Finger on the Pulse of the Times with Automated Peritoneal Dialysis and Remote Patient Monitoring

Benefits of Peritoneal Dialysis

Peritoneal dialysis (PD) as a treatment method for kidney function replacement is significantly gentler on the vascular system and can also preserve residual kidney function longer compared to classical hemodialysis. It is suitable for patients who are able to follow precisely defined procedures, thus involving them in their own treatment without the need for constant medical supervision. The advantage of home dialysis lies mainly in saving time, more convenient organization of activities, or the possibility of performing dialysis in various environments. On the other hand, a potential barrier may stem from the patient's fear regarding the safety of the method and the ability to manage therapy without direct medical supervision.

Automated PD

A newer type is the so-called automated peritoneal dialysis, in which a portable device known as a cycler is used. The patient connects to it in the evening before going to bed and wakes up in the morning already dialyzed.

Telemedicine in the Service of Nephrology

Newly, patients on automated peritoneal dialysis can use the telemedicine platform Sharesource. After each dialysis session, it automatically transmits data about the treatment process to the treating doctor's computer, who can assess it and possibly immediately adjust the treatment. Ultimately, therapy is more effective also thanks to the higher time savings. Very important is also the easy and intuitive operation of the device in the native language, which can be handled even by those who otherwise do not get along well with technology.

Findings from a Recent Italian Study

The benefit of remote technology for the management and treatment of patients on automated peritoneal dialysis is also confirmed by the latest Italian observational study published in 2019. It monitored 43 patients using the cycler Homechoice Claria with the platform Sharesource for 1 year. The data were compared with historical data from 42 patients with automated peritoneal dialysis without the use of the remote platform.

The results were quite surprising. In patients whose treatment was managed using Sharesource, there was almost a doubling of treatment prescription changes, while the number of nightly alarms and personal visits to the doctor significantly decreased. The total time savings for doctors amounted to 3673 minutes, and for nurses 2647 minutes.

Satisfaction with remote monitoring was also evaluated. All patients confirmed that the new system is easy to use, were pleased with the high level of interaction from the care team, and the ability to quickly resolve some technical issues.

Conclusion

The innovative concept in peritoneal dialysis treatment functioning on telemedicine moves patient care one level further towards better control of treatment processes. However, despite all the advantages that peritoneal dialysis offers, according to official statistics from 2018, it was used in only about 5% of patients in the Czech Republic. Greater expansion is often hindered by a lack of information among healthcare personnel, and thus even patients who could benefit from home treatment are automatically sent for classical hemodialysis.

(mraf)

Sources:
1. Wood E., McCarthy K., Roper M. Remote monitoring of peritoneal dialysis: evaluating the impact of the Claria Sharesource system. J Kidney Care 2019; 4 (1): 16–24, doi: 10.12968/jokc.2019.4.1.16.
2. Milan Manani S., Rosner M., H. Virzì G. M. et al. Longitudinal experience with remote monitoring for automated peritoneal dialysis patients. Nephron 2019; 142 (1): 1–9, doi: 10.1159/000496182.
3. Rychlík I., Lopot F. Statistical Yearbook of Dialysis Treatment in the Czech Republic in 2018. Czech Nephrology Society, 2018.
4. Homechoice Claria. Detail of the medical device. Available at: https://eregpublicsecure.ksrzis.cz/Registr/RZPRO/ZdravotnickyProstredek/Detail/112076 (information on safe and correct use).