Potential applications of telenephrology to enhance global kidney care.

Chronic kidney disease (CKD) is an important public health issue that increasingly affects more patients globally and is associated with adverse clinical consequences with huge economic impact. Effective management of patients with CKD requires delivery of kidney care in a primary care setting where possible and at a higher level with a nephrologist when necessary to improve outcomes. In many instances and for various reasons, it is not possible to follow this pathway of care delivery. With improving telecommunication technologies worldwide, it is hoped that increasing utilisation of electronic communication devices can be used to facilitate kidney care to improve the quality of care delivered to patients, especially those who live in remote regions. Kidney care and therefore outcomes for patients with CKD is often compromised due to lack of access to a nephrologist, either because of distance or shortage of nephrologists, high proportion of patients being unaware they have CKD, lack of population screening for early detection of CKD and risk factors and prevention programmes and poor patient adherence and absence of appropriate CKD management strategies. Telenephrology can play a significant role in addressing these factors and therefore can be leveraged to improve CKD outcomes globally, especially in low to middle-income countries. This paper provides an overview on the potential role of telenephrology in enhancing access to and quality of care delivered to patients with CKD to improve outcomes.