Telenephrology care for veterans in the covid-19 pandemic
Journal of the American Society of Nephrology
; 31:224-225, 2020.
Article
in English
| EMBASE | ID: covidwho-984133
ABSTRACT
Background:
Chronic kidney disease (CKD) affects 37 million adults in the United States. Since 2013 our Nephrology section has carried out a telenephrology clinic and implemented electronic consults (E-consults). During the COVID-19 pandemic, we implemented changes to evaluate patients with kidney disease. The aim of this study is to report our experience.Methods:
This is a single-center, retrospective chart review study, which evaluated the effect of our telenephrology clinic (video-on-demand and telemedicine clinic visits), as well as E-consults. Between January 2013 and 2020, 410 patients were seen at telemedicine clinic visits, and 1020 E-consults were evaluated. During the COVID-19 pandemic, between March 2020 and May 2020, 40 patients were assessed through videoon-demand.Results:
For telemedicine, a total of 169 patients were included, 99.4% were males, and 87% were white. The mean age was 66 ± 10 years, 92% had hypertension, and 41% diabetes mellitus. The baseline eGFR was 45 ± 14 ml/min/1.73m2. A one-way analysis of variance was conducted showing a statistically significant reduction on the systolic (SBP) and diastolic (DBP) blood pressure (p-value = 0.000), and improvement in potassium and bicarbonate levels (p-value = 0.000). Phosphorus levels did not show a significant difference (p-value 0.37). There was a significant association between attendance to >;3 telenephrology visits and SBP control (p-value=0.027), DBP control (p-value=0.002) and potassium improvement (p-value=0.013). The overall decrease in GFR was 1.2 ± 11.1 ml/ min/1.73 m2 (95% CI-0.41 to 2.95), lower than the reported natural progression of CKD (1.03 ml/min/1.73 m2/year). A survey for the video-on-demand patients showed 100% satisfaction, reflecting that patients felt their renal care needs were fulfilled. E-consults were answered in less than 24 hours, with 100% satisfaction from primary care physicians.Conclusions:
This is the first study evaluating the use of telenephrology in patients with kidney disease during the COVID-19 pandemic. In our cohort, telenephrology interventions improved SBP, DBP, bicarbonate, and potassium control. All three options improved health outcomes and guaranteed safety during the COVID-19 pandemic, at a reduced cost for the patient and the institution.
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of the American Society of Nephrology
Year:
2020
Document Type:
Article
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