# The evolution of consultation practices with general practitioners and nephrologists for patients with chronic kidney disease before and after the COVID-19 pandemic in France

## TL;DR

This study examines how the care of patients with chronic kidney disease in France changed before and after the COVID-19 pandemic, focusing on consultations and hospitalizations.

## Contribution

The study provides new insights into the adaptation of outpatient care for CKD patients in France during the pandemic using national health data.

## Key findings

- Teleconsultations helped maintain outpatient care for CKD patients during lockdown periods.
- Hospitalizations decreased by 10% during the pandemic, raising questions about the reasons for reduced inpatient care.
- Consultation rates with general practitioners and nephrologists remained stable despite pandemic disruptions.

## Abstract

The COVID-19 pandemic led to concerns about disruptions in the follow-up of chronic diseases, including chronic kidney disease (CKD). Here, we assessed the COVID-19 pandemic impact on healthcare use by patients with CKD in France.

We used the French National Health Data System (SDNS) that contains data on outpatient and inpatient healthcare of the whole French population. Using a validated algorithm, we identified two CKD cohorts based on their healthcare utilization: (i) the 2019 cohort (pandemic-exposed) and (ii) the 2017 cohort (comparator). We followed these cohorts for 2 years and compared consultations (in-person and teleconsultation) with a general practitioner (GP) and a nephrologist and all-cause hospitalizations (excluding COVID-19 as primary diagnosis). We stratified comparisons by age group and sex.

We identified 4,866,096 individuals with CKD in 2017 and 5,089,706 in 2019. During the first year of follow-up, 95.2% and 6.4% of patients in the 2017 cohort had at least one consultation with a GP and with a nephrologist, respectively, versus 94% and 6.3% in the 2019 cohort. Teleconsultations compensated for the reduction of in-person GP and nephrologist consultations throughout the lockdown periods in 2020 and 2021 (40.5% of patients in the 2019 cohort had at least one in-person consultation and 52.5% an in-person or tele-consultation with a GP). Hospitalizations ≥ 24 h decreased in 2020 and 2021 (-10%).

In France, outpatient care for CKD was maintained during the 2 years following the COVID-19 pandemic, thanks to teleconsultations. The persistently lower inpatient care utilization warrants further investigation.

The online version contains supplementary material available at 10.1007/s40620-025-02376-5.