Corzo Leyder, Wilkie Martin, Vesga Jasmin I, Lindholm Bengt, Buitrago Giancarlo, Rivera Angela S, Sanabria Rafael M
Renal Therapy Services, Instituto Nacional del Riñón, Bogotá, Colombia.
Sheffield Teaching Hospital, NHS Foundation Trust, Sheffield, UK.
Perit Dial Int. 2022 May;42(3):288-296. doi: 10.1177/0896860820982223. Epub 2020 Dec 31.
Remote patient monitoring (RPM) programs in automated peritoneal dialysis (APD) allow clinical teams to be aware of many aspects and events of the therapy that occur in the home. The present study evaluated the association between RPM use and APD technique failure.
A retrospective, multicentre, observational cohort study of 558 prevalent adult APD patients included between 1 October 2016 and 30 June 2017 with follow-up until 30 June 2018 at Renal Therapy Services network in Colombia. Patients were divided into two cohorts based on the RPM use: APD-RPM ( = 148) and APD-without RPM ( = 410). Sociodemographic and clinical characteristics of all patients were summarized descriptively. A propensity score was used to create a pseudo-population in which the baseline covariates were well balanced. The association of RPM with technique failure was estimated adjusting for the competing events death and kidney transplant.
Five hundred fifty-eight patients were analyzed. 26.5% had APD-RPM. In the matched sample comprising 148 APD-RPM and 148 APD-without RPM patients, we observed a lower technique failure rate of 0.08 [0.05-0.15] episodes per patient-year in APD-RPM versus 0.18 [0.12-0.26] in APD-without RPM cohort; incidence rate ratio = 0.45 95% confidence interval: [0.22-0.91], -value = 0.03.
The use of an RPM program in APD patients may be associated with a lower technique failure rate. More extensive and interventional studies are needed to confirm its potential benefits and to measure other patient-centered outcomes.
自动化腹膜透析（APD）中的远程患者监测（RPM）程序使临床团队能够了解在家中进行的治疗的许多方面和事件。本研究评估了RPM的使用与APD技术失败之间的关联。
对2016年10月1日至2017年6月30日期间纳入的558例成年APD患者进行回顾性、多中心、观察性队列研究，在哥伦比亚的肾脏治疗服务网络进行随访直至2018年6月30日。根据RPM的使用情况将患者分为两个队列：APD-RPM（n = 148）和无RPM的APD（n = 410）。对所有患者的社会人口统计学和临床特征进行描述性总结。使用倾向评分创建一个伪总体，其中基线协变量得到良好平衡。在对竞争事件死亡和肾移植进行调整的情况下，估计RPM与技术失败之间的关联。
分析了558例患者。26.5%的患者使用APD-RPM。在由148例APD-RPM患者和148例无RPM的APD患者组成的匹配样本中，我们观察到APD-RPM患者的技术失败率较低，为每患者年0.08[0.05-0.15]次事件，而无RPM的APD队列中为0.18[0.12-0.26]；发病率比 = 0.45，95%置信区间：[0.22-0.91]，P值 = 0.03。
在APD患者中使用RPM程序可能与较低的技术失败率相关。需要更广泛的干预性研究来证实其潜在益处并衡量其他以患者为中心的结局。
