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Observational Study
. 2023 Jul;38(7):2171-2178.
doi: 10.1007/s00467-022-05828-3. Epub 2022 Nov 30.

Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Eugene Yu-Hin Chan  1 , Mei-Shan Liu  2 , Po-Chu Or  2 , Alison Lap-Tak Ma  2
Affiliations
Observational Study

Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Eugene Yu-Hin Chan et al. Pediatr Nephrol. 2023 Jul.

Abstract

Background: Remote patient monitoring (RPM) for automated peritoneal dialysis (APD) may improve clinical outcomes. Paediatric data, however, remain extremely scarce.

Methods: We conducted a prospective observational study of children (0-18 years) receiving APD with cloud-based RPM over two 24-week periods (pre- and post-RPM). Primary outcomes were unplanned hospitalizations and fluid management. Children receiving APD without RPM (non-RPM) were included as control.

Results: Seven patients (6 females) receiving APD were enrolled in the RPM programme at 11.3 years (IQR 2.6-17.1). Main indications for RPM included history of fluid overload (n = 3) and non-adherence (n = 2). Ten children were included in the non-RPM group (6 females; 16.9 years, IQR 12.8-17.6). Four patients (57.1%, 95% CI 22.5-100%) experienced fewer unplanned hospitalizations and 5 patients (71.4%, 95% CI 34.1-100%) had shorter hospital stays during the post-RPM period. The hospitalization rates and length of stay were reduced by 45% and 42%, respectively. The higher hospitalization rates among the RPM group, compared to the non-RPM group, were no longer observed following implementation of RPM. There was a significant increase in ultrafiltration (565.6 ± 248.7 vs. 501.7 ± 286.6 ml/day, p = 0.03) and reduction in systolic blood pressure (114.1 ± 12.6 vs. 119.9 ± 11.19 mmHg, p = 0.02) during the post-RPM period. All patients demonstrated satisfactory adherence. Although quality of life (PedsQL 3.0 ESRD module) was not different pre- and post-RPM, all patients agreed in the questionnaires that the use of RPM improved their quality of life and sense of security.

Conclusions: In conclusion, RPM in children receiving APD is associated with fewer and shorter unplanned hospitalizations, improved fluid management and favourable adherence to PD. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: Children; Claria; Peritoneal dialysis; Remote patient monitoring.

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Conflict of interest statement

The authors declare no competing interests.

Figures

None
A higher resolution version of the Graphical abstract is available as Supplementary information
Fig. 1
Fig. 1
A Reasons for red flag alarms during remote patient monitoring. B Interventions performed through remote patient monitoring programme
See this image and copyright information in PMC

References

    1. Chan Y, Ma AL, Tong P, Lai W, Tse NK. Chronic peritoneal dialysis in Chinese infants and children younger than two years. Hong Kong Med J. 2016;22:365–371. - PubMed
    1. Chan EYH, Yap DYH, Wong WHS, Ho TW, Tong PC, Lai WM, Chan TM, Ma ALT. Demographics and long-term outcomes of children with end-stage kidney disease: a 20-year territory-wide study. Nephrology (Carlton) 2022;27:171–180. doi: 10.1111/nep.14007. - DOI - PubMed
    1. Chan EY, Borzych-Duzalka D, Alparslan C, Harvey E, Munarriz RL, Runowski D, Vidal E, Coccia PA, Jankauskiene A, Principi I. Colostomy in children on chronic peritoneal dialysis. Pediatr Nephrol. 2020;35:119–126. doi: 10.1007/s00467-019-04372-x. - DOI - PubMed
    1. Neu AM, Sander A, Borzych-Dużałka D, Watson AR, Vallés PG, Ha IS, Patel H, Askenazi D, Bałasz-Chmielewska I, Lauronen J. Comorbidities in chronic pediatric peritoneal dialysis patients: a report of the International Pediatric Peritoneal Dialysis Network. Perit Dial Int. 2012;32:410–418. doi: 10.3747/pdi.2012.00124. - DOI - PMC - PubMed
    1. Chua AN, Warady BA. Adherence of pediatric patients to automated peritoneal dialysis. Pediatr Nephrol. 2011;26:789–793. doi: 10.1007/s00467-011-1792-2. - DOI - PubMed

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