NEPHROLOGY TRAINING AND DIGITAL LEARNING OPPORTUNITIES: A 10-YEAR EXPERIENCE OF THE RENAL HEALTH PROJECT

In the era of the 4th Industrial Revolution, technology has spread across all sectors of our society, including healthcare. Currently digital health is a reality, and there are several technological tools that help people to cope with diseases. Chronic kidney disease (CKD) is a public health concern which is growing and affects more than 800 million people worldwide. The aim of this study is to present and analyse the first 10 years of experience of the Renal Health project, an initiative that explores the world of technology applied to healthcare in kidney disease.

This is a multidisciplinary project that begun at the University of Fortaleza, Brazil, in 2015, aiming to create technological tools to help CKD patients in their treatment, with initial focus on haemodialysis and kidney transplantation. The first step of the study was to listen to CKD patients and people in general to understand the level of knowledge about CKD, and then identify their needs to improve health literacy. The second step was to create an application (app) that provide information about CKD and that contained useful tools to help patients during treatment (schedule for medications, alarms, water ingestion control, laboratory tests results, medical appointments’ agenda and other functionalities). Educational videos were created and made available on youtube, with information about CKD, from prevention to treatment, in a plain language, and a social network was created on Instagram. The name of the project was “Renal Health”. “Renal” was chosen because it is the Latin word for kidney and it is common for many languages.

During the “knowledge study” about CKD, a total of 735 people were interviewed, and only 17% known what was CKD. The concept of creatinine (the main biomarker for kidney function) was known by only 5.8% of people. Patients on dialysis and transplanted patients had pointed as the main difficulties during their treatment journey the nutritional aspects, including several restrictions, high number of medications, medical appointments and complementary tests. With these information, the Renal Health app was developed, aiming to provide educational information for patients and help them self-monitor treatment. There are sections for patients on dialysis and kidney transplantation. The app is available for free: https://apps.apple.com/br/app/renal-health/id1485397798, and the main screens can be seen at: https://pmc.ncbi.nlm.nih.gov/articles/instance/6451080/bin/mmc2.pptx. Two clinical studies were conducted by now to test the use of the Renal Health app with patients on haemodialysis, one in South and other in Northeast Brazil. In the study in the South region, where income in higher, the use of the app was associated with improvement in quality of life (domains mental health, social and pain), while in the study in Northeast, where there is a higher prevalence of disadvantaged and vulnerable populations, the app use was associated with improvement in medication adherence and decrease in interdialytic weight gain. Educational videos were published on a channel in youtube (https://www.youtube.com/@renalhealth4413), and by February 2025 a total of 9,821 views were registered. The Instagram account (https://www.instagram.com/renal_health/) had more than 1,836 publications with health information by February 2025 and more than 17,000 followers.

In the first 10 years of studies, the Renal Health project evidenced that innovations such as m-health has great importance to support patients with chronic diseases, such as CKD, and can be an effective way of increasing health outcomes, including better quality of life and treatment adherence.