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Kidney Week

Abstract: TH-PO322

Experience with Remote Monitoring of Automated Peritoneal Dialysis: The First 50 Patients in a Private Peritoneal Dialysis Program in Mexico

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Author

  • Gómez Ruiz, Ismael Antonio, Médica Santa Carmen, Mexico City, Mexico
Background


The benefits of remote monitoring (RM) of automated peritoneal dialysis (APD) have been established, the aim of this study is to describe the characteristics and outcome of the first 50 patients who were mantained in APD with RM, from November 2019 to February 2022 in a private peritoneal dialysis program in Mexico City. Also, we analyzed time and distance traveled savings for patients.

Methods


Retrospective cohort study. This was an observational study, describing the main clinical outcomes in our patients maintained in APD with RM.

Results


A total of 50 patients were admitted to the study. Their mean age was 62.5 years. Most patients lived in an urban setting. 2 patients were lost to follow-up. The main causes of end stage renal disease were diabetes mellitus (60%) and hypertension (20%). The basal frequency of clinic visits was 1 per month; During the study, 92% of the prescribed PD sessions were completed. Just 2% of prescribed sessions were interrupted, and 6% were missed treatments. The median lost dwelling time was 78 minutes per patient-month (range 0-366), the mean number of prescription changes was 3 (range 0-8). Among patients who had a change in prescription during the study, the main adjustment was an increase in infusion volume and time spent on treatment (57%). Icodextrin 7.5% was prescribed, 16% of the prescribed PD sessions. The leak rate was only 5%. Peritonitis rate was 0.36 episodes/patient-year, both episodes were caused by gram positive microorganisms. 1-year PD catheter migration rate was 30%, most catheters were placed by a variety of surgical techniques (65%). 1-year PD catheter patency rate was 75%. Weekly Kt/V mean was 1.60 (± 0.28). 1-year PD technique survival was 60 %, the main causes of PD technique failure were mechanical failure (35%) and infections (35%). Twelve patients died during the study, the main cause was infections 50% (COVID-19 25%).The distance traveled by patients was reduced by 534 km with a time saving of 804 min for patients.

Conclusion


APD with RM allows a better use of healthcare resources, helping to improve patients follow up and remote early prescription modification. The main outcomes rates were similar than previously reported in similars countries. It is important to consider the COVID-19 pandemic impact on these results.