Abstract: FR-PO0543
Managing Refractory Heart Failure in Stage 4 CKD with Telemedicine-Assisted Peritoneal Dialysis: A Real-World Experience
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Lentini, Paolo, Nephrology Department "St Bassiano Hospital", Bassano del Grappa-Vi-Italy, Italy
- Laudadio, Giorgio, Nephrology Department "St Bassiano Hospital", Bassano del Grappa-Vi-Italy, Italy
- Benedetti, Claudia, Nephrology Department "St Bassiano Hospital", Bassano del Grappa-Vi-Italy, Italy
- Previti, Antonino, Nephrology Department "St Bassiano Hospital", Bassano del Grappa-Vi-Italy, Italy
- Ronco, Claudio, IRRIV International research institute of Vicenza, Vicenza, Italy
Background
Heart failure(HF)unresponsive to diuretics presents a challenge.These pts are at high risk of recurrent hospitalizations,poor clinical outcomes and healthcare resource utilization.In this context,the 1st goal of peritoneal dialysis (PD) is fluid volume management.This study investigates the impact of teledialysis(TD)on clinical outcomes,hospitalization rates and care optimization.
Methods
10 pts with stage IV CKD diuretic-resistant fluid overload(FO)were enrolled.Inclusion criteria were preserved renal function(eGFR >15 mL/min),NYHA class III–IV symptoms and frequent admissions for FO.TD was perfomed by integration of two systems:
Sharesource®Platform(Vantive):Cloud-based interface connected to the APD device,enabling secure remote access to treatment data and adjustment of cycler settings tailored to patient needs.Totem eVISUS® System(TesiSquare/T4Med,Italy):a plug-and-play solution composed of:
a) Patient-side remote station equipped with a high-definition camera,touchscreen monitor,speaker-microphone and wireless router.
b) Hospital-based control station to perform real-time visual assessments,inspect the catheter exit site,evaluate PDeffluent and deliver clinical guidance.
Results
Pts were followed for 12 months with the following outcomes:
Hospitalizations:Average of 1.8/ pt-reduced healthcare burden.
NYHA Class:Improved-better functional capacity.
NTproBNP Levels:Decreased slightly(-536.2pg/mL)-reduction in cardiac stress.
Ejection Fraction (EF):Improved (avg 7.6%)-better cardiac function[fig1]
Conclusion
TD offers a valuable strategy for fluid management in HF pts with stageIV CKD,where volume control is the primary objective.This approach reduced hospitalization rates and enhanced care coordination and delivery.These findings support the broader applicability of TD as an innovative solution for managing clinically complex and resource-intensive patient populations.