Evaluating the Efficacy of Telemedicine in Managing Chronic Kidney Disease during Resource Shortages: A Randomized Controlled Trial in Quetta, Pakistan

Background: Chronic kidney disease (CKD) poses a significant health challenge in resource-limited settings like Quetta, Pakistan. Telemedicine offers a potential solution to bridge the gap in specialized care access. This study aimed to evaluate the effectiveness of a telemedicine intervention in managing CKD patients in Quetta. Methods: A randomized controlled trial was conducted involving 300 CKD patients from Quetta. Participants were randomly assigned to either the telemedicine intervention group or the standard care group. The telemedicine intervention included remote monitoring of key health indicators, virtual consultations with nephrologists, and patient education through digital platforms. The primary outcome was the change in estimated glomerular filtration rate (eGFR) from baseline to 12 months. Secondary outcomes included hospitalization rates, patient satisfaction, and healthcare costs. Results: At the 12-month follow-up, the telemedicine group exhibited a mean increase in eGFR of 3.2 mL/min/1.73m², compared to a decrease of 1.1 mL/min/1.73m² in the standard care group (p<0.05). Hospitalization rates were significantly lower in the telemedicine group (15%) compared to the standard care group (30%) (p<0.01). Patient satisfaction scores were higher in the telemedicine group, with 85% reporting satisfaction compared to 60% in the standard care group (p<0.05). Healthcare costs were reduced by 20% in the telemedicine group due to fewer hospital admissions and travel expenses. Conclusions: The telemedicine intervention demonstrated significant improvements in eGFR, reduced hospitalization rates, higher patient satisfaction, and lower healthcare costs compared to standard care. These findings suggest that telemedicine can be an effective and sustainable model for CKD management in resource-limited settings like Quetta.