Open AccessEmperor’s syndrome in the COVID-19 era: Time for patient-centered nephrology?
Author(s) -
Dimitra Bacharaki,
Athanasios Diamandopoulos
Publication year - 2021
Publication title -
world journal of nephrology
Language(s) - English
Resource type - Journals
ISSN - 2220-6124
DOI - 10.5527/wjn.v10.i1.1
Subject(s) - medicine , nephrology , intensive care medicine , kidney disease , pandemic , health care , disease , covid-19 , infectious disease (medical specialty) , law , political science
The coronavirus disease-19 (COVID-19) pandemic has been a wake-up call in which has forced us to react worldwide. Health policies and practices have attracted particular attention in terms of human and financial cost. Before COVID-19, chronic kidney disease was already considered a risk multiplier in patients with diabetes and hypertension, the two now being the major risk factors for COVID-19 infection and adverse outcome. In contrast to the urgent need for action, the nephrology field is considered to be in a state of stagnation regarding the management of chronic kidney disease patients who still experience unacceptably high morbidity and mortality. Ironically and paradoxically in a field lacking robust clinical trials, clinical practice is driven by guidelines-based medicine on weak evidence. The Emperor's syndrome, referring to Hans Christian Andersen's fairy tale, has been described in medicine as voluntary blindness to an obvious truth, being a weak evidence-based therapeutic intervention or weak health care. A promising positive example of improving heart and kidney outcomes is the emerging treatment with sodium-glucose cotransporter 2 inhibitors. COVID-19 could boost actions for patient-centered care as a positive shift in nephrology care.