{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:19:53Z","timestamp":1777504793848,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2020,1]]},"abstract":"\n Rationale:<\/jats:title>\n Hemodialysis patients are at significant risk from COVID-19 due to their frequent interaction with the health care system and medical comorbidities. We followed up the trajectory of the first COVID-19\u2013positive maintenance hemodialysis patient at Sunnybrook Health Sciences Centre in Toronto. We present the lessons learned and changes in practices that occurred to prevent an outbreak in our center.<\/jats:p>\n <\/jats:sec>\n \n Presenting concerns of the patient:<\/jats:title>\n The patient, a 66-year-old woman on in-center hemodialysis, initially presented with a 2-day history of a productive cough. She subsequently developed a fever, was placed on contact and droplet isolation, and admitted to hospital.<\/jats:p>\n <\/jats:sec>\n \n Diagnoses:<\/jats:title>\n On March 13, 2020, the patient tested positive for COVID-19. Within the next 48 hours, she developed hypoxia and acute respiratory distress syndrome as a complication of her illness requiring an extended critical care stay. This extended critical care stay resulted in critical illness\u2013associated secondary sclerosing cholangitis.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n An interprofessional team was established, performing rapid Plan-Do-Study-Act quality improvement cycles to improve screening practices and promote the safety of patients and staff in the hemodialysis unit.<\/jats:p>\n <\/jats:sec>\n \n Outcomes:<\/jats:title>\n We present here the lessons learned, the changes to our screening protocols, and the clinical course of our first in-center hemodialysis patient with SARS-CoV-2.<\/jats:p>\n <\/jats:sec>\n \n Teaching points:<\/jats:title>\n Regular review of the infection screening processes is paramount in preventing outbreaks of COVID-19, particularly in hemodialysis units. Hospital admission should be arranged if a patient exhibits any clinical signs of hemodynamic compromise or hypoxia. Early education for health care practitioners caring for patients with COVID-19 and refresher information regarding personal protective equipment helped promote the safety of staff and prevent health care\u2013associated outbreaks.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/2054358120957473","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T02:25:39Z","timestamp":1599618339000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An Interprofessional Approach in Caring for a Patient on Maintenance Hemodialysis with COVID-19 in Toronto, Canada: An Educational Case Report"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0905-4585","authenticated-orcid":false,"given":"Elizabeth M.","family":"Hendren","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Matthews","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew","family":"Oliver","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada"},{"name":"Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Rice","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon W.","family":"Tobe","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada"},{"name":"Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"},{"name":"Northern Ontario School of Medicine, Sudbury, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bourne L.","family":"Auguste","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada"},{"name":"Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"key":"bibr1-2054358120957473","unstructured":"WHO. Coronavirus Disease 2019 (COVID-19): Situation Report\u201451. WHO; 2020. https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/situation-reports\/20200311-sitrep-51-covid-19.pdf. Accessed May 18, 2020."},{"key":"bibr2-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.03.008"},{"key":"bibr3-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30370-6"},{"key":"bibr4-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201017"},{"key":"bibr5-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.04.001"},{"key":"bibr6-2054358120957473","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S115518"},{"key":"bibr7-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.04.013"},{"key":"bibr8-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa460"},{"key":"bibr9-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30196-1"},{"key":"bibr10-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.04.021"},{"key":"bibr11-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1177\/2054358120928153"},{"key":"bibr12-2054358120957473","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.03.009"}],"container-title":["Canadian Journal of Kidney Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2054358120957473","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2054358120957473","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2054358120957473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:23:33Z","timestamp":1777389813000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2054358120957473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":12,"alternative-id":["10.1177\/2054358120957473"],"URL":"https:\/\/doi.org\/10.1177\/2054358120957473","relation":{},"ISSN":["2054-3581","2054-3581"],"issn-type":[{"value":"2054-3581","type":"print"},{"value":"2054-3581","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"article-number":"2054358120957473"}}