#2530 “HOME-MADE” REMOTE MANAGEMENT IN CAPD

Abstract

Abstract Background and Aims Remote control of dialysis parameters has become an essential routine in the Centers that perform Peritoneal Dialysis. For patients in APD there are Cloud-based platforms or with VPN connection that allow daily monitoring and which have proved to be very useful for reducing hospital visits and treatment complications, especially during the recent pandemic. The same cannot be said of CAPD patients for whom the procedures are carried out manually, without electromedical devices, with a paper report of the parameters. Furthermore, to date, there are no dedicated applications able to communicate these important measurements to the Centres. Method In March 2021 we created a calculation table file, with limited data entry, divided by days, daily exchanges and monthly sheets. Patients and/or caregivers can insert loading and drainage volumes, type of bags used, blood pressure values, weight and diuresis at an agreed time. The system automatically calculates and graphically displays the total daily and monthly average ultrafiltration for each exchange, the daily balance as well as the average of all the aforementioned parameters for the entered period (Figure 1). There is also a graphic sheet with an annual summary of the average values (Figure 2). The file is uploaded online, subject to the patient's consent, via a free file hosting service that allows modification and reading shared and protected by password between patients and Center operators. Results To date, 9 CAPD patients in our Center have been included in the program with good acceptance by patients and caregivers, who enter data based on their availability of time and regularly in anticipation of the monthly outpatient visit. The staff of the Centre, both Doctors and Nursing, access the file periodically, in case of need and in preparation for the visit. In this way, regular checks and evaluations of prescription compliance, ultrafiltration efficacy, maintenance within the expected ranges of weight, blood pressure and fluid balance of patients in CAPD are obtained, as is the case for patients in APD. Conclusion The creation of a shared file for monitoring the dialysis parameters of CAPD patients could be able to reduce the existing gap with those in APD, at least as regards the vital and dialysis parameters, since the functioning of the catheter in individual exchanges cannot be evaluated. A more extensive experience is needed, and is being studied, to confirm the usefulness of this approach which currently already guarantees a reduction in hospital admissions and integrates and structures the clinical information that can be obtained in the traditional way.