A Telemedicine-Based Registration System for the Management of Renal Anemia in Patients on Maintenance Hemodialysis: Multicenter Study

被引：8

作者：

Ni, Zhaohui ^{[1
,2
]}

Jin, Haijiao ^{[1
,2
]}

Jiang, Gengru ^{[2
,3
]}

Wang, Niansong ^{[2
,4
]}

Peng, Ai ^{[5
]}

Guo, Zhiyong ^{[6
]}

Bai, Shoujun ^{[7
]}

Zhou, Rong ^{[8
]}

Lu, Jianrao ^{[9
]}

Wang, Yi ^{[10
]}

Li, Ying ^{[11
]}

Zhuang, Shougang ^{[12
]}

Yu, Chen ^{[13
]}

Deng, Yueyi ^{[14
]}

Jin, Huimin ^{[15
]}

Xu, Xudong ^{[16
]}

Zhang, Junli ^{[17
]}

Zhao, Junli ^{[18
]}

Yu, Xiuzhi ^{[19
]}

Wang, Xiaoxia ^{[2
,20
]}

Zhang, Liming ^{[21
]}

Niu, Jianying ^{[22
]}

Liu, Kun ^{[23
]}

Xiaorong, Bao ^{[24
]}

Wang, Qin ^{[25
]}

Ma, Jun ^{[26
]}

Hu, Chun ^{[2
,27
]}

Zang, Xiujuan ^{[28
]}

Yu, Qing ^{[2
,29
]}

机构：

[1] Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Dept Nephrol, Dongfang Rd 1630, Shanghai, Peoples R China

[2] Shanghai Jiao Tong Univ, Clin Res Ctr, Sch Med, Shanghai, Peoples R China

[3] Shanghai Jiao Tong Univ, Dept Nephrol, Sch Med, Xin Hua Hosp, Shanghai, Peoples R China

[4] Shanghai Jiao Tong Univ, Dept Nephrol, Peoples Hosp 6, Shanghai, Peoples R China

[5] Tongji Univ, Dept Nephrol, Peoples Hosp 10, Shanghai, Peoples R China

[6] Changhai Hosp Shanghai, Dept Nephrol, Shanghai, Peoples R China

[7] Fudan Univ, Zhongshan Hosp, Qingpu Branch, Dept Nephrol, Shanghai, Peoples R China

[8] Tongji Univ, Dept Nephrol, Yangpu Hosp, Shanghai, Peoples R China

[9] Shanghai Univ Tradit Chinese Med, Dept Nephrol, Peoples Hosp 7, Shanghai, Peoples R China

[10] Shanghai Univ Tradit Chinese Med, Dept Nephrol, Yueyang Hosp Integrated Tradit Chinese Med & West, Shanghai, Peoples R China

[11] Cent Hosp Shanghai Jiading Dist, Dept Nephrol, Shanghai, Peoples R China

[12] Shanghai East Hosp, Dept Nephrol, Shanghai, Peoples R China

[13] Tongji Univ, Tongji Hosp, Dept Nephrol, Sch Med, Shanghai, Peoples R China

[14] Shanghai Univ Tradit Chinese Med, Longhua Hosp, Dept Nephrol, Shanghai, Peoples R China

[15] Shanghai Pudong Hosp, Dept Nephrol, Shanghai, Peoples R China

[16] Fudan Univ, Minhang Hosp, Dept Nephrol, Shanghai, Peoples R China

[17] Jiulingwu Hosp, Dept Nephrol, Shanghai, Peoples R China

[18] Shanghai Pudong New Dist Zhoupu Hosp, Dept Nephrol, Shanghai, Peoples R China

[19] Navy Characterist Med Ctr, Dept Nephrol, Shanghai, Peoples R China

[20] Shanghai Jiao Tong Univ, Tongren Hosp, Dept Nephrol, Sch Med, Shanghai, Peoples R China

[21] Zhabei Cent Hosp, Dept Nephrol, Shanghai, Peoples R China

[22] Fudan Univ, Peoples Hosp Shanghai 5, Dept Nephrol, Shanghai, Peoples R China

[23] Shanghai 6 Peoples Hosp, Jinshan Branch, Dept Nephrol, Shanghai, Peoples R China

[24] Fudan Univ, Jinshan Hosp, Dept Nephrol, Shanghai, Peoples R China

[25] Shanghai Fengxian Cent Hosp, Dept Nephrol & Rheumatol, Shanghai, Peoples R China

[26] Jingan Dist Cent Hosp Shanghai, Dept Nephrol, Shanghai, Peoples R China

[27] Shanghai Jiao Tong Univ, Sch Med, People Hosp 9, Dept Nephrol, Shanghai, Peoples R China

[28] Shanghai Songjiang Dist Cent Hosp, Dept Nephrol, Shanghai, Peoples R China

[29] Shanghai Gen Hosp, Dept Nephrol, Shanghai, Peoples R China

来源：

JOURNAL OF MEDICAL INTERNET RESEARCH | 2019年 / 21卷 / 05期

基金：

中国国家自然科学基金;

关键词：

telemedicine; dialysis registration system; hemodialysis; renal anemia; end-stage renal disease; AUTOMATED PERITONEAL-DIALYSIS; PRACTICE PATTERNS; OUTCOMES; DISEASE; CHINA;

D O I：

10.2196/13168

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Renal anemia is one of the most important complications in patients on maintenance hemodialysis (MHD). Telehealth-based dialysis registration systems have the advantage of real-time monitoring and have gradually been applied to the management of chronic diseases. Objective: The objective of our study was to evaluate the impact of a telehealth-based dialysis registration system on patients on MHD in terms of renal anemia control. Methods: The Red China project aimed to develop a dialysis registration system based on the WeChat mobile platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, and baseline creatinine levels were recorded using this system. In addition, the hemoglobin and hematocrit levels were recorded monthly. The platform then generated a hemoglobin and hematocrit statistics report for each hemodialysis center monthly, including the detection rate, target rate, and distribution of hemoglobin and released it to physicians via the WeChat mobile phone app. The physicians were then able to treat the individual's anemia appropriately by changing the doses of erythropoiesis-stimulating agents or iron use on the basis of this report. We analyzed the demographic and baseline laboratory parameters, detection rate, target rate, and average level and distribution of hemoglobin 28 months after the launch of the project. Results: A total of 8392 patients on MHD from 28 hemodialysis centers in Shanghai were enrolled from June 2015 to October 2017. The detection rate of hemoglobin increased from 54.18% to 73.61% (P<.001), the target rate of hemoglobin increased from 47.55% to 56.07% (P<.001), and the mean level of hemoglobin increased from 10.83 (SD 1. 60) g/dL to 11.07 (SD 1.60) g/dL (P<.001). In addition, the proportion of patients with hemoglobin levels >= 11 g/dL but <13 g/dL increased from 40.40% to 47.48%. Conclusions: This telehealth-based dialysis registration system can provide timely reporting of the anemia status in patients on MHD, which may improve the awareness of anemia and the attention to and compliance with anemia monitoring.

引用

页数：8

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