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Background many Spanish hospitals converted scheduled in-person visits to telephone visits during the COVID-19 lockdown. There is scarce information about the performance of those visits. Aim to compare telephone visits during the COVID-19 lockdown period with previous in-person visits Design retrospective descriptive study. Methods telephone visits from 15 March to 31 May 2020 were compared with in-person visits during the same period in 2019. Main Measures the proportions of both groups were compared in term of failure to contact patient, requested diagnostic tests/referrals, discharges, admissions, and emergency visits within 30-60 days. A sample of patients, and all participating physicians completed surveys. Z-score test was used (statistical significance p < 0.05). Results 5602 telephone visits were conducted. In comparison to in-person visits, telephone visits showed higher rates of visit compliance (95.9% vs 85.2%, p < 0.001) and discharges (22.12% vs 11.82%; p < 0.001), and lower number of ancillary tests and referrals. During the 30-day and 60-day period following the telephone visit a reduction of 52% and 47% in the combined number of emergency department visits and hospital admissions was observed compared to in-person visits (p < 0.01). Of the 120 patients surveyed, 95% were satisfied/very satisfied with the telephone visits. Of the 26 physicians, 84.6% considered telephone visits were useful to prioritise patients. Conclusions during health emergencies, previously scheduled outpatient in-person visits can be converted to telephone visits, reducing absenteeism, increasing the rate of discharges, and reducing ancillary tests and referrals without increasing the rate of hospital admissions or emergency department visits.s

Background Semaglutide (glucagon-like peptide-1 receptor-agonist, GLP-1RA) has shown nephroprotective effects in previous cardiovascular studies. However its efficacy and safety in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) has been scarcely studied. Materials and methods this is a multicenter, retrospective, observational study in patients with T2D and CKD with A1c glycosylated haemoglobin (HbA1c) between 7.5-9.5% treated with subcutaneous semaglutide for 12 months in real-world clinical practice. Main objectives were glycemic control as HbA1c<7% and weight loss of >5%. Results 122 patients, age 65.50±11years, 62% men. Duration of T2D: 12 years and baseline HbA1c: 7.57%±1.36%, eGFR: 50.32±19.21 ml/min/1.73m2; 54% had albumin-to-creatinine ratio (UACR):30-300 mg/g and 20% UACR >300 mg/g. After 12 months of follow up: HbA1c declined -0.73%±1.09%(p<0.001) with 57% of patients achieving values <7%; weight loss -6.95 kg(p<0.001) with 59% of patients showing reduction>5% of their body weight. Systolic and diastolic blood pressure decreased -9.85 mmHg and -5.92 mmHg, respectively(p<0.001). The mean UACR reduced 51% in the group with baseline macroalbuminuria (UACR)>300 mg/g. Mean eGFR (by CKD-EPI) remained stable. The needs of basal insulin decreased 20% (p<0.005). Only 7% of patients on insulin had mild hypoglycemic episodes. Semaglutide was stopped in 5.7% of patients for digestive intolerance. Conclusions In this real-world study, patients with T2D and CKD treated with subcutaneous semaglutide for 12 months significantly improved glycemic control and decreased weight. Albuminuria decreased by >50% in patients with macroalbuminuria. The administration of GLP-1RA in patients with T2D and CKD was safe and well tolerated.

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