Trust renal units have already been asked to identify on an ongoing basis, those of their patients receiving dialysis as at high risk, to notify such patients and to submit these patients as high risk to NHS Digital for inclusion on the SPL.
As outlined above, patients with Stage 5 CKD are now also to be included as at high risk of complications from COVID-19.
Trusts should work with their renal units to:
1. Identify adults (18+) with CKD 5 (or G5 A1-3) not on renal replacement therapy (dialysis and renal transplantation), defined as:
- a reduction in kidney function or structural damage (or both) present for more than three months (NICE CG 182)
- a Glomerular Filtration Rate (GFR) less than 15 ml/min
- It excludes individuals who transiently drop below 15 ml/min (e.g. acute kidney injury, acute on chronic kidney disease)
2. Send a list of these patients to your trust’s named COVID-19 data lead(s), asking them to add them to the SPL. When sending a list of these patients to your trust’s named COVID-19 data lead(s), please ensure that you have included each patient’s NHS number, date of birth, postcode and consultant, with a request to add these patients to the SPL.
3. Send adult patients affected an high risk patient additions letter, as per the additions section below, informing them that they have been identified as clinically extremely vulnerable.
4. Ensure trust data leads add your patients to the SPL. When submitting patients with Stage 5 CKD, the trust data lead should submit patients under disease category 6 “Academy of Medical Royal Colleges (AoMRC) categories”, along with supporting information to identify the qualifying condition – See section on “Mapping” below.
5. Ensure this process is ongoing, with patients added and removed from the list in accordance with the definition above. Wherever you no longer think a patient should be considered clinically extremely vulnerable, please have a conversation with them about their personal situation and, if they agree, they should be removed from the list. Please follow the process described above to request removals.