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The outbreak of corona virus disease has rapidly evolved into a global pandemic and named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The World Health Organization (WHO) officially named SARS-CoV-2 as coronavirus disease 2019 (COVID-19). Although diffuse alveolar damage and acute respiratory failure were the main feature{2}, the involvement of other organs needs to be explored.

Chronic Kidney disease (CKD) is associated with an increased risk of both inpatient and outpatient pneumonia{3}. Moreover, the pneumonia related mortality rate in CKD patients seems to be 14–16 times higher than in the general population{4}.CKDpatients have a proinflammatory milieu and functional defects in innate and adaptive immune cell populations{5}.

Experts suggest kidneys are a target for COVID-19.Proximal tubular cells express the ACE2 cell surface receptor that SARS-CoV-2 uses to invade host cells and, thus, serve as a specific target for SARS-CoV-2 {6}. CKD prevalence also increases with age. Therefore, the elderly with the disease are more likely to be hospitalised if infected with the virus.

This vulnerability is likely multifactorial. Patients with CKD, especially those who require dialysis, and patients who have undergone kidney transplantation typically have comorbidities that caused their kidneys to fail in the first place.Plus, kidney disease and the immunosuppressive therapies used to treat it can often impair the immune system.And patients visiting a dialysis centre three times a week, where they come into at least indirect contact with others, ups their chance of infection.

Potential reasons why patients with kidney disease are more likely to suffer severe complications if they contract COVID-19.

First, cardiovascular disease associated with kidney disease, including high blood pressure and susceptibility to heart attacks and strokes hence increase risk of death if contract COVID-19. Patients with CKD are also more likely to be diabetic and can cause severe cardiovascular issues whose risk increase with COVID-19.

Second, patients with kidney disease are commonly immunosuppressed. This can be due to their underlying kidney disease or because they need to take medicines to treat their on-going kidney disease by suppressing their immune system.

People with kidney conditions should take more stringent precautions to protect themselves from the virus and prevent infection, such as staying at home, properly washing hands and avoiding direct human contact as much as is possible.

For Dialysis or transplant patient it is extremely important that those receiving dialysis continue to go to their dialysis treatments and both group to communicate and follow their doctor's recommendations.

If symptoms of COVID-19 (fever, dry cough, aches and pains, tiredness, shortness of breath), call your primary healthcare provider to take care of you remotely and ensure you don't potentially get others sick by coming in when it is not necessary. If symptoms are not severe enough to require hospitalization, you will recover at home and keep in close contact with your healthcare providers.

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