Kidney Care Partners Opposes Discriminatory Policies Toward Nation’s Most Vulnerable Patients with Kidney Disease, Kidney Failure During Pandemic

Kidney Community Applauds HHS Office for Civil Rights for Enforcing Anti-Discrimination Regulations to Address Potential for Denial of Medical, Ventilator Care for Kidney Patients with COVID-19

Washington, DC, April 29, 2020 --( Kidney Care Partners (KCP) – the nation’s leading kidney care multi-stakeholder coalition representing patient advocates, physician organizations, health professional groups, dialysis providers, researchers, and manufacturers – sent a letter the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) yesterday to express support for OCR’s quick response to reports that some state governments and health systems were considering implementing crisis-management policies that would deprive certain patients – including patients with dialysis-dependent end-stage renal disease (ESRD)–of life-saving interventions for COVID-19, including ventilation.

The letter, signed by John P. Butler, Chair of KCP, noted:

Our members who are battling on the frontlines of the COVID-19 pandemic to provide access to high quality care for patients with kidney disease/kidney failure applaud OCR for reminding all providers of the need to provide care “guided by the fundamental principles of fairness, equality, and compassion that animate our civil rights laws,” particularly “with respect to the treatment of persons with disabilities during medical emergencies as they possess the same dignity and worth as everyone else.” We are concerned that some hospitals and providers in their efforts to address scarce resources could implement historic policy to triage access to life-saving ventilators, other equipment, drugs, and services in a manner that would discriminate against people with disabilities, including those living with kidney failure who require dialysis.

“The more than 37 million individuals living with end stage renal disease (ESRD), chronic kidney disease (CKD) and kidney transplants all have inherent dignity and worth regardless of functional ability or any other characteristic,” said Butler. “We thank OCR for their guidance that all COVID-19 patients should be evaluated for treatment based on individualized assessment and circumstances, using the best available objective medical evidence- not broad and arbitrary care criteria.”

Many of the nation’s leading organizations throughout the kidney community representing nephrologists, patient advocates and kidney dialysis providers expressed similar concerns and sentiments:

"Every patient with kidney disease is a unique individual whose health requires a thoughtful and individualized care plan, particularly those who are also affected with COVID-19,” said Dr. Anupam Agarwal, President of the American Society of Nephrology, Director, Division of Nephrology and Executive Vice Dean, School of Medicine at the University of Alabama at Birmingham. “Blanket policies that categorically restrict the access of kidney patients, and other vulnerable populations, to critical care are scientifically unfounded and inappropriately interfere with the trusted patient-physician relationship as well as disregard basic principles of medical ethics."

“As a nephrologist who treats ESRD patients,” said Dr. Holly Kramer, President of National Kidney Foundation and a board-certified nephrologist, “I can tell you that each patient is different and medical judgment, instead of arbitrary hospital or health system guidelines, should be used when determining who gets access to a life-saving ventilator and other COVID-19 treatments. Thanks to the miracles of dialysis and transplant, end-stage renal disease is not a terminal condition and should not be treated as such.”

“People with advanced kidney disease come in varied degrees of health and functional status, but they all want to be productive and active members of their families and communities, and we are doing everything in our power to support their desire for individual choices on the level of care they receive,” said Dr. Frank Maddux, Global Chief Medical Officer of Fresenius Medical Care. “We want to avoid population-based decisions on care that may not be in the best interests of the individual person.”

To learn more about the kidney community’s response to COVID-19, including regulatory and legislative relief requests from KCP, please visit our website.
Kidney Care Partners
Sarah Ann Rhoades