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Increase in peritoneal dialysis-related hospitalization rates after telemedicine implementation during the COVID-19
Fabiana Baggio Nerbass1, Raíssa Martins Vodianitskaia2, Helen Caroline Ferreira3
1Fundação Pró-Rim, Rua Alexandre Dumas, 50, CEP: 89227-630 Joinville, SC, Brazil.
Insights
Hospitalization rates significantly increased in peritoneal dialysis patients post-COVID-19 pandemic and telemedicine implementation, primarily due to PD-related infections. Improved remote monitoring strategies are crucial for this vulnerable population.
Area of Science:
- Nephrology
- Public Health
- Infectious Diseases
Background:
- The COVID-19 pandemic necessitated rapid implementation of telemedicine for peritoneal dialysis (PD) patients to minimize exposure.
- Understanding the impact of this transition on patient outcomes is critical for optimizing care.
Purpose of the Study:
- To compare hospitalization rates and metabolic disorders in PD patients before and after the COVID-19 pandemic and telemedicine implementation.
- To identify factors associated with hospitalization in the PD population during this period.
Main Methods:
- A single-center retrospective analysis of 103 prevalent PD patients.
- Comparison of clinical, demographic, laboratory, and hospitalization data from 6 months pre-pandemic to 6 months post-pandemic.
- Analysis included total, PD-related, and non-PD-related hospitalizations and key metabolic parameters.
Main Results:
- Total hospitalizations increased significantly (IRR 2.48), with PD-related admissions rising sharply (IRR 7.25).
- Serum potassium levels showed a significant increase in the post-pandemic period (P < 0.01).
- Pre-pandemic, lower educational level was linked to PD-related hospitalizations; post-pandemic, sex distribution differed for non-PD-related admissions.
Conclusions:
- The study revealed a significant rise in hospitalization rates among PD patients following the COVID-19 pandemic and telemedicine adoption.
- PD-related infections were the primary driver of increased hospitalizations.
- Enhanced remote monitoring strategies are essential to support the PD population effectively.
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.
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