Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study
Abstract Introduction: The coronavirus-19 pandemic threatens the lives of all people, but results in higher mortality rates for patients with end-stage kidney disease (ESKD) including those on peritoneal dialysis (PD). Telemedicine was the main alternative to reduce exposure to the virus, but it wa...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Nefrologia
2022-02-01
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| Series: | Brazilian Journal of Nephrology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000400473&tlng=pt |
| _version_ | 1797957062421905408 |
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| author | Nicole Iasmin Magario Tabuti Caio Pellizzari Henrique Carrascossi Viviane Calice-Silva Ana Figueiredo Gina Moreno Gordon Gilson Biangini Mario Ernesto Rodrigues Dayana Bitencourt Dias Dirceu Reis da Silva Thyago Proença de Moraes |
| author_facet | Nicole Iasmin Magario Tabuti Caio Pellizzari Henrique Carrascossi Viviane Calice-Silva Ana Figueiredo Gina Moreno Gordon Gilson Biangini Mario Ernesto Rodrigues Dayana Bitencourt Dias Dirceu Reis da Silva Thyago Proença de Moraes |
| author_sort | Nicole Iasmin Magario Tabuti |
| collection | DOAJ |
| description | Abstract Introduction: The coronavirus-19 pandemic threatens the lives of all people, but results in higher mortality rates for patients with end-stage kidney disease (ESKD) including those on peritoneal dialysis (PD). Telemedicine was the main alternative to reduce exposure to the virus, but it was introduced in the Brazil without proper training. Objective: To investigate the impact of telemedicine on metabolic control, peritonitis rates, and hospitalization in PD patients during the pandemic. Methods: This was a retrospective multicenter cohort study. We included all adult patients on chronic PD from 9 clinics selected by convenience during the pandemic. The outcomes of interest were measured and compared between before and after switching to telemedicine using repeated measure analysis and multilevel Poisson regression. Results: The study included 747 patients with a mean age of 59.7±16.6 years, of whom 53.7% were male and 40.8% had diabetes. Biochemical parameters including hemoglobin, potassium, phosphate, calcium, and urea serum levels did not change significantly after transition to telemedicine. There was no association between telemedicine and peritonitis rates. In contrast, hospitalization rates increased significantly in the telemedicine period. The incidence rate ratio (IRR) for hospitalization in the telemedicine period was 1.54 (95%CI 1.10-2.17; p 0.012) and 1.57 (95%CI 1.12-2.21; p 0.009) in the mixed-effects Poisson regression before and after adjustment for the presence of confounders. Admissions for hypervolemia and infections not related to PD doubled after transition to telemedicine. Conclusion: The implementation of telemedicine without proper training may lead to an increase in adverse events in PD patients. |
| first_indexed | 2024-04-10T23:59:32Z |
| format | Article |
| id | doaj.art-ff5f7e34d6cc46c88d45e61ce74c8509 |
| institution | Directory Open Access Journal |
| issn | 2175-8239 |
| language | English |
| last_indexed | 2024-04-10T23:59:32Z |
| publishDate | 2022-02-01 |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj.art-ff5f7e34d6cc46c88d45e61ce74c85092023-01-10T07:36:20ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-82392022-02-0144447348110.1590/2175-8239-jbn-2021-0113Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort studyNicole Iasmin Magario TabutiCaio PellizzariHenrique CarrascossiViviane Calice-Silvahttps://orcid.org/0000-0002-9696-0529Ana Figueiredohttps://orcid.org/0000-0002-8555-8649Gina Moreno GordonGilson BianginiMario Ernesto Rodrigueshttps://orcid.org/0000-0002-9670-1594Dayana Bitencourt DiasDirceu Reis da SilvaThyago Proença de Moraeshttps://orcid.org/0000-0002-2983-3968Abstract Introduction: The coronavirus-19 pandemic threatens the lives of all people, but results in higher mortality rates for patients with end-stage kidney disease (ESKD) including those on peritoneal dialysis (PD). Telemedicine was the main alternative to reduce exposure to the virus, but it was introduced in the Brazil without proper training. Objective: To investigate the impact of telemedicine on metabolic control, peritonitis rates, and hospitalization in PD patients during the pandemic. Methods: This was a retrospective multicenter cohort study. We included all adult patients on chronic PD from 9 clinics selected by convenience during the pandemic. The outcomes of interest were measured and compared between before and after switching to telemedicine using repeated measure analysis and multilevel Poisson regression. Results: The study included 747 patients with a mean age of 59.7±16.6 years, of whom 53.7% were male and 40.8% had diabetes. Biochemical parameters including hemoglobin, potassium, phosphate, calcium, and urea serum levels did not change significantly after transition to telemedicine. There was no association between telemedicine and peritonitis rates. In contrast, hospitalization rates increased significantly in the telemedicine period. The incidence rate ratio (IRR) for hospitalization in the telemedicine period was 1.54 (95%CI 1.10-2.17; p 0.012) and 1.57 (95%CI 1.12-2.21; p 0.009) in the mixed-effects Poisson regression before and after adjustment for the presence of confounders. Admissions for hypervolemia and infections not related to PD doubled after transition to telemedicine. Conclusion: The implementation of telemedicine without proper training may lead to an increase in adverse events in PD patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000400473&tlng=ptKidney FailureChronicBiomarkersPeritonitisMortality |
| spellingShingle | Nicole Iasmin Magario Tabuti Caio Pellizzari Henrique Carrascossi Viviane Calice-Silva Ana Figueiredo Gina Moreno Gordon Gilson Biangini Mario Ernesto Rodrigues Dayana Bitencourt Dias Dirceu Reis da Silva Thyago Proença de Moraes Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study Brazilian Journal of Nephrology Kidney Failure Chronic Biomarkers Peritonitis Mortality |
| title | Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
| title_full | Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
| title_fullStr | Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
| title_full_unstemmed | Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
| title_short | Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
| title_sort | impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the covid 19 pandemic a national multicentric cohort study |
| topic | Kidney Failure Chronic Biomarkers Peritonitis Mortality |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022000400473&tlng=pt |
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