprise for Tess Harris, chief executive of the Polycystic Kidney Disease (PKD) charity. But recognition of this often unseen group provided no pleasure. Instead, it led to confusion.

Chronic kidney disease covers people with a wide range of symptom severity. Those at stage one usually have no obvious symptoms, or possibly blood in their urine. Those with stage five disease, like Harris, have lost nearly all kidney function. Yet Whitty’s comments had people at stage one unnecessarily worried that they’d have to go into self-isolation, Harris told The BMJ. They were asking whether they should go to work, or let their children go to school, she explains. “That’s been a big challenge—trying to interpret for patients.”

Harris receives peritoneal dialysis at home. “It’s life saving that I get my home dialysis fluids delivered along with everything else I need to stay safe,” she explained. Because she has a tube protruding from her stomach, it’s important for her to avoid infection, including maintaining good hand hygiene. Her deliveries come every two weeks, with her most recent arriving two days after Whitty’s announcement. “Luckily, there was hand gel,” she says. “In two weeks’ time, however, I don’t know.” She has a routine appointment on 23 March but doesn’t know if that’s going ahead.

PKD is an inherited condition, meaning that several family members can have it, adding extra complications for self-isolation. As the disease advances, dialysis or …

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