Remote patient management (RPM) has the potential to help clinicians detect early issues, allowing intervention prior to development of more significant problems. A 23-year-old end-stage kidney disease patient required urgent start of renal replacement therapy. A newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity was implemented in her care. Pre-defined RPM threshold parameters were set to identify clinically relevant issues. Red flag dashboard alerts heralded prolonged drain times leading to clinical evaluation with subsequent diagnosis of and surgical repositioning for catheter displacement, although it took several days for newly-RPM-exposed staff to recognize this issue. Post-PD catheter repositioning, drain times were again normal as indicated by disappearance of flag alerts and unremarkable cycle volume profiles. Identification of < 90% adherence to prescribed PD therapy was then documented with the RPM system, alerting the clinical staff to address this important issue given its association with significant negative clinical outcomes. Healthcare providers face a “learning curve” to effect optimal utilization of the RPM tool. Larger scale observational studies will determine the impact of RPM on APD technique survival and resource utilization.

Several studies have reported a worldwide increase in incidence and prevalence of nephrolithiasis, with some specificities across countries and regions. A retrospective review was performed on all urinary calculi submitted between 2009 and 2019 from a large part of the western Switzerland to our laboratory. A total of 10,437 stones were analysed and the presence of 18,804 compounds revealed. The median age of patients was 51 years and the global male-to-female ratio was 2.49:1. From 2009 to 2019, calcium oxalates containing calculi were the most frequent, followed by calcium phosphate and uric acids, the latter being more common in men, whereas carbapatite was the second most frequent component in women. Infection stone frequency remained unchanged and low, with a higher rate for women. Finally, while Randall's plaque frequency was relatively small (7.4%), patients experiencing them were significantly younger. In this review, we identified an age and gender relationship of stone composition and Randall's plaque formation in our Swiss region, which paves the way for future investigations.

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