Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas

Marco A. Ladino, Joslyn Wiley, Ivonne Hernandez Schulman, Alberto J. Sabucedo, Desiree Garcia, Jose M. Cardona, Alejandro Valdes, Fernando Pedraza, Roberto J. Echeverri

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: The Miami VA Healthcare System serves veterans in three South Florida counties: Miami-Dade, Broward, and Monroe, with an estimated veteran population of 175,000. To overcome geographical barriers and facilitate the access to nephrology clinics, we implemented provider-patient tele-nephrology using secured videoconferencing. Methods: A retrospective and descriptive study design was used to evaluate the effect of the tele-nephrology clinic intervention. Multiple clinical indicators were included in the analysis: blood pressure (BP) control, stabilization of the renal function, and electrolyte/metabolic control. One hundred one patients who were evaluated in the clinic between 2013 and 2015 were included in the analysis, and the indicators were collected retrospectively. Results: One hundred one patients were included in the analysis, with 95% of patients being male (n = 96) and 5% female (n = 5). The mean age was 65.5 years. Fifty patients had chronic kidney disease (CKD) stage III (49.5%), 14 patients had CKD stage IV (13%), and 8 patients had CKD stage II (7.9%). A one-way analysis of variance between subjects was conducted and showed that the effect of the tele-nephrology clinic intervention on reducing BP was statistically significant (systolic BP less than 140 p value <0.0001). Renal function stabilized but the creatinine changes over time were not statistically significant (p value: 0.50). Potassium showed a significant improvement in this sample (p value: 0.0076). Phosphorous and bicarbonate did not show a statistically significant improvement (p value 0.79 and 0.91, respectively). Conclusion: With the tele-nephrology clinic intervention, we were able to effectively improve BP and stabilize renal function in patients with kidney disease who reside in underserved areas.

Original languageEnglish (US)
Pages (from-to)650-654
Number of pages5
JournalTelemedicine and e-Health
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • care
  • CKD
  • electrolytes
  • hypertension
  • telenephrology

ASJC Scopus subject areas

  • Medicine(all)
  • Health Informatics
  • Health Information Management

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    Ladino, M. A., Wiley, J., Schulman, I. H., Sabucedo, A. J., Garcia, D., Cardona, J. M., Valdes, A., Pedraza, F., & Echeverri, R. J. (2016). Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas. Telemedicine and e-Health, 22(8), 650-654. https://doi.org/10.1089/tmj.2015.0197