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

Yeter, Hasan; Akcay, Omer Faruk; Ronco, Claudio; Derici, Ülver

doi:10.1159/000506699

Cited by 20 publications

(43 citation statements)

References 28 publications

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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%

“…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 . It has provided many opportunities, such as instant monitoring of treatment adherence, early detection of problems, and resolving most of the problems remotely without admitting to the hospital 9,26 .…”

Section: Discussionmentioning

confidence: 99%

“…The International Society of Peritoneal Dialysis (ISPD) provided practical guidelines that encourage clinicians to choose PD as a maintenance dialysis modality during this pandemic 6 . Technological advances, such as remote access modules in the PD eld, made it easier to manage patients' dialysis prescriptions for physicians and provided increased patient treatment compliance [7][8][9] . However, it is known that there is a strong relationship between depression and noncompliance 10 .…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yeter

Oğuz

Akcay

et al. 2020

Preprint

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“…11,12 We previously demonstrated that RM-APD provided improvement of dialysis adherence, increased ultrafiltration and better blood pressure control. 13 Poor compliance to dialysis prescription is a common problem in patients with PD, and it is associated with decreased long-term technical survival and increased morbidity and mortality. 14 RPM-APD allows to maintain a better compliance to treatment prescription and increase patient's responsibility and participation in the maintenance of dry weight and as a consequence, blood pressure control.…”

mentioning

confidence: 99%

“…Information such as fill volumes, alerts during treatment, drainage problems, interruption of therapy and blood pressure not within range together with prescription adjustments are continuously exchanged without the need of in person visits to the hospital 11,12 . We previously demonstrated that RM‐APD provided improvement of dialysis adherence, increased ultrafiltration and better blood pressure control 13 …”

mentioning

confidence: 99%

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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