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Kidney failure, the advanced stage of chronic kidney disease, is the irreversible loss of kidney function, often requiring kidney replacement therapy, including dialysis and kidney transplantation. Approximately 850 million people are affected by CKD worldwide, and although people are involved, people from disadvantaged populations may be at higher risk. Most countries, particularly Low-middle income countries ( LMICs), report shortages of at least one health care professional essential for kidney failure care delivery. To promote the use of a multidisciplinary team in decision-making and kidney failure care delivery, make services more comprehensive, and increase overall capacity to respond to the needs of people with kidney disease. There is also an opportunity for Telemedicine to expand the reach of nephrologists and other healthcare professionals. In the literature, Telemedicine can assist in monitoring dialysis patients, has the potential to reduce costs, overcome geographic barriers as it allows access, and helps in the lack of specialist professionals to meet the population's demand. In most countries, including Brazil, all Renal Replacement Therapy services must have a multidisciplinary team. They also provide a monthly consultation for every patient undergoing dialysis for their clinical evaluation and intention to receive a transplant. In Brazil, it is estimated that only 50% of candidates to receive a transplant are on the waiting list. Unfortunately, this consultation is often not carried out, missing a critical moment to inform the patient about their illness and the possibility of receiving an organ. Other studies have described the use of virtual clinics to evaluate transplants with improved waiting times and significant savings in time and money. This work aims to report the experience of interdisciplinary teleconsulting specialized in Nephrology at the Catholic University of Pelotas, the fourth most populous city in Rio Grande do Sul, in all groups of individuals with Chronic Kidney Disease.
Transversal study, from patients attending since January 2022 to May 2023, assist the physicians of primary health in the Nephrology Reference of Nephrology, Sao Francisco de Paula Hospital, University of Catholic of Pelotas, Brazil,
One of 80 teleconsultations at the HUSF Nephrology Service were conducted. Of these, 60% were female; the average age was 57. As for education, the majority had a secondary level, 67.8%. Of these, 14 patients underwent in-hospital hemodialysis, eight peritoneal dialysis, and 58 interconsults. Regarding comorbidities, more than 85% were hypertensive and 40% had diabetes mellitus. The distance traveled from home to the service location is 878km between the round trip were not to happen.
Chronic kidney disease is now a global public health problem, considered an epidemic of the 21st century, it will be a fifth cause of lost years in the population by 2040, with high costs for both patients and paying institutions. Despite being undersized and taking little time for evaluation, our study can identify that Telemedicine and interdisciplinary monitoring can be an excellent strategy for tackling the epidemic of individuals with chronic kidney disease in the 21st century.