COVID-19 NICE Guidance - patients with chronic kidney disease

The purpose of this guideline is to maximise the safety of adults with chronic kidney disease during the COVID-19 pandemic.

  1. Communicating with patients and minimising risk
  • Communicate with patients, their families and carers and support their mental wellbeing to help alleviate any anxiety they may have about COVID-19. Signpost to sources of information (such as Kidney Care UK)
  • Some patients will have received a letter telling them they are at high risk of severe illness from COVID-19, support them to follow UK Government guidance
  • Minimise face-to-face contact
  • Inform patients that they should contact the NHS 111 online coronavirus service if they think they have COVID-19, they should also contact their renal team
  • If patients need to attend face-to-face appointments or require blood tests, inform them how they can reduce the risk
  • Use local services for blood tests where possible
  • Minimise times in waiting areas
  1. Patients with known or suspected cases of COVID-19
  • When patients with known or suspected COVID-19 have been identified follow appropriate UK Government guidance
  • If COVID-19 is later diagnosed in a patient not isolated from admission or presentation, follow appropriate UK Government guidance
  • If a patient not previously known or suspected to have COVID-19 shows symptoms at presentation, follow appropriate UK Government guidance
  1. Managing chronic kidney disease
  • Think about how to modify usual care to reduce patient exposure to COVID-19
  • Modify individual patient’s treatment plans as required
  • Discuss the risks and benefits of changing treatment schedules or interrupting treatment with patients
  • Advise patients to continue taking their medicines
  • Reassess renal function in patients with CKD who have recovered from COVID-19
  • For patients who are stable on treatment, assess whether it is safe to reduce the frequency of routine blood and tests during the COVID-19 pandemic
  • Encourage self-monitoring and self-management for patients who are able to do this and ensure they know when they should seek help and who to contact
  1. Specialist services
  • To minimise risk from COVID-19, delay referral if the clinical need is not urgent
  • Continue to refer patients for urgent outpatient appointments if there is a clinical need
  • Contact the renal team by telephone or virtually if there is uncertainty about the need for an urgent outpatient referral
  • To minimise risk from COVID-19 delay referral for a renal ultrasound if the result is unlikely to change management immediately
  • Continue to refer patients for a renal ultrasound if the result might immediately change management
  • When deciding whether to refer a patient for hospital admission, discuss with the admitting clinician
  1. Advanced chronic kidney disease
  • For patients who will be starting dialysis, continue to plan and carry out procedures to create vascular and peritoneal access
  • Think about whether it is safe to delay starting dialysis during COVID-19 pandemic
  • Continue to refer patients for transplantation if suitable
  • Ensure all patients with advanced CKD have had the opportunity to participate in advance care planning

You can read the full NICE guidance here.

Stay up to date with the latest NHS COVID-19 guidance here.