Abstract: TH-PO911
COVID-19 Pandemic and Its Impact on CKD Patient Care and Clinical Parameters
Session Information
- COVID-19: Long COVID
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Taki, Fumika, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Kadota, Nozomi, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Konishi, Kasumi, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Shimoyama, Kotaro, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Ito, Yugo, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Fujimaru, Takuya, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Nagahama, Masahiko, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
- Nakayama, Masaaki, St.Lukes International Hospital, Division of Nephrology, Tokyo, Japan
Background
In CKD management, periodic visit of nephrologist and multiple professions are known to be important. However, with the COVID-19 pandemic from the end of 2019, due to the tightening of medical care resources and intermittent lockdowns, these patients seem to be could not receive the full of nephrology care. We assessed changes of CKD patients care during the COVID-19 Pandemic and evaluated its impact on clinical parameters.
Methods
Patients with CKD over stage 4 and who had regularly attended CKD out-patients clinic in St. Luke’s International Hospital, Tokyo, Japan, were included. We definite the pre post pandemic periods as: pre-pandemic: Pre-C, from January 2018 to December 2019, and post-pandemic; Post-C, January 2020 to December 2021. The following data was compared between the 2 periods: 1. number of nephrology visits per patient; 2. rate of using telemedicine; 3. rate of receiving multidisciplinary educational support; 4. rate of drop-out patients; 5. Decline rate of GFR and 6. number of initiating renal replacement therapy, newly.
Results
289 individual patients were eligible for the analysis. The baseline data were as follows: mean age 67.9±14 years, 63.5% male, mean eGFR 22.2±5.9 ml/min and 40.2% comorbid DM. The number of nephrology visits and receiving multidisciplinary support was decreased in Post-C periods: Nephrology visits; Pre-C: 9.8±5.1 visits/year, Post-C 7.7±5.2 visits/year,P<0.01, Multidisciplinary support; Pre-C: 78%, Post-C 32%, P<0.01. Multiprofessional educational support was provided mainly for CKD stage 5 patients during the Post-C. More, the rate of using telemedicine and dropout increased in Post-C. Especially, the dropout rate of elderly patients over 70 years old was significant: 8% in Pre-C and 17% in Post-C,P<0.05. On the other hand, clinical indicators such as delta GFR and RRT initiation rate remained unchanged.
Conclusion
Although the frequency of nephrology visits and multidisciplinary educational care has been decreased with COVID-19, there was no difference in the short-term prognosis of CKD patients, from our study. This may be an effect of a kind of triage function, which focused on the more severely ill patients with CKD. On the other hand, the drop out rate in the elderly was increased, the prognosis of these patients needs to be followed up and verified.