Telehealth interventions reduced serum creatinine by 80.45 in HD and 162.67 in PD patients and increased hemoglobin by 8.66 in PD patients at approximately 3 months compared to usual care.
Meta-Analysis (n=316)
No
Do telehealth interventions improve serum albumin, serum creatinine, hemoglobin, and hematocrit at 3 months in adults receiving maintenance dialysis compared to usual care?
Telehealth interventions, particularly education-only models, may provide short-term improvements in serum creatinine and hemoglobin for patients on maintenance dialysis, though evidence certainty is low.
Effect estimate: MD -80.45 in serum creatinine for HD patients; MD -162.67 in serum creatinine for PD patients; MD 8.66 increase in hemoglobin in PD patients (95% CI 95% CI [-136.63, -24.27] for HD serum creatinine; 95% CI [-193.09, -132.25] for PD serum creatinine; 95% CI [5.89, 11.42] for hemoglobin in PD patients)
This systematic review and meta-analysis aimed to evaluate the effects of telehealth interventions compared with usual care on clinical indicators during the initial 3 months among adults receiving peritoneal dialysis (PD) or hemodialysis (HD) and to investigate whether different telehealth intervention models produce differentiated outcomes. Following PRISMA guidelines, a comprehensive search of eight databases was conducted for randomized controlled trials (RCTs) published until August 2024, involving adult dialysis patients receiving telehealth interventions versus usual care. Outcomes were serum albumin, serum creatinine, hemoglobin, and hematocrit measured at approximately 3 months. Data were analyzed using random-effects models, subgroup analyses, and GRADE for evidence quality assessment. Five RCTs involving 1455 screened articles were included. Telehealth interventions were associated with changes in serum creatinine in both HD (MD = −80.45; 95% CI −136.63, −24.27) and PD patients (MD = −162.67; 95% CI −193.09, −132.25). Hemoglobin levels improved notably in PD patients (MD = 8.66; 95% CI 5.89, 11.42), but not in HD patients. Subgroup analyses showed that education-only interventions increased hemoglobin (MD = 6.68; 95% CI 2.30, 11.05; I2 = 0%; p = 0.003). Education-only models indicated short-term improvements in certain laboratory markers; results for education + monitoring were mixed. High heterogeneity (I2 ≥ 75%), limited number of studies, small sample sizes, regional restrictions, and low-quality evidence reduced certainty. Telehealth interventions may provide short-term benefits for specific clinical indicators in maintenance dialysis for PD. Future large-scale, multicenter trials with extended follow-up are needed to clarify optimal telehealth strategies and determine how best to integrate telehealth into routine practice. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) at the National Institute for Health Research (CRD: 42024574257). Not applicable.
Shao et al. (2026) conducted a meta-analysis in maintenance dialysis including peritoneal dialysis and hemodialysis (n=316). Telehealth interventions vs. Usual care was evaluated on Clinical indicators including serum albumin, serum creatinine, hemoglobin, and hematocrit measured at approximately 3 months (MD -80.45 in serum creatinine for HD patients; MD -162.67 in serum creatinine for PD patients; MD 8.66 increase in hemoglobin in PD patients, 95% CI 95% CI [-136.63, -24.27] for HD serum creatinine; 95% CI [-193.09, -132.25] for PD serum creatinine; 95% CI [5.89, 11.42] for hemoglobin in PD patients). Telehealth interventions reduced serum creatinine by 80.45 in HD and 162.67 in PD patients and increased hemoglobin by 8.66 in PD patients at approximately 3 months compared to usual care.