Intersections of Health Inequities, COVID-19, and Kidney Disease Care in 2020

Abstract

Purpose

In the context of US kidney disease care in 2020, this chapter highlights challenges of managing COVID-19–related acute pathology, sustaining safe chronic dialysis treatment for individuals with kidney failure during a pandemic, and identifying ways to effectively address intersections of race/ethnicity, SES, and health.

Methodology/Approach

Medical literature and American Society of Nephrology (ASN) online member forum review, and Emory School of Medicine Renal Grand Rounds participant observation: April 2020–March 2021.

Findings

Among persons infected with COVID-19, especially persons of African descent, acute kidney injury (AKI) risk was elevated and associated with need for long-term dialysis. Dialysis-dependent chronic kidney disease patients constituted a high-risk group for COVID-19 infection and hospitalization, due to underlying chronic conditions as well as required travel to clinics for multiple weekly dialysis treatments with exposure to possibly infected staff and other patients.

Research Limitations/Implications

Findings that are discussed are based on a limited time frame. The longer-term impact of COVID-19 for patient outcomes and for the structure of kidney disease care is a fertile area for continued study, especially in relation to broad health equity goals.

Originality/Value of Paper

Racial justice activism in 2020 highlighted the imperative to address socioeconomic and racially structured inequities in the United States, and health equity goals and strategies that target kidney disease care have been outlined. The acute/chronic continuum of kidney disease care is a fertile area for research that is informed by the COVID-19 experience and population health inequity challenges.

Citation

Kutner, N.G. (2022), "Intersections of Health Inequities, COVID-19, and Kidney Disease Care in 2020", Kronenfeld, J.J. (Ed.) Health and Health Care Inequities, Infectious Diseases and Social Factors (Research in the Sociology of Health Care, Vol. 39), Emerald Publishing Limited, Leeds, pp. 3-19. https://doi.org/10.1108/S0275-495920220000039001