Role of Remote Monitoring in Automated Peritoneal Dialysis: Impact in SONG-PD (Standardized Outcomes in Nephrology-Peritoneal Dialysis) and Results from RPM-APD Multicenter Study
Francisco Javier Centellas Pérez, Juan Pérez Martínez, Alonso R. Valente, María Peña Ortega, Paula Jara Caro Espada, Ramon Devesa Such, Agustín Ortega Cerrto, Manel Vera Rivera, Francisco Barbosa, Laura Espinel, Mercedes Prats, José Pedro Morais Macedo, E. Muñoz de Bustillo, Marco Montomoli · Journal of the American Society of Nephrology · 2023
Background: The use of remote monitoring (RPM) in automated peritoneal dialysis (APD) has shown lower hospitalization rates in those patients who used this technique in addition to another series of clinical advantages such as greater technique survival. The present study evaluated the association between RPM use and SONG-PD outcomes. Methods: A prospective observational multicenter cohort study included 232 patients in 16 Hospitals. A RPM program was used in 176 of the patients and 56 were treated with APD without RPM. The primary outcomes were standardized outcomes in Nephrology (SONG)-PD clinical outcomes and quality of life (EQ-5D-L). Data was recorded al least during 6 months. Propensity score matching (PSM) 1:1 was used to evaluate the association of RPM exposure with outcomes. Results: There were no differences between baseline and demographic characteristics. Before PSM, APD with RPM (n=176) vs without RPM (n=56) was associated with less mortality (n=1 vs n=4)(HR (95%CI): (0.08 (0.01-0.69) (p=0.020) and with better technique survival (n=10 vs n=11) (HR (95%CI): (0.25 (0.11-0.59) p=0.001). After PSM, APD with RPM continued to associate con with better technique survival (figures 1 and 2) Conclusions: The use of an RPM program in APD patients may be associated with better technique survival. RPM could be a tool for improvement of APD therapy. Funding: Commercial Support - Baxter Health Company Table 1. - Clinical Outcomes Associated with RPM in Matched Sample Outcomes APD- RPM N=56 APD-without RPM N=56 OR (95%CI)* HR (95%CI) IRR (95%CI) P value Primary outcomes PD associated infection1 12 (21.4) 13 (23.2) 0.90 (0.37-2.21) 0.821 Infections per patient-year 0.34 (0.79) 0.30 (0.63) 1.11 (0.49-2.56) 0.792 Cardiovascular disease2 9 (16.1) 2 (3.6) 3.92 (0.84-18.2) 0.081 Mortality 1 (1.8) 4 (7.1) 0.24 (0.03-2.16) 0.204 Technique survival1 3 (5.6) 11 (21.6) 0.23 (0.06-0.83) 0.024