Dialysis Provider Expects COVID-19 Mortality to Stay High



A company that provides care for people with serious kidney disease is assuming that COVID-19 mortality will be higher this quarter than it was in the fourth quarter of 2021.

Executives from DaVita, a Denver-based kidney dialysis provider, talked about their pandemic mortality outlook Thursday, on a conference call the company held to go over earnings for the latest quarter with securities analysts.

DaVita’s patient population is much older and sicker than any commercial life or health insurer’s enrollees, but the company’s experience could give insurers a preview of what might happen to the mortality level for their highest-risk insureds.


“While it’s too early to accurately forecast incremental mortality in 2022, given a significant uptick in infections in January, we expect COVID-driven mortality in the first quarter to be at or above what we experienced in Q4,” Joel Ackerman, DaVita’s chief financial officer, said on the earnings call.

Author(s): Allison Bell

Publication Date: 11 Feb 2022

Publication Site: Think Advisor

U.S. Pathology and Laboratory Society Endorses NKF-ASN Joint Task Force



The final NKF-ASN Task Force report recommends:

  • The use of the CKD-EPI 2021 eGFR creatinine equation for calculating eGFRcr in adults.2,3 This new equation is recommended because a race coefficient is not included in its computation and reporting.  The CKD-EPI 2021 eGFR creatinine equation included diversity in its development and does not disproportionately affect any one group.3
  • National efforts are also underway to facilitate increased, routine, and timely use of cystatin C (CPT 82610), especially to further evaluate eGFRcr in adults who are at risk for or have chronic kidney disease, or in individuals with abnormally high or low muscle mass.  The CKD-EPI 2021 eGFR using creatinine and cystatin C (eGFRcr-cys) is more accurate, more closely approximates measured GFR and supports better clinical decisions than either marker alone.2,3   

Publication Date: 8 Feb 2022

Publication Site: National Kidney Foundation

Supplements: COVID-19; Racial and Ethnic Disparities: Chapter 13




Among beneficiaries with CKD, mortality during COVID-19 hospitalization was approximately 40% during the first wave of the pandemic but decreased thereafter, reaching an average of 18% from July to December (Figure 13.10).

During all of 2020, the incidence of in-hospital death during COVID-19 hospitalizations was 21.5% among older Medicare beneficiaries with CKD, 18.8% among beneficiaries undergoing dialysis, and 19.3% among beneficiaries with a kidney transplant.

Between epidemiologic week 13 of 2020 and epidemiologic week 8 of 2021, the number of prevalent dialysis patients fell from 567,303 to 555,264, an unprecedented decline of over 2% (Figure 13.11).

Among patients undergoing dialysis, mortality was consistently elevated, relative to recent historical norms, between epidemiologic week 12 of 2020 and week 10 of 2021. Among patients with a kidney transplant, excess mortality was persistent through the second quarter of 2021 (Figure 13.12a).

The cumulative number of deaths among dialysis patients in 2020 was 18% higher than in 2019, while the cumulative number of deaths among transplant patients in 2020 was 41% higher than in 2019 (Figure 13.12b).

Publication Date: accessed 9 Feb 2022

Publication Site: U.S. Renal Data System

COVID-19 and its Impact on Kidney Patients Utilizing U.S. Dialysis Centers



The National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) stress the precarious position people with kidney failure, who are immunocompromised, face as the recent Omicron wave continues to spread among patients and staff at dialysis facilities. Cases of COVID-19 are causing serious illness, forcing shortened treatment times for patients, and exacerbating shortages in staff and supplies that impede access to this life-sustaining treatment. COVID-19’s impact on people with kidney diseases has resulted in the first decline in the number of patients on dialysis in the United States in the 50-year history of the Medicare ESRD Program.


There are 783,000 individuals in the United States who have kidney failure, and just under 500,000 of these individuals require life-sustaining dialysis delivered in a dialysis center three times a week, four hours a day. During dialysis treatments, patients typically sit near other patients and staff in facilities that are not always well ventilated. Many of these patients are older, low-income, and from historically disadvantaged communities, and most have underlying conditions like diabetes and cardiovascular diseases.

Despite concerted efforts by dialysis organizations, nephrologists, and other clinicians to slow its spread, COVID-19 continues to run rampant through dialysis facilities. According to data from the US Renal Data System, 15.8% of all patients on dialysis in the United States had contracted COVID-19 as of the end of 2020. During the winter 2020 wave, weekly deaths due to COVID-19 peaked at nearly 20% and annual mortality during 2020 was 18% higher than in 2019.[1]

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. Furthermore, although antibody levels decline more rapidly in dialysis patients than in the general population[i], 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.[2] In addition, dialysis patients were also excluded from the groups eligible to receive prophylactic long-acting antibody therapy targeting the SARS-CoV-2 virus. Lastly, the National Institutes of Health did not receive funding for COVID-19 research to help people with kidney diseases or failure in any of last year’s relief packages.

[1] https://adr.usrds.org/2021/supplements-covid-19-disparities/13-covid-19-supplement

Publication Date: 18 Jan 2022

Publication Site: National Kidney Foundation