Umthelela Omkhulu We-COVID-19 Ezigulini Zezinso Ezisebenzisa I-Dialysis

Ibhalwe ngu umhleli

I-National Kidney Foundation (NKF) kanye ne-American Society of Nephrology (ASN) igcizelela isikhundla esibucayi abantu abanenkinga yezinso, abangenaso amandla omzimba, ababhekene nayo njengoba igagasi lakamuva le-Omicron liqhubeka nokusabalala phakathi kweziguli nabasebenzi ezikhungweni zokuhlanza igazi. Amacala e-COVID-19 adala ukugula okubi kakhulu, okuphoqa izikhathi zokwelashwa ezifushanisiwe ezigulini, futhi andisa ukushoda kwabasebenzi nezinto ezisetshenziswayo ezithiya ukufinyelela kulokhu kwelashwa okusekela impilo. Umthelela we-COVID-19 kubantu abanesifo sezinso uholele ekwehleni kokuqala kwenani leziguli eziku-dialysis e-United States emlandweni weminyaka engama-50 woHlelo lwe-Medicare ESRD.

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Ukushoda kwabasebenzi nokuhlinzekwa kwezidingo nakho kuholele ekuvaleni kwesikhungo se-dialysis kanye nokusilela emuva ekuhambiseni iziguli phakathi kwe-dialysis, izibhedlela, kanye Nezinsiza Zobuhlengikazi Ezinekhono (SNFs). Yize ukusheshisa ukufinyelela ku-dialysis ekhaya kusiza ukuhlukaniswa nomphakathi futhi kunciphisa ubunzima bokushoda kwabasebenzi, lesi sixazululo esingaba khona ngeke siyixazulule inkinga enkulu. Kudingeka isinyathelo esisheshayo ukuze kuqinisekiswe ukuthi izikhungo ze-dialysis ziyafinyelela ezintweni ezidingekayo nabasebenzi.

I-NKF kanye ne-ASN batusa uhulumeni wesifundazwe, wesifunda, nowasekhaya:

• Ukungenelela ukuze kuncishiswe izinkinga zokuhlinzekwa kwempahla (isb., i-dialysate concentrates) ezikhungweni ze-dialysis ngenxa yokuntuleka kwezindawo zokugcina izimpahla kanye nabasebenzi bamaloli.

• Sabalalisa imaski yobuso yezinga eliphezulu, egunyazwe uhulumeni ezindaweni zokucofa igazi.

• Misa isikhashana isimiso samanje se-Centers for Medicare and Medicaid Services (CMS) esidinga ukusetshenziswa kwemijovo kasawoti esele igcwaliswe ngaphambili, engatholakali kwezinye izindawo, kuze kudlule isimo esibucayi.

• Khuthaza ohulumeni bezifundazwe nohulumeni ukuba bavumele ukufana kwabahlengikazi ukuze bavumele umkhuba wangaphakathi, kungakhathaliseki ukuthi izwe libumbene, phakathi nalesi simo esibucayi.

Kunabantu abangu-783,000 e-United States abanenkinga yezinso, futhi abangaphansi kuka-500,000 balaba bantu badinga i-dialysis esekela ukuphila ilethwe esikhungweni se-dialysis kathathu ngesonto, amahora amane ngosuku. Ngesikhathi sokwelashwa kwe-dialysis, iziguli zivame ukuhlala eduze kwezinye iziguli nabasebenzi ezindaweni ezingahlali kungena umoya kahle. Iningi lalezi ziguli ngabantu abadala, abahola kancane, futhi abavela emiphakathini eyayincishwe amathuba phambilini, futhi iningi lazo linezimo ezikhona njengesifo sikashukela nezifo zenhliziyo.

Ngaphandle kwemizamo ebumbene yezinhlangano ze-dialysis, odokotela bezifo ezithinta inhliziyo, nabanye odokotela ukunciphisa ukusabalala kwayo, i-COVID-19 iyaqhubeka nokudlondlobala ngezikhungo zokudayela. Ngokusho kwedatha evela ku-US Renal Data System, u-15.8% wazo zonke iziguli eziku-dialysis e-United States zase zinenkontileka ye-COVID-19 ngasekupheleni kuka-2020. Ngesikhathi sasebusika igagasi lika-2020, ukufa kwamasonto onke ngenxa ye-COVID-19 kwanda cishe kwabangama-20. I-% kanye nokufa kwabantu ngonyaka ka-2020 bekungaphezulu ngo-18% kunango-2019.1

Naphezu kwalawa mazinga aphezulu okutheleleka nokufa, iziguli ze-dialysis azizange zibekwe phambili ekufinyeleleni ekugomeni lapho imigomo itholakala ngonyaka odlule nakuba ubufakazi bubonisa ukuthi ukuphendula kwamasosha omzimba ekugomeni kufiphele ezigulini ze-dialysis. Ngaphezu kwalokho, nakuba amazinga e-antibody ehla ngokushesha ezigulini ze-dialysis kunasemphakathini jikelele, iziguli ze-dialysis azizange zibekwe phambili yiFood and Drug Administration (FDA) noma iCenters for Disease Control and Prevention (CDC) lapho imithamo yesithathu yomgomo ivunywa. ngo-August.2 Ngaphezu kwalokho, iziguli ze-dialysis nazo zakhishwa ngaphandle emaqenjini afanelekayo ukuthola ukwelashwa kwe-antibody okuthatha isikhathi eside okuqondiswe kugciwane le-SARS-CoV-2. Okokugcina, iNational Institutes of Health ayizange iluthole uxhaso lwezimali lokucwaninga nge-COVID-19 ukusiza abantu abanezifo zezinso noma abahlulekayo kunoma imaphi amaphakheji osizo angonyaka odlule.

Enye inselelo ukungabibikho kwemithi yokwelapha efanele kubantu abanenkinga yezinso. Yize kuvela izindlela zokwelapha ezinciphisa ubungozi be-COVID-19, izinkomba zamanje azibafaki abantu abanenkinga yezinso ngoba laba bantu bavamise ukukhishwa ezivivinyweni zomtholampilo. Lo mkhuba akwamukelekile. I-NKF ne-ASN zinxusa abakhiqizi ukuthi baqinisekise ukuthi le mikhiqizo ihlanganisa ukudoselwa kweziguli ezinenkinga yezinso. Ngaphezu kwalokho, sinxusa i-FDA ukuthi ibone ukuzivikela okunciphayo kubantu abagonyiwe abanokwehluleka kwezinso futhi iqinisekise ukuthi ukwelashwa kugunyazwa Nge-Emergency Use Authorization (EUA) yeziguli ezingenawo amandla omzimba.

Njengoba i-Biden Administration ithenga inoveli yokwelapha ye-COVID-19 ukuze isatshalaliswe e-United States, kubalulekile ukuthi iziguli ze-dialysis nabasebenzi babekwe phambili ukuze bathole. Ukwehluleka ukubeka phambili iziguli ze-dialysis ukuze zithole ukugoma ekuqaleni kwalolu bhubhane kube nemiphumela ehlukahlukene yokulaliswa esibhedlela nokufa. Akumele sivumele iphutha elifanayo ukuthi lenzeke futhi.

Okokugcina, i-COVID-19 ihlotshaniswa nengozi enkulu yokulimala kabi kwezinso (AKI), ngisho nakubantu abanokusebenza kwezinso ezilondoloziwe, okuholela ekuguleni okubi ngisho nokufa, futhi okuvame ukudinga i-dialysis nezinye izinhlobo zokwelapha ezishintsha izinso. Ngokuphindaphindiwe phakathi nobhubhane, futhi futhi, ngesikhathi sokuhlinzwa kwe-Omicron kwamanje, izibhedlela eziningi ziye zazabalaza ukuhlinzeka ngale ndlela yokwelapha esindisa impilo ezigulini ngenxa yokushoda kwabasebenzi abaqeqeshiwe kanye nempahla.

Kubalulekile ukuthi i-United States yenze konke okusemandleni ayo ukulungiselela ukuhlinzwa okuzayo kwamacala e-COVID-19 futhi kuvinjwe ukufa okungadingekile phakathi kwabantu bethu abasengozini kakhulu. I-NKF ne-ASN zimi ngomumo ukusebenzelana nabenzi benqubomgomo futhi bakhiqize ukufeza lo mgomo.

Izifo Zezinso Amaqiniso

E-United States, abantu abadala abayizigidi ezingu-37 kulinganiselwa ukuthi banesifo sezinso, esaziwa nangokuthi isifo sezinso esingamahlalakhona (CKD)—futhi cishe amaphesenti angama-90 abazi ukuthi banaso. Umuntu omdala oyedwa kwabangu-1 e-US usengozini yesifo sezinso. Izici eziyingozi zesifo sezinso zihlanganisa: isifo sikashukela, umfutho wegazi ophakeme, isifo senhliziyo, ukukhuluphala, nomlando womndeni. Abantu Bomdabu WaseMelika Omnyama/wase-Afrika, ama-Hispanic/Latino, ama-American Indian/Alaska Native, ama-Asian American, noma ama-Hawaiian/Abanye bozalo lwase-Pacific Island basengozini enkulu yokuthola lesi sifo. Abantu abamnyama/abaseMelika baseMelika basemathubeni aphindwe izikhathi ezi-3 kunabaMhlophe ukuthi babe nenkinga yezinso. I-Hispanics/Latinos inethuba eliphindwe izikhathi ezingu-3 ngaphezu kwe-non-Hispanics yokwehluleka kwezinso.

Cishe abantu baseMelika abangu-785,000 banokuhluleka kwezinso okungenakulungiseka futhi badinga i-dialysis noma ukufakelwa izinso ukuze baphile. Zingaphezu kuka-555,000 zalezi ziguli ezithola i-dialysis ukuze zithathe indawo yokusebenza kwezinso kanti ezingu-230,000 ziphila ngokufakelwa. Cishe abantu baseMelika abangu-100,000 basohlwini lokulinda lokufakelwa izinso njengamanje. Kuya ngokuthi isiguli sihlala kuphi, isilinganiso sesikhathi sokulinda sokufakelwa izinso singaba ngaphezulu kweminyaka emithathu kuya kweyisikhombisa.

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Umhleli omkhulu we-eTurboNew nguLinda Hohnholz. Uzinze e-eTN HQ e-Honolulu, e-Hawaii.

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