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

Cardiorenal Med. 2020;10(3):198-208. doi: 10.1159/000506699. Epub 2020 Apr 14.

Abstract

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 health-related 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 [490-986] vs. 824 mL [537-1,183]). 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.

Keywords: Compliance; Health-related quality of life; Peritoneal dialysis; Pittsburg Sleep Quality Index; Remote access technology.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure / physiology*
  • Blood Pressure Determination / statistics & numerical data
  • Dialysis Solutions / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Italy / epidemiology
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / adverse effects*
  • Monitoring, Physiologic / methods
  • Outcome Assessment, Health Care
  • Patient Compliance / statistics & numerical data
  • Peritoneal Dialysis / psychology
  • Peritoneal Dialysis / statistics & numerical data*
  • Quality of Life / psychology
  • Remote Consultation / instrumentation
  • Time Factors
  • Ultrafiltration / statistics & numerical data

Substances

  • Dialysis Solutions