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Lew SQ, Ronco C. Use of eHealth and remote patient monitoring: a tool to support home dialysis patients, with an emphasis on peritoneal dialysis. Clin Kidney J 2024; 17:i53-i61. [PMID: 38846414 PMCID: PMC11151118 DOI: 10.1093/ckj/sfae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 06/09/2024] Open
Abstract
Implementing eHealth requires technological advancement, universal broadband and internet access, and devices to conduct telemedicine and remote patient monitoring in end-stage kidney disease patients receiving home dialysis. Although eHealth was beginning to make inroads in this patient population, the COVID-19 pandemic spurred telemedicine usage when many regulations were waived during the Public Health Emergency to limit the spread of infection by endorsing social distancing. At the same time, two-way communication automatic peritoneal dialysis cyclers were introduced to advance remote patient monitoring. Despite the numerous advantages and potential benefits afforded by both procedures, challenges and untapped resources remain to be addressed. Continuing research to assess the use of eHealth and technological innovation can make eHealth a powerful tool in home dialysis. We review the past, present and future of eHealth and remote patient monitoring in supporting home dialysis.
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Affiliation(s)
- Susie Q Lew
- Division of Renal Diseases and Hypertension, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Claudio Ronco
- International Renal Research Institute and IRRIV Foundation for Research in Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
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2
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Augustyńska J, Lichodziejewska-Niemierko M, Naumnik B, Seweryn M, Leszczyńska A, Gellert R, Lindholm B, Lange J, Kopel J. Automated Peritoneal Dialysis With Remote Patient Monitoring: Clinical Effects and Economic Consequences for Poland. Value Health Reg Issues 2024; 40:53-62. [PMID: 37976660 DOI: 10.1016/j.vhri.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/24/2023] [Accepted: 09/06/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Remote patient monitoring (RPM) of patients treated with automated peritoneal dialysis (APD) at home allows clinicians to supervise and adjust the dialysis process remotely. This study aimed to review recent scientific studies on the use of RPM in patients treated with APD and based on extracted relevant data assess possible clinical implications and potential economic value of introducing such a system into practice in Poland. METHODS A systematic literature review was performed in the MEDLINE, EMBASE, and Cochrane databases. The model of clinical effects and costs associated with APD was built as a cost-effectiveness analysis with a 10-year time horizon from the Polish National Health Fund perspective. Cost-effectiveness analysis compared 2 strategies: APD with RPM versus APD without RPM. RESULTS Thirteen publications assessing the clinical value of RPM among patients with APD were found. The statistical significance of APD with RPM compared with APD without RPM was identified for the main clinical outcomes: frequency and length of hospitalizations, APD technique failure, and death. An incremental cost-effectiveness ratio was equal to €27 387 per quality-adjusted life-year. The obtained incremental cost-effectiveness ratio is below the willingness-to-pay threshold for the use of medical technologies in Poland (€36 510 per quality-adjusted life-year), which means that APD with RPM was a cost-effective technology. CONCLUSIONS RPM in patients starting APD is a clinical option that is worth considering in Polish practice because it has the potential to decrease the frequency of APD technique failure and shorten the length of hospitalization.
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Affiliation(s)
| | | | - Beata Naumnik
- The First Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Białystok, Białystok, Poland
| | | | | | - Ryszard Gellert
- Department of Nephrology and Internal Medicine, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Bengt Lindholm
- Division of Baxter Novum and Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
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Outcomes of Remote Patient Monitoring in Peritoneal Dialysis: A Meta-Analysis and Review of Practical Implications for COVID-19 Epidemics. ASAIO J 2023; 69:e142-e148. [PMID: 36867191 DOI: 10.1097/mat.0000000000001891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The present study seeks to determine clinical outcomes associated with remote patient monitoring of peritoneal dialysis (RPM-PD), with potential implications during COVID-19 outbreaks. We performed a systematic review in the PubMed, Embase, and Cochrane databases. We combined all study-specific estimates using the inverse-variant weighted averages of logarithmic relative risk (RR) in the random-effects models. Confidence interval (CI) including the value of 1 was used as evidence to produce a statistically significant estimate. Twenty-two studies were included in our meta-analysis. Quantitative analysis demonstrated that RPM-PD patients had lower rates of technique failure (log RR = -0.32; 95% CI, -0.59 to -0.04), lower hospitalization rates (standardized mean difference = -0.84; 95% CI, -1.24 to -0.45), and lower mortality rates (log RR = -0.26; 95% CI, -0.44 to -0.08) compared with traditional PD monitoring. RPM-PD has better outcomes in multiple spheres of outcomes when compared with conventional monitoring and likely increases system resilience during disruptions of healthcare operations.
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Tong Y, Wang H, Cao X, Cai G, Chen X, Zhou J. Research hotspots and emerging trends of automated peritoneal dialysis: A bibliometric analysis from 2000 to 2020. Semin Dial 2023; 36:117-130. [PMID: 35352408 DOI: 10.1111/sdi.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The implementation of automated peritoneal dialysis (APD) has considerably increased in many countries. We conducted a bibliometric analysis to evaluate the accumulating studies on APD in the last two decades quantitatively and qualitatively. METHODS Publications regarding APD research between 2000 and 2020 were retrieved from the Web of Science Core Collection database by using the index term "automated peritoneal dialysis." CiteSpace, VOSviewer, and an online platform were employed to analyze the number of publications and the collaboration relationships between countries, institutions, authors, and co-cited journals. Cluster analysis and burst keywords detection were performed on co-cited references and keywords, respectively. RESULTS We obtained a record of 545 publications related to APD in total. The United States was the country that contributes most, and Baxter Healthcare Corporation was the leading institution. Peritoneal Dialysis International was the most active journals in this field. Claudio Ranco was the most productive author, and Simon J Davies ranked the first in the cited authors. Co-cited reference cluster analysis and high frequency keywords showed that survival, ultrafiltration and peritonitis are continuous hot topics. While remote monitoring (RM) and telemedicine may be APD research frontiers according to burst keywords detection. CONCLUSION This bibliometric study provides comprehensive overview on the publications of APD over the past two decades. These findings help to identify the hotspots and explore new directions for future research. RM has become an emerging trend in APD field.
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Affiliation(s)
- Yan Tong
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Hong Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Xueying Cao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Xiangmei Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Jianhui Zhou
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
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Uzun Kenan B, Demircioglu Kilic B, Akbalık Kara M, Taktak A, Karabay Bayazit A, Yuruk Yildirim ZN, Delibas A, Aytac MB, Conkar S, Kaya Aksoy G, Donmez O, Yel S, Saygili S, Akaci O, Buyukkaragoz B, Alpay H, Bakkaloglu SA. Evaluation of the Claria sharesource system from the perspectives of patient/caregiver, physician, and nurse in children undergoing automated peritoneal dialysis. Pediatr Nephrol 2023; 38:471-477. [PMID: 35562513 PMCID: PMC9106572 DOI: 10.1007/s00467-022-05563-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Automated peritoneal dialysis (APD) is increasingly preferred worldwide. By using a software application (Homechoice with Claria sharesource system (CSS)) with a mod-M added to the APD device, details of the home dialysis treatment become visible for PD nurses and physicians, allowing for close supervision. We aimed to evaluate the perceptions of patients/caregivers, PD nurses, and physicians about the advantages and disadvantages of CSS. METHODS Three different web-based questionnaires for patients/caregivers, nurses, and physicians were sent to 15 pediatric nephrology centers with more than 1 year of experience with CSS. RESULTS Respective questionnaires were answered by 30 patients/caregivers, 22 pediatric nephrologists, and 15 PD nurses. Most of the nurses and physicians (87% and 73%) reported that CSS improved patient monitoring. A total of 73% of nurses suggested that CCS is not well known by physicians, while half of them reported reviewing CSS data for all patients every morning. Sixty-eight percent of physicians thought that CSS helps save time for both patients/caregivers and healthcare providers by reducing visits. However, only 20% of patients/caregivers reported reduced hospital visits. A total of 90% of patients/caregivers reported that being under constant monitoring made them feel safe, and 83% stated that the patient's sleep quality improved. CONCLUSIONS A remote monitoring APD system, CSS, can be successfully applied with children for increased adherence to dialysis prescription by giving shared responsibility and may help increase the patient's quality of life. This platform is more commonly used by nurses than physicians. Its potential benefits should be evaluated in further well-designed clinical studies with larger patient groups. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Bahriye Uzun Kenan
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey
| | | | | | - Aysel Taktak
- Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | | | | | - Ali Delibas
- Mersin University School of Medicine, Mersin, Turkey
| | | | - Secil Conkar
- Ege University School of Medicine, Izmir, Turkey
| | | | - Osman Donmez
- Uludag University School of Medicine, Bursa, Turkey
| | - Sibel Yel
- Erciyes University School of Medicine, Kayseri, Turkey
| | - Seha Saygili
- Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Okan Akaci
- Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Bahar Buyukkaragoz
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey
| | - Harika Alpay
- Marmara University School of Medicine, Istanbul, Turkey
| | - Sevcan A Bakkaloglu
- Department of Pediatric Nephrology, Gazi University School of Medicine, Besevler, Ankara, Turkey.
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Shi X, Du H, Zhang Z, Zhou Y. Clinical outcomes of automated versus continuous ambulatory peritoneal dialysis for end-stage kidney disease: protocol of a systematic review and meta-analysis. BMJ Open 2022; 12:e065795. [PMID: 36323481 PMCID: PMC9639101 DOI: 10.1136/bmjopen-2022-065795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION An increasing number of studies comparing automated peritoneal dialysis (APD) with continuous ambulatory peritoneal dialysis (CAPD) in clinical outcomes have been published since the publication of a systematic review and meta-analysis including three randomised controlled trials in 2007. We will conduct a systematic review and meta-analysis to explore more clinical outcomes of APD versus CAPD for end-stage kidney disease. METHODS AND ANALYSIS The protocol is conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Three databases-PubMed, EMBASE and the Cochrane Library-will be searched comprehensively from inception to 16 June 2022, without language restriction. Studies reporting clinical outcomes comparing APD with CAPD will be included. Two independent reviewers will screen the titles and abstracts and then obtain and assess full texts of potential relevant articles for eligibility following the inclusion and exclusion criteria. The methodological quality of included observational studies will be assessed by using the Newcastle-Ottawa Scale. The risk of bias of included randomised controlled studies will be assessed by using the Cochrane Risk of Bias tool. Relative risk for dichotomous outcomes and standard mean difference for continuous outcomes with corresponding 95% CIs will be pooled for summary effects. Cochrane Q test and I 2 values will be used to assess heterogeneity between studies. To assess and explore the source of heterogeneity, subgroup analyses and sensitivity analyses will be conducted, and meta-regression, funnel plot and Egger's test will be performed if there are no less than 10 studies. Analyses will be performed using STATA software, V.13.0 (STATA Corporation, College Station, Texas, USA). ETHICS AND DISSEMINATION Ethics approval is not applicable as no personal information is collected from patients. The results will be published in a peer-reviewed journal or disseminated in relevant academic conferences. PROSPERO REGISTRATION NUMBER CRD42022311401.
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Affiliation(s)
- Xinmiao Shi
- Department of Clinical Affairs, Fresenius Medical Care Shanghai Co, Beijing Branch, Beijing, China
| | - Hui Du
- Department of Clinical Affairs, Fresenius Medical Care Shanghai Co, Beijing Branch, Beijing, China
| | - Zhouhang Zhang
- Department of Clinical Affairs, Fresenius Medical Care Shanghai Co, Beijing Branch, Beijing, China
| | - Yun Zhou
- Department of Clinical Affairs, Fresenius Medical Care Shanghai Co, Shanghai, China
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Uchiyama K, Morimoto K, Washida N, Kusahana E, Nakayama T, Itoh T, Kasai T, Wakino S, Itoh H. Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial. Int Urol Nephrol 2022; 54:2673-2681. [PMID: 35362819 PMCID: PMC8972739 DOI: 10.1007/s11255-022-03178-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
Abstract
Purpose Remote patient monitoring (RPM) has contributed to improved patient-centered outcomes and prognosis in patients with end-stage renal disease on automated peritoneal dialysis (APD). However, evidence from prospective trials is lacking. Methods The participants (n = 15; median age: 65 years; males: 10; peritoneal dialysis vintage: 6.4 ± 3.5 years) randomly received APD therapy using the Kaguya® APD system either with or without the connective use of the cloud-based RPM software Sharesource® for 12 weeks. The primary outcome was patient satisfaction assessed using a modified nine-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) questionnaire. The secondary outcomes were healthcare resource consumption, the health-related quality of life (HRQOL) subscales assessed with the Kidney Disease Quality of Life-Short Form questionnaire, and clinical laboratory parameters. Results Significant improvements were observed in the TSQM-9 subscales of Effectiveness (64.4 ± 18.8 vs. 57.8 ± 18.8; P = 0.006) and Convenience (76.3 ± 15.4 vs. 63.3 ± 17.3; P < 0.001) in patients on Sharesource®. Moreover, Sharesource® reduced the total amount of healthcare resource consumption (0.80 ± 1.32 vs. 1.87 ± 2.39 times/12 weeks; P = 0.02) and consultation time during regular monthly visits (813 ± 269 vs. 1024 ± 292 s; P < 0.001). A significant increase in ultrafiltration volume was found associated with more frequent modification of APD prescription in patients with Sharesource®. Sharesource® also improved the HRQOL subscale of General Health and Vitality. Conclusion Sharesource® can improve patient-centered outcomes in patients on APD while reducing the treatment burden for both patients and medical staff. Trial registration: The study was registered in the Japan Registry of Clinical Trials (jRCT Number: jRCTs032190005). Supplementary Information The online version contains supplementary material available at 10.1007/s11255-022-03178-5.
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Affiliation(s)
- Kiyotaka Uchiyama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kohkichi Morimoto
- Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Naoki Washida
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.,Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Ei Kusahana
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takashin Nakayama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Tomoaki Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takahiro Kasai
- Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Shu Wakino
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
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Yeter HH, Manani SM, Ronco C. The utility of remote patient management in peritoneal dialysis. Clin Kidney J 2021; 14:2483-2489. [PMID: 34938532 PMCID: PMC8344514 DOI: 10.1093/ckj/sfab111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022] Open
Abstract
Remote patient management (RPM) programs are one of the most crucial innovations in the peritoneal dialysis (PD) field that have been developed in the last decade. RPM programs are associated with favourable clinical outcomes by increasing the adherence of the patients to PD prescription. The literature supports that RPM is associated with increased blood pressure control and technique survival, and decreased hospitalization rate, length of hospital stay and health costs. RPM programs also facilitate patient follow-up during the coronavirus disease 2019 pandemic, increase treatment adherence and lead to better clinical outcomes. However, published data remain scarce and mainly consist of observational or retrospective studies with relatively low numbers of patients. Therefore, randomized controlled trial results will be more informative to demonstrate the effect of RPM programs on clinical outcomes.
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Affiliation(s)
- Haci Hasan Yeter
- Department of Nephrology Dialysis and Transplantation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Sabrina Milan Manani
- Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
| | - Claudio Ronco
- Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
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Jung HY, Jeon Y, Kim YS, Kim DK, Lee JP, Yang CW, Ko EJ, Ryu DR, Kang SW, Park JT, Lim JH, Choi JY, Cho JH, Kim CD, Kim YL, Park SH. Outcomes of Remote Patient Monitoring for Automated Peritoneal Dialysis: A Randomized Controlled Trial. Nephron Clin Pract 2021; 145:702-710. [PMID: 34515160 DOI: 10.1159/000518364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/05/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We hypothesize that remote patient monitoring (RPM) for automated peritoneal dialysis (APD) and feedback could enhance patient self-management and improve outcomes. The aim of this study was to evaluate the efficacy of RPM-APD compared to traditional APD (T-APD) without RPM. METHODS In this multicenter, randomized controlled trial, patients on APD were randomized to T-APD (n = 29) or RPM-APD (n = 28) at 12 weeks and followed until 25 weeks. Health-related quality of life (HRQOL), patient and medical staff satisfaction with RPM-APD, and dialysis-related outcomes were compared between the 2 groups. RESULTS We found no significant differences in HRQOL scores at the time of enrollment and randomization between RPM-APD and T-APD. At the end of the study, the RPM-APD group showed better HRQOL for the sleep domain (p = 0.049) than the T-APD group and the T-APD group showed better HRQOL for the sexual function domain (p = 0.030) than the RPM-APD group. However, we found no significant interactions between the time and groups in terms of HRQOL. Different HRQOL domains significantly improved over time in patients undergoing RPM-APD (effects of kidney disease, p = 0.025) and T-APD (burden of kidney disease, p = 0.029; physical component summary, p = 0.048). Though medical staff satisfaction with RPM-APD was neutral, most patients were quite satisfied with RPM-APD (median score 82; possible total score 105 on 21 5-item scales) and the rating scores were maintained during the study period. We found no significant differences in dialysis adherence, accuracy, adequacy, overhydration status, blood pressure, or the number of unplanned visits between the 2 groups. DISCUSSION/CONCLUSION Although HRQOL and dialysis-related outcomes were comparable between RPM-APD and T-APD, RPM-APD was positive in terms of patient satisfaction. Further long-term and large-scale studies will be required to determine the efficacy of RPM-APD. TRIAL REGISTRATION CRIS identifier: KCT0003390, registered on December 14, 2018 - retrospectively registered, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=12348.
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Affiliation(s)
- Hee-Yeon Jung
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea,
| | - Yena Jeon
- Department of Statistics, Kyungpook National University, Daegu, Republic of Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chul Woo Yang
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Eun Jeong Ko
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hoon Lim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ji-Young Choi
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jang-Hee Cho
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Sun-Hee Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
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10
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Kojima S, Okuyama E, Shibagaki Y, Sakurada T. Onset of pleuroperitoneal communication detected by remote patient monitoring. Nephrology (Carlton) 2021; 27:215-216. [PMID: 34288267 DOI: 10.1111/nep.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Shigeki Kojima
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Emiko Okuyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tsutomu Sakurada
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Yeter HH, Gok Oguz E, Akcay OF, Karaer R, Yasar E, Duranay M, Ayli MD, Guz G. The reliability and success of peritoneal dialysis during the COVID-19 pandemic. Semin Dial 2020; 34:147-156. [PMID: 33210375 PMCID: PMC7753638 DOI: 10.1111/sdi.12940] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID-19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross-sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID-19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ferritin levels significantly elevated at the end of 97 ± 31 days. PTH and phosphorus levels remained stable in remote monitoring automated PD (RM-APD) group (p = 0.4 and p = 0.5), they tended to increase in continuous ambulatory PD group and significantly increased in automated PD group (p = 0.09 and p = 0.01 for PTH and p = 0.06 and p = 0.001 for phosphorus, respectively). Moderate to severe depression was associated with dyspnoea, weight gain more than 5 kg, fatigue, palpitation and increased anxiety. PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. Also, RM-APD may be a better choice because of providing more stable bone-mineral metabolism. Moreover, evaluating depression and anxiety is essential for the accurate clinical assessment.
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Affiliation(s)
- Hasan H Yeter
- Department of Nephrology Dialysis and Transplantation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ebru Gok Oguz
- Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Omer F Akcay
- Department of Nephrology Dialysis and Transplantation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Refika Karaer
- Department of Nephrology, University of Health Sciences, Ankara Education and Research Hospital, Ankara, Turkey
| | - Emre Yasar
- Department of Nephrology Dialysis and Transplantation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Murat Duranay
- Department of Nephrology, University of Health Sciences, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mehmet D Ayli
- Department of Nephrology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Galip Guz
- Department of Nephrology Dialysis and Transplantation, Faculty of Medicine, Gazi University, Ankara, Turkey
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Yeter HH, Karacalik C, Eraslan E, Akcay OF, Derici U, Ronco C. Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control. Nephrology (Carlton) 2020; 25:856-864. [PMID: 32621370 DOI: 10.1111/nep.13751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 11/28/2022]
Abstract
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 anti-hypertensive 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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Affiliation(s)
- Hasan H Yeter
- Department of Nephrology Dialysis and Transplantation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ceren Karacalik
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Esra Eraslan
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Omer F Akcay
- Department of Nephrology Dialysis and Transplantation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ulver Derici
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Claudio Ronco
- Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
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