The recent infection caused by SARS-CoV-2, a new strand of the Coronavirus, is challenging healthcare systems world-wide. Italy is one of the countries in which the infection has spread most rapidly and where the number of deaths is steadily increasing .
The initial Italian policy has been one of extensive testing of suspected cases including their contacts, and while this may have increased the efficacy of preventive measures, it has contributed to spreading concern. The lack of precise knowledge about the natural history of the disease, the awareness that even non-symptomatic or oligo-symptomatic cases (which probably account for about half of the individuals testing positive for the virus) may spread the infection, and the fact that re-infection is possible, further complicate the situation [2,3,4].
In common with other viral diseases, mortality is higher in elderly patients with high comorbidity, but no age is spared, and the impressive figures of transmission in different communities underline the need for reorganization of efforts to limit contagion, particularly in crowded settings .
Proximity and comorbidity require special attention [6,7,8]. In this context some populations, such as dialysis patients, combine fragility with the need for care in settings in which several individuals are treated at the same time.
Dialysis patients have a less efficient immune system and are more prone to develop severe infectious diseases than the general population [9,10,10]. In the case of the SARS-CoV-2, the few data available in the literature referring specifically to dialysis patients suggest that the inflammatory reaction may be less violent and, as a consequence, patients on dialysis may have mild clinical signs, at least in the early stages of the disease, with a higher risk of diffusing the infection in the dialysis ward .