Telemedicine and Remote Monitoring in peritoneal dialysis improve clinical outcomes, quality of life and cost efficiency.

Abstract

Introduction: peritoneal dialysis (PD) is a widely used renal replacement therapy allowing end-stage renal disease patients to undergo a home-based treatment. The remote monitoring (RM) and the telemedicine in patients undergoing automated peritoneal dialysis (APD) improve the technique and the patient survival. This study evaluated their impact on PD patients, evaluating the safety of the technique, infectious complications and hospitalizations, and the effects on the quality of life. Patients and methods: 73 patients undergoing PD at the Nephrology and Dialysis Unit of the Papardo Hospital in Messina were enrolled. 39 patients (APD group) were followed with scheduled visits at the hospital centre, whereas the remaining 34 patients (RM-APD group) received complete assistance at home. Results: the hospitalizations were statistically lower in the RM-APD group than APD patients (7 vs 17; p: 0.03). During the follow-up period, 13 patients were switched from the PD technique to HD. In particular, 10 patients belonged to the ADP group, whereas the remaining 3 patients were followed through the remote control. PD patients had a better psycho-physical state, with better scores in physical performance (p = 0.02) and psycho-emotional well-being (p = 0.001), performing social functions more adequately than HD patients (p = 0.01). The final result is a better perception of health in general in PD patients. Conclusion: the telemedicine and the remote control have opened new ways to increase the number of patients who can perform PD treatment at home safely, reducing the infective risk and the rate of hospitalization.