A remote management program in automated peritoneal dialysis patients in Colombia

Sanabria, Mauricio; Rosner, Mitchell H.; Vesga, Jasmín; Molano, Alejandra; Corzo, Leyder; Rodríguez, Patricia; Rios, Cristina; Rivera, Ángela; Bunch, Alfonso

doi:10.24875/nefro.18000048

Cited by 17 publications

(61 citation statements)

References 14 publications

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“…It has been shown that dialysis prescription adherence became more than 90% with the use of RM-APD. 31 We observed an improvement in patients' office blood pressure measurements, with approximately 30% less anti-hypertensive drugs in patients with performing RM-APD at the end of 1 year observation period.…”

Section: Discussionmentioning

confidence: 57%

Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control

et al. 2020

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Aim: Reduced treatment compliance in patients with peritoneal dialysis facilitates the development of fluid overload and as a result increased blood pressure and vascular stiffness in the long term. We aimed to evaluate blood pressure change and antihypertensive needs of patients within 1 year after the changeover to remote monitoring automated peritoneal dialysis (RM-APD) and compare the effect of RM-APD and continuous ambulatory peritoneal dialysis (CAPD) on peripheral and central haemodynamic parameters, volume status of patients and anti-hypertensive drug needs. Methods: This was an observational and cross-sectional study. We enrolled 15 patients performing CAPD, 20 patients performing RM-APD, and 38 age, and gender-matched healthy control. We measured pulse wave velocity to assess arterial stiffness, peripheral and central haemodynamic parameters. We measured the volume status of participants via bioimpedance spectroscopy. Results: The mean excess hydration of patients who underwent CAPD were higher than those who performed RM-APD and healthy control (P = .02). We found that mean diastolic blood pressure, heart rate, central systolic and diastolic blood pressure, and central pulse pressure were significantly different between the RM-APD, CAPD and healthy control (P = .02, P = .05, P = .007, P = .05 and P = .005, respectively). Post hoc analysis of these results showed that the differences between the groups were caused by the healthy control group and the patients with underwent CAPD. Daily anti-hypertensive drug count in patients with performing RM-APD was reduced over time (P < .001). Conclusion: The RM-APD provides better control of peripheral blood pressure and decrease of central haemodynamic parameters via controlling the excess body water.

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Section: Discussionmentioning

confidence: 57%

Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control

et al. 2020

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“…Figure 2 was depicted to demonstrate how patients' treatment adherence has changed after switching to RM-APD. According to Figure 2, alarms received from the device decreased within months, and treatment adherence of patients increased (from 4 [3][4][5][6][7][8] to 2 [0-3], p = 0.001). Also, patient median body weight decreased from 62.7 to 61 kg within 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…When a problem is detected, the physician and/ or PD nurse could interfere actively by either arranging the remote treatment (change the prescription using remote connection) or contacting the patient. It has been shown that dialysis prescription adherence became more than 90% with the use of RM-APD [5]. A study that is focused on outcomes of using RM-APD and published in 2019 showed that the use of RM-APD is associated with reduced hospital visits, nonsignificant but increased technical survival and reduced health costs during 1 year of follow-up [8].…”

Section: Discussionmentioning

confidence: 99%

“…Scores for each subscale range from 0 to 100, and higher scores are related to a better quality of life [13]. Subscale measurements consisted of 6 parts: (1) physical functioning, (2) role limitations due to physical health, (3) mental health, (4) role limitation due to mental health, (5) vitality, (6) bodily pain, (7) general health, and (8) social function. The Turkish version was validated in a Turkish population [14].…”

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confidence: 99%

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Automated Remote Monitoring for Peritoneal Dialysis and Its Impact on Blood Pressure

et al. 2020

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Introduction: Peritoneal dialysis (PD) provides a safe, home-based continuous renal replacement therapy for patients. The adherence of the patients to the prescribed dialysis fluids cannot always be monitored by physicians. Remote monitoring automated peritoneal dialysis (RM-APD) can affect patients' compliance with treatment and, thus, clinical outcomes. Objective: We aimed to evaluate the clinical outcomes of patients with a remote access program. Methods: This was an observational study. We analyzed the effect of RM-APD on treatment adherence, dialysis adequacy, and change in blood pressure control, sleep quality, and healthrelated quality of life during the 6 months of follow-up. Results: A total of 15 patients were enrolled in this study. It was found that there was a significant decrease (99 ± 19 vs. 89 ± 11 mm Hg) in mean arterial blood pressure of patients, and a considerable increase in Kt/V was observed in the sixth month after the RM-APD switch (2.11 ± 0.4 vs. 2.25 ± 0.5). A significant increase was found when comparing the 3-month and 6-month ultrafiltration amounts before RM-APD and the ultrafiltration amount within 6 months after RM-APD (800 mL [500-1,000] and 752 mL vs. 824 mL 183]). The daily antihypertensive pill need (4 [0-7] vs. 2 [0-6]) and alarms received from the device decreased (from 4 [3-8] to 2 [0-3]) at the sixth month of the switch. There was no significant change in sleep quality and health-related quality of life within 6 months. Conclusion: This study showed that treatment adherence and ultrafiltration amounts of patients increased with the use of RM-APD, as well as better blood pressure control with fewer antihypertensive drugs.

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“…However, the overall non-adherence rates to peritoneal dialysis prescription were 2.6% to 85% in the literature, and non-adherence to APD prescription was reported to be 5% to 20% 23,24 . It has been shown that dialysis prescription adherence became more than 90% with the use of RM-APD 7,25 . This platform enables patient treatment data, including peritoneal volume, alerts during treatment, drainage problems, interruption of therapy, loss of dwell time, loss of therapy time to receive, and transmission through to the PD center 7,9 .…”

Section: Discussionmentioning

confidence: 99%

The reliability and success of peritoneal dialysis during the COVID-19 pandemic

Yeter

Oğuz

Akcay

et al. 2020

Preprint

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Aim: This study aimed to evaluate the symptoms, changes in laboratory findings during the COVID-19 pandemic, and the effect of depression on symptoms associated with end-stage kidney disease in patients with peritoneal dialysis (PD).Methods: This was an observational and cross-sectional study. The patients underwent three different PD modalities, including continuous ambulatory PD, automated peritoneal dialysis, and remote monitoring automated peritoneal dialysis (RM-APD). All patients were asked to complete the clinical assessment form and Beck depression and anxiety inventory. Additionally, the last two laboratory evaluations during this period were examined.Results: A total of 123 patients undergoing PD were included. None of the patients were diagnosed with COVID-19 infection. Serum ferritin, creatinine, phosphorus, albumin and parathyroid hormone levels were significantly elevated in the total study population (p=0.03, p=0.01, p=0.02, p=0.02 and p=0.05, respectively). While calcium, phosphorus, and parathyroid hormone tended to increase in patients with APD or CAPD, they remained stable in patients performing RM-APD. Most of the patients did not experience dyspnea, pitting edema, difficulty in blood pressure control, palpitation, bone muscle pain, or peritonitis. Moderate to severe depression was associated with dyspnea, weight gain, fatigue, palpitation, and increased anxiety.Conclusion: PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. PD is a safe method of renal replacement therapy to protect patients from COVID-19 infection. Additionally, RM-APD may be a better choice because it provides more stable bone mineral metabolism. Moreover, evaluating depression and anxiety at phone visits may be necessary for accurate clinical assessment.

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A remote management program in automated peritoneal dialysis patients in Colombia

Cited by 17 publications

References 14 publications

Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control

Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control

Automated Remote Monitoring for Peritoneal Dialysis and Its Impact on Blood Pressure

The reliability and success of peritoneal dialysis during the COVID-19 pandemic

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