Adoption of renal supportive care in Asian countries has been slow. This study aims to investigate the barriers towards renal supportive care as perceived by physicians in Singapore. METHOD: An online survey was sent out to all practising and training nephrologists, geriatricians and palliative physicians in Singapore public hospitals between October 1 st and October 30 th 2020. Responses were compiled and analysed. RESULTS: Out of 365 surveys sent, 75 nephrologists, 43 geriatricians and 28 palliative care physicians responded, accounting for a 40% response rate. Most of the participants managed 16 to 30 chronic kidney disease patients in a week. Older patients aged >75 years accounted for at least 30% of the chronic kidney disease cohort managed by 72% of respondents. Most agreed that renal supportive care aims to improve quality of life in chronic kidney disease (97.9%) and can be implemented alongside life-prolonging treatments such as dialysis (83.6%). However, only 51.4% recognised a distinction between renal supportive care and palliative care. Fewer nephrologists compared to geriatricians received prior palliative care training (54.7% vs 93.0%) or were certified advanced care planning facilitators (33.3% vs 67.4%). All respondents agreed that nephrologists should be aware of basic principles of palliative care, and 89.7% felt that palliative care should be incorporated into nephrology training. Most were comfortable holding discussions regarding dialysis withholding and withdrawal (93.8% and 87.7% respectively), and managing symptoms of pain (74.7%), breathlessness (87.0%) and anticipated symptoms after dialysis withdrawal (78.8%). Fewer physicians were comfortable with managing symptoms of pruritus (65.1%) and restless legs syndrome (56.2%). Majority (60%) did not feel confident in providing spiritual support as part of end-of-life care. Main barriers to renal supportive care included inadequate time during clinic consults to address the patients’ needs (87%), reliance on family members to make decisions (69.2%), inadequate palliative training during fellowship (67.1%) and inadequate community support services (55.5%). Some cited lack of awareness and acceptability of renal supportive care amongst patients and relatives in Singapore’s Asian cultural context. Most felt that encouraging advanced care planning discussions earlier in the course of chronic kidney disease (80.8%), having dedicated renal supportive care services in hospital (78.1%) and including palliative care rotation as part of training (69.2%) could potentially increase uptake of renal supportive care in Singapore. CONCLUSION: Nephrologists, geriatricians and palliative physicians in Singapore recognise the value of renal supportive care, but are faced with barriers such as patients’ and family’s resistance toward renal supportive care as well as inadequate palliative training. A unique model of renal supportive care with the patient as well as family’s involvement early in the decision-making process is likely to be better perceived in Asian countries. Incorporation of palliative care training in the nephrology fellowship curriculum should be considered. MO172 HYPONATREMIA IN PATIENTS WITH COVID19 Esmeralda Castillo-Rodr  ıguez 1 , Daniel Villa 2 , Marta  Alvarez Nadal 1 , Paula Regueiro Toribio 2 , Milagros Fernandez Lucas 1 1 Hospital Ram on y Cajal, Nephrology, Madrid, Spain and 2 Hospital Ram on y Cajal, General physician, Madrid, Spain BACKGROUND: Among laboratory abnormalities described in the context of SARS- COV-2 infection, hyponatremia seem to be the most common. The mechanism of this sodium disbalance is not well known. AIMS: Characterize the incidence, etiology and prognostic value of sodium disbalance in patients with COVID19. METHOD: Observational pilot study with 37 patients admitted to Hospital Ramon y Cajal in Madrid, Spain, between March and April 2020, with a confirmed diagnosis of COVID19. Patients were followed until discharge or death. Clinical and laboratory data were collected at admission and before the clinical outcome. Variables were analyzed comparing hyponatremic vs eunatremic patients. RESULTS: Distribution of patients according to their serum sodium was as follows: 16 patients with hyponatremia (44%), 19 with normal serum sodium (51%) and 2 with hypernatremia (5%). The average sodium level in hyponatremic patients was 130 63.2 mmol/l, median urine sodium was 36 63.2 mmol/l (only 6 urine sample available). Hyponatremia was associated with dyspnea at admission and with higher levels of LDH, neutrophil cells account and C reactive protein. However, no worse prognostic was associated with lower serum sodium. All patients recover sodium levels at discharge treated with salt supplementation and free water intake. CONCLUSION: mild hyponatremia is a common electrolyte disorder associated with COVID19. Sing as low urine sodium and recover with water and salt ingestion, point toward hydrosaline dehydration instead of SIADH as most common origin of hyponatremia. MO173 SPONTANEOUS RENAL ARTERY DISSECTION (SRAD): IS IT REALLY SO RARE? Fausta Catapano 1 , Maria Cristina Galaverni 2 , Simone NIcoletti 1 , Elena Mancini 1 1 Nephrology, Dialysis and Hypertension Unit, Policlinico S. Orsola, Bologna, Italy and 2 Radiology Unit, Policlinico S. Orsola, Bologna, Italy INTRODUCTION.: Spontaneous Renal Artery Dissection (SRAD) is a rare and often unrecognized clinical entity, which only accounts for 1-2% of all arterial dissections. Due to its rarity, it may be difficult to diagnose and treat. METHODS.: All patients affected by SRAD and admitted in our Unit in the last year were included. RESULTS.: Five patients presented with renal infarction due to SRAD were admitted in our Unit in 2020. Patient Characheristics are shown in Table 1. At onset, all suffered from abdominal pain and high blood pressure. In all patients renal function was normal. Abdomen computed tomography angiography (CTA) was diagnostic in all patients (Figure 1). They were treated with antihypertensive drugs and systemic anticoagulation followed by oral anticoagulants. At 3 month-follow-up, all patients became normotensive and partial or total renal artery recanalization were found (Figure 2). MO173 Figure 1: Abdominal CTA of 4 patients with SRAD at onset MO173 Figure 2: Abdominal CTA of 4 patients with SRAD after therapy Nephrology Dialysis Transplantation Abstracts 10.1093/ndt/gfab092 | i171 Downloaded from https://academic.oup.com/ndt/article/36/Supplement_1/gfab092.0051/6288724 by guest on 29 April 2023