Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control

Aim Reduced treatment compliance in patients with peritoneal dialysis facilitates the development of fluid overload and as a result increased blood pressure and vascular stiffness in the long term. We aimed to evaluate blood pressure change and anti‐hypertensive needs of patients within 1 year after...

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Published in:Nephrology (Carlton, Vic.) Vic.), 2020-11, Vol.25 (11), p.856-864
Main Authors: Yeter, Hasan H., Karacalik, Ceren, Eraslan, Esra, Akcay, Omer F., Derici, Ulver, Ronco, Claudio
Format: Article
Language:English
Subjects:
Antihypertensives
bioimpedance spectroscopy
Blood pressure
Body water
Heart rate
Hypertension
Peripheral blood
Peritoneal dialysis
Peritoneum
pulse wave velocity
remote access technology
Spectroscopy
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Summary:Aim Reduced treatment compliance in patients with peritoneal dialysis facilitates the development of fluid overload and as a result increased blood pressure and vascular stiffness in the long term. We aimed to evaluate blood pressure change and anti‐hypertensive needs of patients within 1 year after the changeover to remote monitoring automated peritoneal dialysis (RM‐APD) and compare the effect of RM‐APD and continuous ambulatory peritoneal dialysis (CAPD) on peripheral and central haemodynamic parameters, volume status of patients and anti‐hypertensive drug needs. Methods This was an observational and cross‐sectional study. We enrolled 15 patients performing CAPD, 20 patients performing RM‐APD, and 38 age, and gender‐matched healthy control. We measured pulse wave velocity to assess arterial stiffness, peripheral and central haemodynamic parameters. We measured the volume status of participants via bioimpedance spectroscopy. Results The mean excess hydration of patients who underwent CAPD were higher than those who performed RM‐APD and healthy control (P = .02). We found that mean diastolic blood pressure, heart rate, central systolic and diastolic blood pressure, and central pulse pressure were significantly different between the RM‐APD, CAPD and healthy control (P = .02, P = .05, P = .007, P = .05 and P = .005, respectively). Post hoc analysis of these results showed that the differences between the groups were caused by the healthy control group and the patients with underwent CAPD. Daily anti‐hypertensive drug count in patients with performing RM‐APD was reduced over time (P 
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.13751