Ukunqongophala kwabasebenzi kunye nokubonelela kuye kwabangela ukuba kuvalwe indawo yokucoca i-dialysis kunye ne-backlogs kwizigulane ezihambayo phakathi kwe-dialysis, izibhedlele, kunye neZibonelelo zoBongikazi abanobuchule (SNFs). Nangona ukukhawulezisa ukufikelela kwi-dialysis ekhaya kuququzelela ukungenelela ekuhlaleni kwaye kunokunciphisa ubunzima bokunqongophala kwabasebenzi, esi sisombululo sinokubakho asizukusombulula ingxaki enkulu. Kufuneka inyathelo elikhawulezileyo ukuqinisekisa ukuba izibonelelo ze-dialysis ziyafikelela kwizinto ezifunekayo kunye nabasebenzi.
I-NKF kunye ne-ASN zicebisa umanyano, urhulumente kunye noorhulumente basekhaya:
• Ukungenelela ukunciphisa iingxaki zobonelelo (umzekelo, i-dialysate concentrates) kwiindawo zokucofa ii-dialysis ngenxa yokunqongophala kwendawo yokugcina impahla kunye nabasebenzi beelori.
• Ukuhambisa iimaski zobuso ezikumgangatho ophezulu, ezivunywe ngurhulumente kwiindawo zokucofa igazi.
• Ukunqumamisa ummiselo okhoyo ngoku wamaZiko eMedicare kunye neeNkonzo zeMedicaid (CMS) efuna ukusetyenziswa kweesirinji zetyuwa ezifakwe kwangaphambili, ezingafumanekiyo kwezinye iindawo, de kudlule ingxaki eqatha.
• Khuthaza oorhulumente bamazwe kunye nabezizwe ngezizwe ukuba bavumele ukufana kwabongikazi ukuvumela ukuziqhelanisa ne-intrastate, nokuba urhulumente ukwimeko ebumbeneyo, ngeli xesha lobunzima.
Kukho abantu abangama-783,000 eUnited States abanokusilela kwezintso, kwaye bangaphantsi nje kwe-500,000 yaba bantu bafuna i-dialysis egcina ubomi iziswe kwiziko le-dialysis kathathu ngeveki, iiyure ezine ngosuku. Ngexesha lonyango lwe-dialysis, izigulana zihlala kufutshane nezinye izigulana kunye nabasebenzi kwiindawo ezingahlali kungena umoya kakuhle. Uninzi lwezi zigulana ngabantu abadala, abanemivuzo ephantsi, kwaye besuka kwiindawo ezazifudula zisingelwe phantsi, kwaye uninzi lwezigulana zineemeko ezisisiseko ezifana nesifo seswekile kunye nezifo zentliziyo.
Ngaphandle kweenzame ezidityanisiweyo yimibutho ye-dialysis, ii-nephrologists, kunye nabanye oogqirha ukuba bacothise ukusasazeka, i-COVID-19 iyaqhubeka nokubaleka ngamandla ngokusebenzisa izibonelelo ze-dialysis. Ngokwedatha evela kwiNkqubo yeDatha yeRenal yase-US, i-15.8% yazo zonke izigulana ezikwi-dialysis e-United States zinekhontrakthi ye-COVID-19 ukuya ekupheleni kuka-2020. Ngexesha lasebusika ngo-2020 wamaza, ukusweleka kweveki ngenxa ye-COVID-19 kwanda malunga nama-20. Ipesenti kunye nokufa kwabantu ngonyaka ngo-2020 bekuphezulu nge-18% kunowama-2019.1
Nangona la mazinga aphezulu osulelo kunye nokufa, izigulane ze-dialysis azizange zibekwe phambili ekufikeleleni kugonyo xa izitofu zokugonya zifumaneka kunyaka odlulileyo nangona ubungqina bubonisa ukuba impendulo yokuzivikela ekugonyweni iyancipha kwizigulane ze-dialysis. Ngaphaya koko, nangona amanqanaba e-antibody ehla ngokukhawuleza kwizigulana ze-dialysis kunabemi ngokubanzi, izigulana ze-dialysis azizange zibekwe phambili kuLawulo lokuTya kunye neDrugs (FDA) okanye amaZiko oLawulo lweSifo kunye noThintelo (CDC) xa idosi yesithathu yesitofu sokugonya ivunyiwe. ngo-Agasti.2 Ukongeza, izigulane ze-dialysis nazo zazingabandakanywanga kumaqela afanelekileyo ukufumana unyango lwe-antibody oluthatha ixesha elide olujoliswe kwintsholongwane ye-SARS-CoV-2. Okokugqibela, amaZiko eSizwe ezeMpilo akazange afumane mali yophando lwe-COVID-19 ukunceda abantu abanezifo zezintso okanye ukusilela kuyo nayiphi na iphakheji yoncedo yalo nyaka uphelileyo.
Omnye umceli mngeni kukungabikho konyango olufanelekileyo kubantu abanokusilela kwezintso. Ngelixa unyango olunciphisa umngcipheko we-COVID-19 luvela, iimpawu zangoku zibakhuphela ecaleni abantu abanokusilela kwezintso kuba aba bantu bahlala bekhutshelwa ngaphandle kulingo lwezonyango. Lo mkhwa awamkelekanga. I-NKF kunye ne-ASN zibongoza abavelisi ukuba baqinisekise ukuba ezi mveliso ziquka idosi kwizigulana ezinokusilela kwezintso. Ngaphaya koko, sibongoza i-FDA ukuba iqonde ukuncipha kokugonywa kwabantu abagonyiweyo abanokusilela kwezintso kwaye iqinisekise ukuba unyango luvunyiwe ngoGunyaziso lokuSebenzisa oluNgxamisekileyo (i-EUA) kwizigulana ezingakhuselekanga.
Njengoko uLawulo lweBiden luthenga inoveli yonyango ye-COVID-19 ukuze isasazwe e-United States, kubalulekile ukuba abaguli be-dialysis kunye nabasebenzi babekwe phambili ukuze bafikelele. Ukusilela ukubeka phambili izigulana ze-dialysis ukuze zifikelele kugonyo ekuqaleni kwalo bhubhani zineziphumo ezibanzi ekulalisweni nasekufeni. Akufunekanga sivumele le mpazamo ifanayo ukuba yenzeke kwakhona.
Okokugqibela, i-COVID-19 inyanyaniswa nomngcipheko omkhulu wokonzakala kwezintso (AKI), nakubantu abanomsebenzi wezintso ogciniweyo, okukhokelela kwisigulo esinzulu kunye nokufa, kwaye ihlala ifuna i-dialysis kunye nezinye iindlela zonyango lwezintso. Rhoqo ngexesha lobhubhane, kwaye kwakhona, ngexesha lotyando lwe-Omicron yangoku, izibhedlele ezininzi ziye zasokola ukubonelela ngonyango olusindisa ubomi kwizigulana ngenxa yokunqongophala kwabasebenzi abaqeqeshiweyo kunye noncedo.
Kunyanzelekile ukuba i-United States yenze konke okusemandleni ayo ukulungiselela utyando lwexesha elizayo kwiimeko ze-COVID-19 kunye nokuthintela ukusweleka okungeyomfuneko phakathi kwabantu bethu abasesichengeni. I-NKF kunye ne-ASN zilungele ukusebenzisana nabaqulunqi bomgaqo-nkqubo kwaye zivelise ukuphumeza le njongo.
Iinkcukacha ngesifo sezintso
EUnited States, abantu abadala abazizigidi ezingama-37 baqikelelwa ukuba banesifo sezintso, esaziwa ngokuba sisifo sezintso esingapheliyo (CKD)-kwaye malunga neepesenti ezingama-90 abazi ukuba banaso. I-1 kwaba-3 abadala base-US basengozini yesifo sezintso. Izinto ezinobungozi kwisifo sezintso ziquka: isifo seswekile, uxinzelelo lwegazi oluphezulu, isifo senhliziyo, ukutyeba, kunye nembali yosapho. Abantu abamnyama / base-Afrika baseMelika, i-Hispanic / Latino, i-American Indian / Alaska Native, i-Asian American, okanye i-Native Hawaiian / enye inzala yase-Pacific Islander basemngciphekweni omkhulu wokuphuhlisa isifo. Abantu abamnyama / abantu base-Afrika baseMelika bangaphezu kwamaxesha e-3 njengokuba abantu abaMhlophe banokungaphumeleli kwezintso. I-Hispanics / i-Latinos ngamaxesha e-1.3 ngaphezulu kune-non-Hispanics ukuba ibe nokungaphumeleli kwezintso.
Malunga nama-785,000 abantu baseMelika abanokusilela kwezintso okungenakuguquleka kwaye bafuna i-dialysis okanye uqhaqho lwezintso ukuze baphile. Ngaphezulu kwe-555,000 yezi zi gulane zifumana i-dialysis ukuze ithathe indawo yokusebenza kwezintso kwaye i-230,000 ihlala kunye nokutshintshwa. Phantse i-100,000 yabantu baseMelika abakuluhlu lokulinda ukufakelwa kwezintso ngoku. Ngokuxhomekeke apho isigulana sihlala khona, ixesha eliphakathi lokulinda uqhaqho-fakelo lwezintso linokuba ngaphezulu kweminyaka emithathu ukuya kwesixhenxe.
INTO ONOKUYITHATHA KWELI NQAKU:
- Furthermore, although antibody levels decline more rapidly in dialysis patients than in the general populationi, dialysis patients were not prioritized by the Food and Drug Administration (FDA) or the Centers for Disease Control and Prevention (CDC) when third doses of the vaccine were approved in August.
- Despite these high rates of infection and mortality, dialysis patients were not prioritized for access to immunization when the vaccines became available a year ago even though evidence shows that the immune response to vaccination is blunted in dialysis patients.
- Finally, COVID-19 is associated with a significant risk of acute kidney injury (AKI), even in people with preserved kidney function, resulting in serious illness and even death, and often requiring dialysis and other forms of kidney replacement therapy.
