Stauss Madelena, Dhaygude Ajay, Ponnusamy Arvind, Myers Martin, Woywodt Alexander
Department of Nephrology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
Department of Clinical Biochemistry, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
Clin Kidney J. 2021 Dec 21;15(5):903-911. doi: 10.1093/ckj/sfab286. eCollection 2022 May.
The COVID-19 pandemic has necessitated the provision of healthcare through remote and increasingly digitalized means. The management of glomerular pathology, for which urinalysis is crucial, has been notably affected. Here we describe our single-centre experience of using remote digital urinalysis in the management of patients with glomerular disease during the COVID-19 pandemic.
All patients with native kidney glomerular disease who consented to participate in digital smartphone urinalysis monitoring between March 2020 and July 2021 were included. Electronic health records were contemporaneously reviewed for outcome data. Patient feedback was obtained through the testing portal.
Twenty-five patients utilized the digital urinalysis application. A total of 105 digital urinalysis tests were performed for a wide variety of indications. Four patients experienced a relapse (detected remotely) and two patients underwent three successful pregnancies. The majority of patients were managed virtually (60%) or virtually and face to face (F2F) combined (32%). The average number of clinic reviews and urine tests performed during the pandemic either virtually and/or F2F was comparable to levels pre-pandemic and the ratio of reviews to urinalysis (R:U) was stable (pre-pandemic 1:0.9 versus during the pandemic 1:0.8). Patients seen exclusively F2F with supplementary home monitoring had the highest R:U ratio at 1:2.1. A total of 95% of users provided feedback, all positive.
Remote urinalysis proved a safe and convenient tool to facilitate decision-making where traditional urinalysis was difficult, impractical or impossible. Our approach allowed us to continue care in this vulnerable group of patients despite a lack of access to traditional urinalysis.
新冠疫情使得通过远程且日益数字化的方式提供医疗保健成为必要。对肾小球疾病的管理而言，尿液分析至关重要，而这一管理受到了显著影响。在此，我们描述了在新冠疫情期间，我们单中心使用远程数字尿液分析管理肾小球疾病患者的经验。
纳入了2020年3月至2021年7月期间同意参与数字智能手机尿液分析监测的所有原发性肾小球疾病患者。同时回顾电子健康记录以获取结局数据。通过测试门户获得患者反馈。
25名患者使用了数字尿液分析应用程序。共进行了105次数字尿液分析测试，用于各种适应症。4名患者病情复发（远程检测到），2名患者成功经历了三次妊娠。大多数患者通过虚拟方式（60%）或虚拟与面对面（F2F）相结合的方式（32%）进行管理。疫情期间通过虚拟和/或F2F方式进行的门诊复查和尿液检测的平均次数与疫情前水平相当，复查与尿液分析的比例（R:U）稳定（疫情前为1:0.9，疫情期间为1:0.8）。仅通过面对面方式就诊并辅以家庭监测的患者的R:U比例最高，为1:2.1。共有95%的用户提供了反馈，均为积极反馈。
远程尿液分析被证明是一种安全便捷的工具，有助于在传统尿液分析困难、不切实际或无法进行的情况下进行决策。我们的方法使我们能够在无法进行传统尿液分析的情况下，继续为这一弱势群体提供护理。
