Nerbass Fabiana Baggio, Vodianitskaia Raíssa Martins, Ferreira Helen Caroline, Sevignani Gabriela, Vieira Marcos Alexandre, Calice-Silva Viviane
Fundação Pró-Rim, Rua Alexandre Dumas, 50, CEP: 89227-630 Joinville, SC, Brazil.
Escola de Medicina, Universidade da Região de Joinville - UNIVILLE, Rua Paulo Malschitzki - Zona Industrial Norte, CEP: 89219-710 Joinville, SC, Brazil.
Nefrologia. 2023 Mar-Apr;43(2):239-244. doi: 10.1016/j.nefro.2021.10.008. Epub 2021 Nov 26.
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.
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.
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).
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.
为尽量减少我们腹膜透析（PD）人群接触冠状病毒病（COVID-19）的机会，我们于2020年4月制定并实施了一项远程医疗计划。在本调查中，我们旨在比较COVID-19大流行和远程医疗实施前后6个月接受PD治疗的患者的住院率和代谢紊乱情况。
这项单中心回顾性分析纳入了自2020年4月起所有正在进行PD治疗的现患患者。查阅透析记录以获取临床、人口统计学、实验室检查、预约和住院数据。我们比较了大流行前后6个月的住院率（总住院率、非PD相关住院率和PD相关住院率）、住院相关因素和代谢紊乱情况（血红蛋白、血清钾和血清磷酸盐）。
我们的样本包括103名参与者。在大流行前和大流行后期间，分别有13次和27次住院。总住院发生率比（IRR）为2.48（95%置信区间[CI]，1.29 - 4.75）。PD相关住院次数从3次增加到15次（IRR = 7.25 [95% CI，2.11 - 24.78]）。在大流行前时期，因PD相关问题住院的参与者的教育水平低于未住院的参与者。在大流行后时期，未住院患者与因非PD相关问题住院患者之间仅性别分布存在差异。在大流行后时期，只有血清钾水平发生了显著变化（4.79 ± 0.48 vs. 4.93 ± 0.54 mg/dL；P < 0.01）。
本研究表明，在COVID-19大流行时期和远程医疗实施后，住院率显著增加，主要是由于PD相关的感染原因。对于PD人群，需要采取策略来改善远程监测援助。
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