Peritoneal Dialysis International最新文献

{"title":"Successful localization and repair of pleuroperitoneal communication using indocyanine green fluorescence in peritoneal dialysis: A case series.","authors":"Hyeran Park, Kwan Yong Hyun, Hanbi Lee, Cheol Whee Park, Yaeni Kim","doi":"10.1177/08968608251351132","DOIUrl":"https://doi.org/10.1177/08968608251351132","url":null,"abstract":"<p><p>Pleuroperitoneal communication affects 1.6%-10% of continuous ambulatory peritoneal dialysis (PD) patients and often leads to discontinuation of peritoneal dialysis. In pleuroperitoneal communication, an important aspect is not only the diagnosis but also the detection of the diaphragmatic defect. Traditional methods have often failed to detect small defects, which contributes to the recurrence of pleuroperitoneal communication. We present three cases of intractable diaphragmatic defects in pleuroperitoneal communication, successfully localized and treated using indocyanine green (ICG) fluorescence staining of peritoneal dialysate, visualized with an infrared camera. After detecting the defect, surgical repair involved defect plication and the application of talc for pleural adhesion. This approach enabled immediate and successful on-site repair, allowing all patients to resume peritoneal dialysis post-surgery. Even the smallest diaphragmatic defects were accurately identified using ICG fluorescence dye dissolved in peritoneal dialysate. This case series demonstrates that ICG fluorescence staining enhances the diagnosis and treatment of pleuroperitoneal communication by improving defect localization. Our protocol shows promise in increasing diagnostic accuracy, reducing recurrence rates, and helping patients maintain their preferred dialysis modality.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251351132"},"PeriodicalIF":2.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of air pollutants exposure and increased risk of peritoneal dialysis-related peritonitis: An observational study from PDTAP cohort.","authors":"Shuang Gao, Chao Yang, Shaomei Li, Huaying Pei, Jinghong Zhao, Ying Zhang, Zibo Xiong, Yumei Liao, Ying Li, Qiongzhen Lin, Wenbo Hu, Yulin Li, Zhaoxia Zheng, Gang Fu, Shanshan Guo, Beiru Zhang, Rui Yu, Fuyun Sun, Xiaoying Ma, Li Hao, Guiling Liu, Zhanzheng Zhao, Jing Xiao, Yulan Shen, Yong Zhang, Xuanyi Du, Tianrong Ji, Caili Wang, Lirong Deng, Yingli Yue, Shanshan Chen, Zhigang Ma, Yingping Li, Li Zuo, Huiping Zhao, Xianchao Zhang, Xuejian Wang, Yirong Liu, Xinying Gao, Xiaoli Chen, Hongyi Li, Shutong Du, Cui Zhao, Zhonggao Xu, Li Zhang, Hongyu Chen, Li Li, Lihua Wang, Yan Yan, Yingchun Ma, Yuanyuan Wei, Jingwei Zhou, Yan Li, Liping Duan, Jie Dong","doi":"10.1177/08968608251348814","DOIUrl":"https://doi.org/10.1177/08968608251348814","url":null,"abstract":"<p><p>IntroductionAlthough the impact of air pollutants on infectious diseases is well-known, there is limited evidence regarding its effects on peritoneal dialysis (PD) patients. This study aimed to investigate the association between air pollutants and PD-related peritonitis.MethodsThis is an observational study affiliated to the PD Telemedicine-assisted Platform Cohort Study (PDTAP study), which is a national-level cohort study in China. The primary outcome was PD-related peritonitis, and the secondary outcomes were peritonitis-related death and transfer to hemodialysis. The pollution data were obtained from China High Air Pollutants according to the patients' place of residence. The association between pollutants and outcomes was evaluated by cause-specific Cox proportional hazard regression model. The patients were divided into the high-pollution group and low-pollution group according to the median value of PM_2.5 (53.90 μg/m³) and the WHO standard of PM_2.5 (35.00 μg/m³).ResultsA total of 7439 PD patients from all 7 geographical regions across China were enrolled between June 2016 and April 2019. There were 1585 patients who developed peritonitis during follow-up. The pollution was most severe in the north and central regions of China. Patients in the high-pollution group were characterized by older age, higher BMI, lower income, from rural and non-university affiliated hospitals, and had more comorbidities and better residual renal function. In multivariate analysis, PM_2.5 and its components (SO₄, NO₃, NH₄, OM, and BC), PM₁₀, NO₂, and CO were associated with increased peritonitis risk (<i>P</i> < 0.001-0.027). Additionally, following the propensity score matching to control for key individual-level covariates, the association between PM_2.5 and its components, NO₂, and CO with elevated peritonitis risk remained significant (<i>P</i> < 0.001).ConclusionIn this national large-scale Chinese PD cohort study, air pollutants were found to be associated with increased risk for peritonitis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251348814"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences on dialysis modality choice among African American and Mexican American individuals with kidney failure and their care partners: A qualitative study.","authors":"Karen-Marie Eaton, Danelle Radney, Steven M Brunelli, Eric Weinhandl, Unini Odama, Francesca Tentori","doi":"10.1177/08968608251345680","DOIUrl":"https://doi.org/10.1177/08968608251345680","url":null,"abstract":"<p><p>Rationale and ObjectiveCompared to in-center hemodialysis, home dialysis may better address the needs of some individuals with end-stage kidney disease (ESKD). However, home dialysis utilization is lower in African American and Hispanic individuals with ESKD. We sought to identify the factors that most influence dialysis modality choice, specifically home dialysis, in these individuals and their care partners.Study DesignQualitative research study using focus groups.Setting and ParticipantsFifty-seven participants, including African American and Spanish-speaking Mexican American individuals on dialysis (both in-center and home) and care partners, were recruited to in-person focus groups in five US metropolitan areas. Mexican American focus groups were held in Spanish language and translated in real time by a certified interpreter; recordings for all focus groups were transcribed verbatim for analyses.Analytical ApproachParticipant responses were analyzed using inductive thematic analysis techniques.ResultsPhysician guidance was cited as the most important factor in making the initial modality decision for all groups. African American respondents primarily relied on healthcare professionals for information, but also seek independent validation (e.g., \"trust but verify\"). Mexican American respondents stated that trust in physician recommendation is largely unquestioned, influenced by factors such as cultural respect for physician authority, limited literacy, and language barriers. African American respondents desire additional education about modalities, particularly when they feel ready to comprehend content (sequenced to recognize how overwhelming it can be at the initial diagnosis of kidney failure). Although most individuals on dialysis and their care partners acknowledged the clinical benefits of home dialysis, significant barriers to choosing a home modality included the fear of being solely responsible for a complex procedure and loss of social interaction and/or support from other individuals on dialysis and center staff.LimitationsAs the focus groups were all conducted in metropolitan areas, the transferability of the findings to other settings is uncertain.ConclusionsImproved educational programs on dialysis modality choice should build on the strong preference for physician-led health information to better address educational needs of African American and Mexican American individuals facing the choice of a dialysis modality. Tackling issues pertaining to understanding kidney disease pathogenesis and addressing trust in healthcare professionals is necessary in African American individuals. In Mexican American communities, specific emphasis should be placed on addressing literacy and language barriers. Home dialysis educational material for both groups should also incorporate content regarding concerns about safety and social isolation.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251345680"},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitions to and from peritoneal dialysis: Your questions answered.","authors":"Louis-Charles Desbiens, Annie-Claire Nadeau-Fredette","doi":"10.1177/08968608251343768","DOIUrl":"https://doi.org/10.1177/08968608251343768","url":null,"abstract":"<p><p>Modality transitions are very common in patients undergoing peritoneal dialysis (PD); they can either occur before the initiation of PD, following its termination, or as a temporary interruption during PD treatment. Transfers to and from facility hemodialysis represent the majority of these transitions. In addition to their impact on the quality of life of patients and their caregivers, modality transitions are often linked with hospitalizations, mortality, and increased health expenditures. Yet, some of these transfers are unavoidable and should be considered as part of the \"dialysis life plan\" for patients receiving PD. In this review, we will present the epidemiology, risk factors, and clinical impacts of the most frequent transitions that PD patients experience. We will also discuss strategies to optimize the outcomes of patients undergoing modality transfers. Finally, we will review the evidence underlying the integrated home dialysis paradigm, in which patients transition from PD to home hemodialysis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251343768"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the costs and amount of recyclable polyvinyl chloride plastic waste associated with discarded Icodextrin.","authors":"Anukul Ghimire, Meera Shah, Elena Qirjazi, David Ward, Bhavneet Kahlon, Nikhil Shah, Karthik K Tennankore, Robert R Quinn, George Vitale","doi":"10.1177/08968608251344074","DOIUrl":"https://doi.org/10.1177/08968608251344074","url":null,"abstract":"<p><p>There is limited data characterizing healthcare waste associated with peritoneal dialysis (PD). In Canada, Icodextrin for continuous cycling PD (CCPD) is only available as 2.5L bags for one-time use, and any remaining volume that is not used for a dwell is discarded. The environmental impact of this practice has not been well characterized. As such, we sought to estimate the costs associated with discarded Icodextrin and associated polyvinyl chloride (PVC) plastic waste production within our renal program. We conducted a cross-sectional audit of all patients utilizing CCPD in the Alberta Kidney Care South program in Canada in 2022. Icodextrin fill volume data were captured and the costs associated with Icodextrin use were calculated. Among patients on CCPD, the average fill volume for Icodextrin was 1273 mL, suggesting that an average of 1227 mL was discarded. In fact, 88% of patients used dwell volumes ≤1.5L. In 2021, our program spent $1.27 million CAD on Icodextrin for CCPD. Given that an average of 49% of each 2.5L bag was discarded, we estimate that the annual value of wasted Icodextrin among patients being treated with CCPD in our program was $622,300 CAD, or $3036 CAD per patient. Annual PVC waste was calculated to be 25.9 kg per patient, and we estimate that PVC waste could be reduced by 35% if there was access to 1.5L Icodextrin solutions. Our work suggests that the availability of Icodextrin bags that are better aligned with volumes used by patients could reduce healthcare costs and PVC waste.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251344074"},"PeriodicalIF":2.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of acute peritoneal dialysis using rigid catheters in the critically ill pediatric population.","authors":"Raajashri Rajasegar, Madhileti Sravani, Bobbity Deepthi, Narayanan Parameswaran, Sudarsan Krishnasamy, Sivamurukan Palanisamy, Sriram Krishnamurthy","doi":"10.1177/08968608251344078","DOIUrl":"https://doi.org/10.1177/08968608251344078","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD) offers comparable survival for acute kidney injury (AKI) as other kidney replacement therapies, but concerns about rigid catheter complications like peritonitis persist. This study evaluated outcomes of acute PD using rigid catheters in critically ill children, including peritonitis rates and mechanical complications.MethodsThis retrospective study analyzed data from consecutive pediatric patients (aged <18 years) admitted to our tertiary-level pediatric intensive care unit, who underwent acute PD using either rigid or improvised catheters, with each PD session limited to 72 h followed by re-insertion after 24 h if indicated. Data on primary diagnosis, PD indication, and laboratory parameters were collected from patient records and dialysis registers. Outcome measures, such as peritonitis rates and mechanical complications, were assessed.ResultsOver a 10-year span (January 2014-September 2023), 202 children, 57% males, with a median age of 11 (3.6, 30) months, underwent PD. PD was initiated for fluid overload in 65 (32%), persistent anuria in 51 (25.2%), and refractory hyperkalemia in 47 (23.3%). In 13 (6.4%) patients, PD was initiated for metabolic crisis in the absence of AKI. The median estimated glomerular filtration rate at PD initiation was 21.4 (13.2, 46.5) mL/1.73m²/min. A total of 250 PD sessions/catheter insertions were performed on 202 children, for a median duration of 72 (24, 72) hours. Fourteen (6.9%) children developed peritonitis. Among children who received PD for ≤ 72 h (<i>n</i> = 164), peritonitis frequency was 3%, while it was 15.7% in those with one catheter re-insertion (<i>n</i> = 19) and 31.5% in >1 catheter reinsertion (<i>n</i> = 19). The peritonitis rate-per-catheter was 3% in children with single catheter insertion (<i>n</i> = 164), and 10.4% in children with ≥ 1 catheter re-insertions (<i>n</i> = 38). Among six children, who had extended PD sessions (single PD session duration, irrespective of it being the first or subsequent catheter) of 84 [84,100] (median [IQR]) hours, 3 (50%) developed peritonitis. Mechanical complications included peritubal-leak 28 (13.8%), hemorrhagic effluent in 8 (3%), catheter dislodgement in 3 (1.5%), and PD catheter block in 13 (6.4%). One child (0.49%) developed intestinal perforation.ConclusionsAcute PD with a rigid catheter limited to 72 h appears safe and feasible in resource-constrained settings where soft Tenckhoff PD catheters are not easily available, though peritonitis rates increase with increasing cumulative duration on PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251344078"},"PeriodicalIF":2.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis in acute kidney injury: Your questions answered.","authors":"Jonathan S Chávez-Iñiguez, Jahir R Camacho-Guerrero, Daniela Ponce","doi":"10.1177/08968608251344356","DOIUrl":"https://doi.org/10.1177/08968608251344356","url":null,"abstract":"<p><p>In acute kidney injury, no dialytic method has been shown to be superior in terms of mortality or recovery of kidney function. Peritoneal dialysis is an excellent treatment option, since it is continuous and can be adapted to clinical needs, it offers hemodynamic stability, adequate solute clearance, correction of electrolyte and acidosis disorders, appropriate ultrafiltration in volume overload, it is cheaper, does not require anticoagulation, provides calories, can be performed at the patient's bedside, its prescription is simple and does not require such sophisticated machinery. And when compared with other modalities, it has been shown to be equally efficient and safe, although its use is limited, partly due to the lack of knowledge and experience with this modality. Existing clinical evidence has consistently shown that this modality has very similar results in terms of the most relevant objectives evaluated in AKI. This modality offers certain advantages in specific contexts of acute kidney injury, such as cardiorenal syndrome, hepatorenal syndrome, in unstable patients on vasopressors, and in neurocritical patients. For all these reasons, we believe that peritoneal dialysis in acute kidney injury has sufficient arguments to be implemented more frequently and receive the value it deserves.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251344356"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of thirst in peritoneal dialysis patients.","authors":"Vítor Fernandes, Andrew Davenport","doi":"10.1177/08968608251343766","DOIUrl":"https://doi.org/10.1177/08968608251343766","url":null,"abstract":"<p><p>BackgroundFluid overload adversely impacts on peritoneal dialysis (PD) patients, and fluid restriction is often advised. Thirst is a prevalent and distressing symptom in patients with end-stage kidney disease. Thirst determinants in PD patients are poorly understood, so we wished to evaluate thirst and its determinants in this population.MethodsWe report a cross-sectional study of 387 adult PD patients attending a dialysis centre in London from January 2020 to December 2023. Patients completed a visual analogue scale for thirst, and clinical, biochemical and multifrequency bioelectrical bioimpedance data were reviewed. Based on thirst intensity scores, patients were categorized into three groups: 121 patients (0-3; low thirst), 136 (5-6; moderate thirst) and 130 (6-10; high thirst).ResultsHigher thirst scores were associated with female gender (<i>p</i> = 0.03); lower median of total weekly urea clearance (1.92 vs 1.97 and 2.09, lower and moderate thirst groups respectively; <i>p</i> = 0.04); and higher daily net sodium removal (136 vs 123 and 115 mmoL, lower and moderate thirst groups respectively; <i>p</i> = 0.009). On bivariate analysis, body mass index (BMI) showed a weak inverse correlation with thirst score (<i>p</i> = 0.046). However, there was no association with measured serum osmolality.ConclusionWhile there were weak to moderate associations between thirst and female gender, BMI, higher daily net sodium removal and lower weekly total Kt/V, there was a lack of a robust association with any routinely collected clinical measure. This study highlights the complex mechanism and determinants of thirst in PD patients warranting further study.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251343766"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial biofilm on peritoneal dialysis catheters: A retrospective observational study.","authors":"Aichun Liu, Huiping Zhao, Bei Wu, Shuying Zheng, Lixia Lu, Jie Qiao, Xinxin Chu, Chuncui Men, Yuting He, Li Zuo, Mei Wang","doi":"10.1177/08968608251331894","DOIUrl":"https://doi.org/10.1177/08968608251331894","url":null,"abstract":"<p><p><b>Objective:</b> Biofilm formation significantly impacts infection risks in peritoneal dialysis (PD) patients. However, few studies focused on biofilms on PD catheters. This study aims to explore the formation and characteristics of bacterial biofilm on PD catheters. <b>Methods:</b> A retrospective study was conducted on maintenance PD patients from January 2007 to January 2024. We summarized the general characteristics of the patients, the reasons for catheter removal, scanning electron microscopy (SEM) results of the PD catheter, and bacterial culture results from the PD effluent. The selected patients were divided into two groups: catheter removal due to peritonitis group (20 cases) and catheter removal due to non-peritonitis group (8 cases). <b>Results:</b> (1) The average dialysis duration in catheter removal due to peritonitis group was 84.2 ± 46.6 months, significantly longer than that in catheter removal due to non-peritonitis group (21.8 ± 18.7 months). Thirteen patients (65.5%) in catheter removal due to peritonitis group had a history of peritonitis before the current episode, whereas none in catheter removal due to non-peritonitis group had experienced it previously (<i>p</i> = 0.002). (2) Bacterial biofilm was detected in 20 (71.4%) out of 28 patients. Of these, bacterial biofilm was found in 18 patients (90.0%) in catheter removal due to peritonitis group, compared to only 2 patients (25.0%) in catheter removal due to non-peritonitis group (<i>p</i> = 0.002). SEM revealed that the bacterial biofilm forms present on the PD catheters were exclusively cocci biofilms. The bacterial culture results from the PD fluid of patients in catheter removal due to peritonitis group indicated that the three most prevalent pathogens were Escherichia coli (7/20), methicillin-sensitive Staphylococcus aureus (3/20), and Staphylococcus epidermidis (3/20). <b>Conclusion:</b> Bacterial biofilm formation on PD catheters is common among long-term PD patients. It is important to note that not all PD catheters removed due to peritonitis exhibit bacterial biofilms, and such biofilms may also be present in patients without peritonitis.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251331894"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement and usability of a mobile health app for peritoneal dialysis patients: A pilot randomized controlled trial.","authors":"Javier Cely, Cesar Doria, Maria P Dazzarola, Alvaro Del Castillo Farre, Antony Martinez, David Camargo, Mauricio Sanabria, Jasmin Vesga, Ricardo Sanchez, Bengt Lindholm, Angela Rivera, Peter Rutherford","doi":"10.1177/08968608251339578","DOIUrl":"https://doi.org/10.1177/08968608251339578","url":null,"abstract":"<p><p>BackgroundRemote monitoring programs for peritoneal dialysis (PD) have emerged with evidence of improved clinical and system-related outcomes in automated PD (APD) patients. The digital revolution now includes digital applications (apps) for mobile devices in healthcare. We evaluated the usability and patient engagement of using a newly developed mobile health app, MyPD app, for the care of continuous ambulatory PD (CAPD) and APD patients.MethodsThis randomized controlled, open-label, parallel-group trial was conducted in adult prevalent CAPD and APD patients. One arm used the MyPD app in addition to standard of care, while the other followed the standard of care in PD only. The follow-up was for six months. The primary outcome was engagement measured as frequency of communication between clinic and patient and, vice versa, number of preemptive visits and changes in dialysis prescription. Secondary outcomes included usability, peritonitis events, and number of hospitalizations, emergency room visits, and antihypertensive medicationsResultsA total of 140 patients were included in this study, 70 in the MyPD group and 70 in the standard care group. Their mean age was 52 ± 17 years; 68 (49%) patients received CAPD, while 72 (51%) received APD with remote monitoring based on the Sharesource platform.The mean number of communications between the clinic and patients during follow-up was 4.3 ± 5.2 for MyPD group and 1.2 ± 2.3 for standard of care, <i>p</i> < 0.01. The overall usability score was 6.5 ± 0.7, the maximum possible score is 7.ConclusionsThe use of MyPD app was associated with increased engagement between PD clinic and patients and high usability. The findings from the study are encouraging for integration of mobile health apps like MyPD into routine care in PD as tools to improve communication.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"8968608251339578"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}