【Aging, safety net and fiscal crisis in Japan】No.223: No last resort for dialysis patients that are vulnerable to COVID-19

As shown in Figure 1, the number of artificial dialysis patients in Japan increased from 103,296 in 1990 to 339,841 in 2018. During the same period, the number of patients per million population also increased from 836 to 2,688. Some factors that caused this increase include the low number of kidney transplants and aging . As mentioned in Column No.219, there has been a medical collapse in the Tokyo metropolitan area, resulting in emergency patients having difficulty finding a hospital due to the COVID-19 crisis. This is all the more serious when a dialysis patient has a fever and is suspected of having COVID-19.

If the patient has a fever but no other symptoms, it is recommended that they be treated at home. However, dialysis patients need to undergo dialysis for several days while waiting for PCR test results. Additionally, the place of dialysis treatment is usually a large room rather than a private room, where there is a high risk of nosocomial infection of the patient's doctor, clinical engineer, and nurse, as well as other dialysis patients. Dialysis facilities are constantly working to prevent the spread of such infectious diseases. Yet, as there are many clinics in dialysis facilities, it may not be possible to handle multiple cases of COVID-19 infection. Even when a clinic asks a hospital to accept dialysis patients suspected of having COVID-19 infection, there are cases where the hospital refuses them. In other words, dialysis patients cannot secure their only option of survival.

Figure 1 Number of artificial dialysis patients in Japan

(Source: Japanese Society for Dialysis Therapy)