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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
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Web-based consultation between general practitioners and nephrologists: a cluster randomized controlled trial.

Vincent A van Gelder1, Nynke D Scherpbier-de Haan1, Saskia van Berkel1

  • 1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.

Family Practice
|February 4, 2017
PubMed
Summary

Telenephrology did not significantly reduce referral rates for chronic kidney disease (CKD) patients compared to usual care. However, general practitioners reported positive experiences with the web-based platform, finding it non-inferior in quality and cost.

Keywords:
Chronic kidney diseasepatient care managementprimary health carereferral and consultationteleconsultation

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Area of Science:

  • Nephrology
  • Digital Health
  • Primary Care Medicine

Background:

  • Effective management of chronic kidney disease (CKD) at the primary-secondary care interface is crucial.
  • Current consultation methods pose practical challenges, potentially delaying care or leading to unnecessary referrals.

Purpose of the Study:

  • To evaluate the impact of a web-based consultation platform, telenephrology, on referral rates for CKD patients.
  • To assess consultation rates, quality of care, costs, and general practitioners' (GPs') experiences with telenephrology.

Main Methods:

  • A cluster randomized controlled trial involving 47 general practices in the Netherlands.
  • 3004 CKD patients were included, with practices randomized to telenephrology or enhanced usual care.

Main Results:

  • Referral rates were 2.3% in the telenephrology group versus 3.0% in the usual care group (non-significant difference).
  • Consultation rates were 6.3% versus 5.0% (non-significant).
  • No significant differences were observed in quality of care or costs; GPs generally had a positive opinion of telenephrology.

Conclusions:

  • The study could not establish telenephrology's effect on referral or consultation rates compared to conventional methods.
  • Telenephrology was positively evaluated by GPs and demonstrated non-inferiority in quality of care and costs.