Utilisation and impact of telenephrology from selected studies
| Country (author) | Telehealth platform* | CKD population covered† | Setting‡ | Number of patients | Design | Impact§ | Identified loopholes and limitations (if any) |
| Jordan (AlAzab et al)11 | Electronic consults (e-Consult) | Non-dialysis CKD | Regional hospital in remote location | 64 | Prospective cohort | - Improved access - ↓ cost to patients - Improved patient quality of life | - Small sample (78 patients) - Short follow-up (1 year) - Non-randomised |
| USA (Ishani et al)12 | Android/iPad, emails | Non-dialysis CKD | Regional care centres, aged patients | 600 | Randomised clinical trial | - No difference in composite outcomes (death, hospitalisation, emergency department visits) compared with usual care | - Short follow-up period - Small sample size |
| Spain (Gomez-Martino et al)13 | e-Consult and video conference | Non-dialysis CKD | Regional centre | 105 | Retrospective descriptive study | - ↓ hospital visits | - Small sample (107 patients) - Short follow-up (27 months) |
| Netherlands (Scherpbier-de Haan et al)4 | e-Consultation | Non-dialysis CKD | Regional care centres | 122 | Prospective observational study | - ↓ patient referral to tertiary hospital - ↓ time per consultation | - Short study time - No analysis of actual referrals |
| UK (Stoves et al)14 | e-Consult | Non-dialysis CKD | General practices and a secondary referral hospital | 466 | Prospective observational study | - ↓ of paper consults - ↑ satisfaction by GPs - ↑ Clinical Empowerment of GPs | - Short study time - No analysis of actual referrals |
| USA (Diamantidis et al)43 | SMS PDAs | Non dialysis CKD | Regional hospital | 20 | Randomised parallel study | - Improved medication safety in CKD | - Small sample size |
| Russia (Braverman et al)15 | e–Consult | Non-dialysis Paediatric CKD | Open to public (parents of paediatric patients with CKD provided with e-Consult) | 141 | Retrospective descriptive study | - ↑ patient satisfaction | - None |
| USA (Berman et al)16 | Teleconference (video) | Haemodialysis | Single hospital, high-risk patients (multiple comorbidities) | 44 | Prospective observational study | - ↓ hospitalisation and hospital stay - ↓ overall care cost - ↑ quality of life | - Single hospital - Small sample (44 patients) |
| USA (Bellazi et al) | Teleconference | Haemodialysis | Regional hospital | 117 | Retrospective descriptive study | -↓ patient visit to main hospital -↓ reduced need for doctor travel to satellite unit | - Short study time |
| Canada (Berstein et al) | Teleconference | Haemodialysis | Referral hospitals linked to remote dialysis units (First nations, aborigines) | 2663 | Retrospective descriptive study | - ↑ 2 and 5 year survival on dialysis | - Socioeconomic status not considered - Comorbidity scare not considered |
| Spain (Gallar et al)18 | Teleconference | Peritoneal dialysis | Single centre | 57 | Prospective non- randomised study | - ↓ patient cost of care - ↓ hospitalisation | - Single centre - Small sample (57 patients) |
| Canada (Alison et al) | Teleconference | Peritoneal dialysis | Single centre | 8 | Randomised parallel design | - ↑ patient satisfaction | - Small sample size |
| Canada (Sicotte et al)19 | Teleconference | Haemodialysis | 2 remote haemodialysis centres serving first nations | 19 | Prospective observational study | - No difference between virtual patient rounds and telecase reviews with multidisciplinary teams | - Non randomised |
| USA (Thompson et al)20 | Teleconference | Post -transplant follow-up | Single centre | 138 | Prospective randomised study | - No difference in usual care regarding post-transplant depression prevalence | - Single centre - Short follow-up |
| UK (Connor et al) | Telephone | Post-transplant | Single centre | 30 | Prospective observational study | -Improved post-transplant access to care -↓ visit to hospital by patient -↑ cost effectiveness | - Small sample size |
| USA (Thompson et al)20 | Teleconference | Post -transplant | Single centre | 138 | Prospective randomised study | -No difference in usual care regarding post-transplant depression prevalence | - Single centre - Short follow-up |
*Telephone, video, SMS, Android/iPad technology, email communications, electronic consults (e-Consult), other (outside any of the above platforms).
† Non-dialysis CKD, haemodialysis population, peritoneal dialysis population, transplant population.
‡ Single hospital, regional, national, special populations (remote communities, disadvantaged group, etc).
§ Accessibility (reduction in wait times), efficiency (time savings for providers and/or patients, cost savings, etc), satisfaction (providers and/or patients).
CKD, chronic kidney disease; GP, general practitioner; PDA, personal digital assistant; SMS, short message service.