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. 2023 Mar-Apr;43(2):239-244.
doi: 10.1016/j.nefro.2021.10.008. Epub 2021 Nov 26.

Increase in peritoneal dialysis-related hospitalization rates after telemedicine implementation during the COVID-19 pandemic

Fabiana Baggio Nerbass  1 , Raíssa Martins Vodianitskaia  2 , Helen Caroline Ferreira  3 , Gabriela Sevignani  1   3 , Marcos Alexandre Vieira  1   3 , Viviane Calice-Silva  1   2   3
Affiliations

Increase in peritoneal dialysis-related hospitalization rates after telemedicine implementation during the COVID-19 pandemic

Fabiana Baggio Nerbass et al. Nefrologia. 2023 Mar-Apr.

Abstract
in English, Spanish

Introduction and objectives: To minimize our peritoneal dialysis (PD) population exposure to coronavirus disease (COVID-19), in April 2020 we developed and implemented a telemedicine program. In this investigation, we aimed to compare the hospitalization rates and metabolic disorders in patients undergoing PD 6 months before and after the COVID-19 pandemic and telemedicine implementation.

Materials and methods: This single-center retrospective analysis included all active prevalent patients undergoing PD from April 2020. Dialysis records were reviewed to obtain clinical, demographic, laboratory, appointment, and hospitalization data. We compared hospitalization rates (total, non-PD-related, and PD-related), hospitalization-associated factors, and metabolic disorders (hemoglobin, serum potassium, and serum phosphate) 6 months before and after the pandemic.

Results: Our sample comprised 103 participants. During the pre-pandemic and post-pandemic periods, there were 13 and 27 hospital admissions, respectively. The total hospitalization incident rate ratio (IRR) was 2.48 (95% confidence interval [CI], 1.29-4.75). PD-related hospitalizations increased from 3 to 15 episodes (IRR = 7.25 [95% CI, 2.11-24.78]). In the pre-pandemic period, the educational level was lower in participants hospitalised due to PD-related issues than in participants not hospitalised. In the post-pandemic period, only sex distribution differed between patients not hospitalised and those hospitalised due to non-PD-related issues. Only serum potassium levels changed significantly in the post-pandemic period (4.79 ± 0.48 vs. 4.93 ± 0.54 mg/dL; P < 0.01).

Conclusion: This study showed a significant increase in hospitalization rates after the COVID-19 pandemic period and telemedicine implementation, mainly due to PD-related infectious causes. Strategies to improve distance monitoring assistance are needed for the PD population.

Introducción y objetivos: Para minimizar la exposición de nuestra población de diálisis peritoneal (DP) a la enfermedad por coronavirus (COVID-19), en abril del 2020 desarrollamos e implementamos un programa de telemedicina. En esta investigación, nuestro objetivo fue comparar las tasas de hospitalización y los trastornos metabólicos en pacientes sometidos a DP 6 meses antes y después de la pandemia de COVID-19 y la implementación de la telemedicina.

Materiales y métodos: Este análisis retrospectivo de un solo centro incluyó a todos los pacientes prevalentes activos sometidos a DP desde abril del 2020. Se revisaron los registros de diálisis para obtener datos clínicos, demográficos, de laboratorio, de citas y de hospitalización. Comparamos las tasas de hospitalización (total, no relacionada con la DP y relacionada con la DP), los factores asociados a la hospitalización y los trastornos metabólicos (hemoglobina, potasio sérico y fosfato sérico) 6 meses antes y después de la pandemia.

Resultados: Nuestra muestra fue compuesta por 103 participantes. Durante los períodos prepandémico y pospandémico, hubo 13 y 27 ingresos hospitalarios, respectivamente. La razón de la tasa de incidentes de hospitalización (TIR) total fue de 2,48 (intervalo de confianza [IC] del 95%, 1,29-4,75). Las hospitalizaciones relacionadas con la DP aumentaron de 3 a 15 episodios (TIR = 7,25 [IC del 95%, 2,11-24,78]). En el período prepandémico, el nivel educativo fue más bajo en los participantes hospitalizados debido a problemas relacionados con la DP que en los participantes no hospitalizados. En el período posterior a la pandemia, solo la distribución por sexo difirió entre los pacientes no hospitalizados y los hospitalizados debido a problemas no relacionados con la DP. Solo los niveles de potasio sérico cambiaron significativamente en el período pospandémico (4.79 ± 0.48 frente a 4.93 ± 0.54 mg/dL; P < 0.01).

Conclusión: Este estudio mostró un aumento significativo en las tasas de hospitalización después del período pandémico de COVID-19 y la implementación de la telemedicina, principalmente debido a causas infecciosas relacionadas con la DP. Se necesitan estrategias para mejorar la asistencia de monitoreo a distancia para la población con DP.

Keywords: COVID-19; Hospitalization; Peritoneal dialysis; Telemedicine.

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Figures

Fig. 1
Fig. 1
Hospitalization events 6-month pre- and 6-month post the pandemic.
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References

    1. Estado De Santa Catarina. Decreto no 515, de 17 de março de 2020. Published 2020. http://www.saude.sc.gov.br/coronavirus/arquivos/decreto_515_17_03_20.pdf [accessed 18.3.20].
    1. Conselho Federal de Medicina. Ofício CFM No 1756/2020. Published 2020. http://portal.cfm.org.br/images/PDF/2020_oficio_telemedicina.pdf [accessed 20.3.20].
    1. International Society of Peritoneal Dialysis. ISPD: Strategies regarding COVID-19 in PD patients. Published online 2020:1-4. http://ispd.org/wp-content/uploads/ISPD-PD-management-in-COVID-19_ENG.pdf [accessed 25.3.21].
    1. World Health Organization. https://www.who.int/health-topics/coronavirus#tab=tab_1.
    1. Deboni L.M., Neermann E.M.V., Calice-Silva V., Hanauer M.A., Moreira A., Ambrósio A., et al. Development and implementation of telehealth for peritoneal dialysis and kidney transplant patients monitoring during the COVID-19 pandemic. Braz J Nephrol. 2020:1–7. doi: 10.1590/2175-8239-jbn-2020-0137. Published online November 30. - DOI - PMC - PubMed