Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1590/2175-8239-JBN-2021-0113 http://hdl.handle.net/11449/246616 |
Resumo: | 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. |
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Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort studyChronicBiomarkersPeritonitisMortalityKidney FailureIntroduction: 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.Santa Casa de Misericórdia de Curitiba, PRInstituto do Rim Carrascossi, SPFundação Pró-rim, SCUniversidade da Região de Joinville, SCPontifícia Universidade Católica do Rio Grande do Sul, RSFundação Pró-Renal, PRInstituto do Rim de Curitiba, PRRenal Care, DFUniversidade Estadual de São Paulo, SPInstituto de Doenças Renais, RSPontifícia Universidade Católica do Paraná, PRUniversidade Estadual de São Paulo, SPSanta Casa de Misericórdia de CuritibaInstituto do Rim CarrascossiFundação Pró-rimUniversidade da Região de JoinvillePontifícia Universidade Católica do Rio Grande do SulFundação Pró-RenalInstituto do Rim de CuritibaRenal CareUniversidade Estadual Paulista (UNESP)Instituto de Doenças RenaisPontifícia Universidade Católica do ParanáTabuti, Nicole Iasmin MagarioPellizzari, CaioCarrascossi, HenriqueCalice-Silva, VivianeFigueiredo, AnaMoreno Gordon, GinaBiangini, GilsonRodrigues, Mario ErnestoDias, Dayana Bitencourt [UNESP]da Silva, Dirceu ReisDe Moraes, Thyago Proença2023-07-29T12:45:48Z2023-07-29T12:45:48Z2022-10-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article473-481http://dx.doi.org/10.1590/2175-8239-JBN-2021-0113Jornal Brasileiro de Nefrologia, v. 44, n. 4, p. 473-481, 2022.2175-82390101-2800http://hdl.handle.net/11449/24661610.1590/2175-8239-JBN-2021-01132-s2.0-85145854467Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengJornal Brasileiro de Nefrologiainfo:eu-repo/semantics/openAccess2023-07-29T12:45:49Zoai:repositorio.unesp.br:11449/246616Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T23:49:06.155692Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
title |
Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
spellingShingle |
Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study Tabuti, Nicole Iasmin Magario Chronic Biomarkers Peritonitis Mortality Kidney Failure |
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_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_sort |
Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study |
author |
Tabuti, Nicole Iasmin Magario |
author_facet |
Tabuti, Nicole Iasmin Magario Pellizzari, Caio Carrascossi, Henrique Calice-Silva, Viviane Figueiredo, Ana Moreno Gordon, Gina Biangini, Gilson Rodrigues, Mario Ernesto Dias, Dayana Bitencourt [UNESP] da Silva, Dirceu Reis De Moraes, Thyago Proença |
author_role |
author |
author2 |
Pellizzari, Caio Carrascossi, Henrique Calice-Silva, Viviane Figueiredo, Ana Moreno Gordon, Gina Biangini, Gilson Rodrigues, Mario Ernesto Dias, Dayana Bitencourt [UNESP] da Silva, Dirceu Reis De Moraes, Thyago Proença |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Santa Casa de Misericórdia de Curitiba Instituto do Rim Carrascossi Fundação Pró-rim Universidade da Região de Joinville Pontifícia Universidade Católica do Rio Grande do Sul Fundação Pró-Renal Instituto do Rim de Curitiba Renal Care Universidade Estadual Paulista (UNESP) Instituto de Doenças Renais Pontifícia Universidade Católica do Paraná |
dc.contributor.author.fl_str_mv |
Tabuti, Nicole Iasmin Magario Pellizzari, Caio Carrascossi, Henrique Calice-Silva, Viviane Figueiredo, Ana Moreno Gordon, Gina Biangini, Gilson Rodrigues, Mario Ernesto Dias, Dayana Bitencourt [UNESP] da Silva, Dirceu Reis De Moraes, Thyago Proença |
dc.subject.por.fl_str_mv |
Chronic Biomarkers Peritonitis Mortality Kidney Failure |
topic |
Chronic Biomarkers Peritonitis Mortality Kidney Failure |
description |
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. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-10-01 2023-07-29T12:45:48Z 2023-07-29T12:45:48Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/2175-8239-JBN-2021-0113 Jornal Brasileiro de Nefrologia, v. 44, n. 4, p. 473-481, 2022. 2175-8239 0101-2800 http://hdl.handle.net/11449/246616 10.1590/2175-8239-JBN-2021-0113 2-s2.0-85145854467 |
url |
http://dx.doi.org/10.1590/2175-8239-JBN-2021-0113 http://hdl.handle.net/11449/246616 |
identifier_str_mv |
Jornal Brasileiro de Nefrologia, v. 44, n. 4, p. 473-481, 2022. 2175-8239 0101-2800 10.1590/2175-8239-JBN-2021-0113 2-s2.0-85145854467 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Jornal Brasileiro de Nefrologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
473-481 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
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Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808129555100073984 |