A cross-sectional, national survey on current practices and patterns in telenephrology among nephrologists

Abstract

Introduction: Telenephrology is an emerging but underreported area of practice. This study evaluated nephrologists’ confidence in diagnosing and managing a range of kidney conditions using telenephrology.

Methods: A cross-sectional online survey was conducted between September 2024 and January 2025 among practicing nephrologists in India. The questionnaire included 11 general and 110 condition-specific items. Respondents rated their confidence across clinical scenarios using a Likert scale. A response of moderate, high, or very high (≥60% confidence) was defined as “confident.”

Results: A total of 136 nephrologists from India participated. Of these, 73 (53.7%) used synchronous methods, with half conducting video consultations. The most frequently cited limitations were incomplete clinical examination (115; 84.6%) and medico-legal risks (89; 65.4%). Overall, 11 (44%) of 25 kidney conditions in the naïve diagnostic setting surpassed the confidence threshold. In contrast, only 2 (8%) of 25 conditions in naïve management reached this benchmark, primarily urinary tract infections and early-stage CKD (≤G3a). In chronic dialysis care, confidence was higher for hemodialysis-related complications but notably lower for peritoneal dialysis issues. Follow-up care in general nephrology (97; 71.3%) and kidney transplant recipients (103; 75.7%) exceeded the threshold in several scenarios. Counseling-related tasks reflected the lowest confidence (43; 31.6%). Factors such as pediatric exposure, academic affiliation, years of experience, sector of work, and workload did not significantly affect confidence levels.

Conclusion: This India-focused survey highlights promising confidence in telenephrology for diagnosis and follow-up but underscores the need for targeted improvements in management and counseling applications.