[Telemedicine applied to Nephrology. Another form of consultation].
In 2004, according to socio- demographic criteria and to the improvement in the welfare quality, we incorporated to the portfolio of services of our section a work tool that meant a novel technology; the "telemedicine". The Objective has been to asses the utility of telemedicine in the follow- up of the renal patients, bringing the consultation of nephrology closer to the patient's home as well as the relationship between two welfare levels.


METHODS
Retrospective and descriptive study of the patients with renal pathology treated in the consultation of telenephrology at our hospital in a period of time of 27 months (November 2004-January 2007). Such study is carried out in primary care centers of our sanitary area (4 centers). The general practician (G.P) starts up the system by elaborating a document of derivation to the consultation of "telenephrology". All this information is included in a computerized data base that arrives via "Intranet" at the Hospital. From the consultation of Telenephrology the question is answered in real- time and through a system of videoconference.


RESULTS
A total of 105 first consultations have been made. 52 men and 53 women between 18 and 94 years of age. The diagnoses made in the consultation of Telenephrology have been: HTA (essential and secondary): 90 (85.7%). IRC: 61 (58%). Diabetic Nefropathy: 17 (16%). Renal Polycystic: 3 (2.8%). Urinary Lithiasis: 2 (1.9%). Congenital malformations: 1 (0.95%). Obstructive Nefropathy: 1 (0.95%). Chronic Glomerulonephritis: 6 (5.7%). Urinary infection: 1 (0.95%). Absence of renal pathology: 5 (4.8%). Some of the diagnoses coincide in several patients. The causes of the IRC have been Nephroangioesclerosis: 33. Diabetic Nefropathy: 14. Not drafted: 8. Disease to glomerular: 2. Urinary Lithiasis: 2. Renal Polycystic: 1. Ischemic Nephropathy: 1. 82 out of the 90 patients with HTA had essential arterial hypertension and 8 suffered from secondary HTA. The causes of this were: 5 HTA of parenquimatous renal origin. 2 vasculorrenal HTA and one with a primary hyperaldosteronism. The associated factors of risk to the observed HTA have been: Dyslipemia: 29. Diabetes méllitus: 29. Hyperuricemia: 11. Obesity: 12.


CONCLUSIONS
The telecare in nephrology is possible promoting also the approach between two welfare levels, without a decrease in the quality of assistance. That way, we can get a lower number of hospital visits and, subsequently, a saving in sanitary transport as well as in hospital consultations.
Gómez-Martino
J R
JR
Hospital San Pedro de Alcántara, Cáceres. jgomezmartino@senefro.org
Suárez
M A Santisteban
MA
Gallego
S Domínguez
SD
González
P M Castillo
PM
Covarsí
A Rojas
AR
Castellano
I Cerviño
IC
Novillo
R Santana
RS
Deira
J L Lorenzo
JL
Marigliano
N Cozzolino
NC
Giménez
J J Garrido
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods*; D012017:Referral and Consultation; D012189:Retrospective Studies; D017216:Telemedicine; D055815:Young Adult