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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
Ahead of Print

A unified citywide dashboard for allocation and scheduling dialysis for COVID-19 patients on maintenance hemodialysis


1 Division of Nephrology, Bombay Hospital; Apex Kidney Foundation, Indian Institute of Technology, Mumbai, Maharashtra, India
2 Tata Centre for Technology and Design/Department of Industrial Engineering and Operations Research, Indian Institute of Technology, Mumbai, Maharashtra, India
3 Apex Kidney Foundation, Indian Institute of Technology, Mumbai, Maharashtra, India; Division of Nephrology, PD Hinduja Hospital, USA
4 Apex Kidney Foundation, Indian Institute of Technology, Mumbai, Maharashtra, India; Division of Nephrology, Dr. LH Hiranandani Hospital, USA
5 Division of Nephrology, BYL Nair Charitable Hospital, USA
6 Division of Nephrology, King Edward Memorial Hospital, USA
7 Division of Nephrology, Seven Hills Hospital, USA
8 Division of Nephrology, Sir JJ Group of Hospitals, USA
9 Division of Nephrology, Saifee Hospital, USA
10 Division of Nephrology, Lokmanya Tilak Municipal General Hospital, USA
11 Apex Kidney Foundation, Indian Institute of Technology, Mumbai, Maharashtra, India
12 Division of Nephrology, PD Hinduja Hospital, USA
13 Division of Nephrology, Jupiter Hospital, USA
14 Division of Transplantation, University of Pittsburgh Medical Center, USA
15 Division of Nephrology, Ottawa Hospital, University of Ottawa, Canada
16 Municipal Corporation of Greater Mumbai, India
17 The Project Victory Consortium

Correspondence Address:
Viswanath Billa,
Department of Nephrology, R. No. 6, 2nd Floor, New Wing, Bombay Hospital, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_48_21

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused significant global disruption, especially for chronic care like hemodialysis treatments. Approximately 10,000 end-stage kidney disease (ESKD) patients are receiving maintenance hemodialysis (MHD) at 174 dialysis centers in Greater Mumbai. Because of the fear of transmission of infection and inability to isolate patients in dialysis centers, chronic hemodialysis care was disrupted for COVID-19-infected patients. Hence, we embarked on a citywide initiative to ensure uninterrupted dialysis for these patients. Materials and Methods: The Municipal Corporation of Greater Mumbai (MCGM) designated 23 hemodialysis facilities as COVID-positive centers, two as COVID-suspect centers, and the rest continued as COVID-negative centers to avoid transmission of infection and continuation of chronic hemodialysis treatment. Nephrologists and engineers of the city developed a web-based-portal so that information about the availability of dialysis slots for COVID-infected patients was easily available in real time to all those providing care to chronic hemodialysis patients. Results: The portal became operational on May 20, 2020, and as of December 31, 2020, has enrolled 1,418 COVID-positive ESKD patients. This initiative has helped 97% of enrolled COVID-infected ESKD patients to secure a dialysis slot within 48 hours. The portal also tracked outcomes and as of December 31, 2020, 370 (27%) patients died, 960 patients recovered, and 88 patients still had an active infection. Conclusions: The portal aided the timely and smooth transfer of COVID-19-positive ESKD patients to designated facilities, thus averting mortality arising from delayed or denied dialysis. Additionally, the portal also documented the natural history of the COVID-19 pandemic in the city and provided information on the overall incidence and outcomes. This aided the city administration in the projected resource needs to handle the pandemic.


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