Impact of Remote Monitoring on Standardized Outcomes in Nephrology-Peritoneal Dialysis

Abstract

ObjectiveTo evaluate the association between the use of remote patient monitoring RPM in patients on automated peritoneal dialysis (APD) and the Standardized Outcomes in Nephrology in peritoneal dialysis (SONG-PD) clinical outcomes. MethodsProspective and multicenter cohort study conducted on patients with advanced chronic kidney disease on APD, recruited among 16 Spanish Hospitals, between June 1 and December 31, 2021. Patients were divided into two cohorts, namely patients on APD with RPM (APD-RPM) and patients on APD without RPM. The primary end-points were the standardized outcomes of the SONG-PD clinical outcomes: PD associated infection; CVD; mortality rate; technique survival; and life participation (assessed as health-related quality of life). Propensity score matching (PSM) was used to evaluate the association of RPM exposure with the clinical outcomes. ResultsA total of 232 patients were included, 176 (75.9%) in the APD-RPM group and 56 (24.1%) in the APD-without-RPM group. The mean patient follow-up was significantly longer in the APD-RPM group than in the APD-without-RPM one (10.4±2.8 versus 9.4±3.1 months, respectively, p=0.02). In the overall study sample, the APD-RPM group was associated with lower mortality rate (HR: 0.08; 95%CI: 0.01 to 0.69; p=0.020) and greater technique survival rate (HR: 0.25; 95%CI: 0.11 to 0.59; p=0.001). After PSM, APD-RPM continued to be associated with better technique survival (HR: 0.23; 95% CI: 0.06 to 0.83; p=0.024). ConclusionsThe use of RPM programs in patients on APD was associated with better survival of the technique and lower mortality rates. However, after PSM, only technique survival was significant.