Seminars in Dialysis最新文献

{"title":"The Effects of Fluid Management Approaches on Renin-Angiotensin-Aldosterone System Activity and Blood Pressure Control in Patients on Dialysis.","authors":"Feng Mingming, Yu Yan, Yang Ting","doi":"10.1111/sdi.70047","DOIUrl":"https://doi.org/10.1111/sdi.70047","url":null,"abstract":"<p><strong>Background: </strong>Chronic fluid imbalance in maintenance hemodialysis can increase cardiovascular risk through activation of the renin-angiotensin-aldosterone pathway. This study compared the endocrine and hemodynamic effects of three fluid management strategies in adults receiving maintenance hemodialysis in a prospective two-center observational cohort study.</p><p><strong>Methods: </strong>Six hundred patients were assigned to fluid management by clinical assessment, bioimpedance-guided monitoring, or absolute blood volume monitoring, with 200 patients in each group. Plasma renin activity, angiotensin II, aldosterone, systolic and diastolic blood pressure, and arterial stiffness were measured at baseline and Weeks 6 and 12. Between-group and over-time differences were analyzed using adjusted longitudinal and covariance-based models. Additional analyses examined variation by age, fluid status pattern, and sodium self-management.</p><p><strong>Results: </strong>By Week 12, plasma renin activity, angiotensin II, and aldosterone increased in the clinical assessment group showed smaller increases or minimal change in the bioimpedance-guided group and declined in the absolute blood volume monitoring group. The absolute blood volume monitoring group also showed the greatest improvement in blood pressure and arterial stiffness over follow-up. In addition, this group had the lowest frequency of intradialytic hypotension and the strongest improvement in patient self-management measures.</p><p><strong>Conclusions: </strong>Absolute blood volume monitoring was associated with greater short-term suppression of endocrine activation and better hemodynamic outcomes than clinical assessment or bioimpedance-guided monitoring during the 12-week follow-up period.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Access to Home-Based Renal Replacement Therapies Among Incident End-Stage Renal Disease Patients in the United States.","authors":"Andres Mauricio Garcia-Sierra, Bernardo Ramírez, Marcia Tan","doi":"10.1111/sdi.70050","DOIUrl":"https://doi.org/10.1111/sdi.70050","url":null,"abstract":"<p><strong>Background: </strong>Racial and ethnic disparities in access to home-based renal replacement therapies (RRT) remain a major concern in the management of end-stage renal disease (ESRD) in the United States. Despite national efforts to expand home hemodialysis (HHD) and peritoneal dialysis (PD), inequities at treatment initiation persist. Therefore, the goal was to evaluate racial and ethnic disparities in the initial modality of RRT among incident adult ESRD patients in the United Stated from 2014 to 2020.</p><p><strong>Methods: </strong>This retrospective, pooled cross-sectional study used United States Renal Data System (USRDS) data on adults initiating dialysis between 2014 and 2020. Descriptive analyses compared biological, environmental, and behavioral determinants across modalities. Poisson regression models with robust variance estimated adjusted incidence rate ratios (IRRs) for initiating HHD or PD versus in-center hemodialysis (ICHD), controlling for demographic, clinical, socioeconomic, and behavioral factors within an integrated health risk management framework.</p><p><strong>Results: </strong>Among 3.49 million incident ESRD cases, 82.8% initiated ICHD, 15.5% PD, and 1.7% HHD. Significant disparities were observed by race/ethnicity. Compared with White patients, Black patients had markedly lower adjusted incidence rates of initiating HHD (IRR 0.69; 95% CI 0.67-0.72) and PD (IRR 0.55; 95% CI 0.55-0.56). Hispanic or Latino patients similarly demonstrated reduced initiation of HHD (IRR 0.42; 95% CI 0.40-0.45) and PD (IRR 0.64; 95% CI 0.64-0.65). Asian patients had a modestly higher adjusted rate of PD initiation (IRR 1.08; 95% CI 1.06-1.09) but lower rates of HHD. Other racial groups also showed consistently reduced use of home modalities.</p><p><strong>Conclusions: </strong>Substantial racial and ethnic disparities persist in the initiation of home dialysis in the U.S. While structural and system-level factors likely contribute, patient-level clinical considerations, cultural norms, social support availability, and provider practice patterns also play important roles.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Intradialytic Changes in Cardiac Troponin I-A Systematic Review.","authors":"Johan Ferrier Jørgensen, Frans Brandt, Michael Waldhauer Hunderup, Jan Dominik Kampmann","doi":"10.1111/sdi.70049","DOIUrl":"https://doi.org/10.1111/sdi.70049","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of death in patients receiving hemodialysis. Current guidelines define acute myocardial infarction (AMI) by troponin levels above the 99th percentile, accompanied by a ≥ 20% rise or fall. However, troponin concentrations are often elevated, and hemodialysis may influence troponin levels during treatment. This systematic review aims to evaluate whether these factors compromise the diagnostic accuracy of troponin for AMI in patients undergoing hemodialysis. We performed a systematic review including 6359 studies. Inclusion criteria were adult patients and studies reporting predialysis and postdialysis assessment of troponin I. Twenty-eight studies were deemed suitable. Mean troponin I was assessed before and after dialysis. The risk of bias and applicability of the included studies were assessed. The studies were heterogeneous in terms of reporting intradialytic changes of troponin, either in mean or median, which was a problem, along with the lack of reporting dialysis details. The mean troponin predialysis was 68 ng/L, and the mean troponin postdialysis was 73 ng/L. The troponin changes during dialysis were between -100% and +933%. The per se elevated troponin I and the unpredictable changes during dialysis make the use of the current AMI guidelines challenging for patients on dialysis.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Incremental Hemodialysis: A Systematic Review and Meta-Analysis.","authors":"Berk Mizrak, Sidar Copur, Francesco Gaetano Casino, Carlo Basile, Mehmet Kanbay","doi":"10.1111/sdi.70048","DOIUrl":"https://doi.org/10.1111/sdi.70048","url":null,"abstract":"<p><p>Hemodialysis, the most commonly employed renal replacement therapy in end-stage kidney disease, prescriptions have long been standardized as thrice-weekly at full-dose; however, HD implementation is not without major complications. Incremental HD modalities are developed to face such one-size-fits-all approach with hopes for better preservation of residual kidney function, better quality of life and patient compliance, lower complication rates, and improvements in morbidity and mortality. A comprehensive literature search was conducted through PubMed, Scopus, the Cochrane Library, Web of Science, and Ovid MEDLINE to identify relevant clinical studies on the efficacy and safety of incremental HD modalities over standard of care HD approach. We have included a total of 35 clinical studies in our final meta-analysis. Our analysis has revealed that incremental HD approach was not associated with statistically significant improvement in all-cause mortality, hospitalization rates, cardiovascular events, intradialytic hypotension or quality of life including mental, and physical components compared to standardized HD approach. Incremental hemodialysis was associated with better preservation of residual kidney function and lower rates of vascular access complications. Incremental hemodialysis was associated with non-inferior clinical outcomes, better preservation of residual kidney function, and fewer vascular access complications than standard thrice-weekly hemodialysis. Larger prospective studies with longer follow-up are needed to support its widespread clinical use.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Antimicrobial Lock Solutions on Central Line-Associated Bloodstream Infection and Catheter Survival in Hemodialysis Patients: A Systematic Review and Meta-Analysis.","authors":"Jinghua Liu, Jianpeng Lin, Haihong Liu, KimGeok Soh, Qingmei Ju, KimLam Soh, Xianling Dong","doi":"10.1111/sdi.70046","DOIUrl":"https://doi.org/10.1111/sdi.70046","url":null,"abstract":"<p><p>Hemodialysis (HD) catheters carry a high risk of life-threatening bloodstream infections and failure. Antimicrobial lock solutions (ALS) are used to reduce this risk, but their overall efficacy on key outcomes like infection rates and catheter survival requires comprehensive evaluation. This systematic review and meta-analysis assess the impact of ALS on preventing catheter-related bloodstream infections (including incidence and density) and on improving catheter survival. A systematic search was conducted across the databases of PubMed, Embase, Scopus, Cochrane Library, and Google Scholar. A meta-analysis was conducted using STATA software. A total of 1183 studies were screened based on title and abstract, and further 282 studies were evaluated in full text. Eventually, 14 studies with 15 treatment arms were included. Key outcomes including central line-associated bloodstream infection (CLABSI), exit infection, and catheter-free survival were conducted separately. ALS demonstrated statistically significant benefits on CLABSI infection and catheter-free survival compared to nonantimicrobial solutions, showing a reduction in CLABSI density with a pooled log odd ratio (logOR) of -1.29 (95% CI: -1.59 to -0.99), lower CLABSI rates (pooled logOR = -1.50, 95% CI: -1.85 to -1.15), and improved catheter-free survival with log hazard ratio (logHR) of -1.11 (95% CI: -1.41 to -0.8). Consistent treatment effects were observed across all lock types with no significant heterogeneity detected. ALS demonstrate statistically significant and clinically important efficacy in reducing CLABSI incidence and density while improving catheter survival in HD patients, establishing them as an essential preventive strategy in clinical practice.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Tools for the Presence of Significant Coronary Artery Disease Requiring Intervention in Chronic Hemodialysis Patients.","authors":"Thana Thongsricome, Sarawut Siwamogsatham, Weerapat Kositanurit, Somchai Eiam-Ong, Khajohn Tiranathanagul","doi":"10.1111/sdi.70044","DOIUrl":"https://doi.org/10.1111/sdi.70044","url":null,"abstract":"<p><strong>Purpose: </strong>Hemodialysis (HD) patients have increased cardiovascular risk. Coronary artery disease (CAD) may not typically manifest in these patients, and the investigational results can be confounded by the fluctuation of body fluid and electrolytes. This study explored the accuracy of these findings in identifying CAD in HD patients.</p><p><strong>Methods: </strong>Medical record data of all HD patients undergoing coronary angiography (CAG) at a tertiary hospital between January 2017 and March 2021 were retrospectively reviewed as a discovery cohort to identify factors discriminating patients with and without significant CAG-established CAD. HD patients receiving CAG between April 2021 and March 2023 were assigned as a validation cohort.</p><p><strong>Results: </strong>The discovery and validation cohorts included 108 and 41 patients, respectively. Chest pain out of the dialysis session, but not pulmonary congestion/edema nor other intradialytic events, was associated with significant CAD (odds ratio 3.281, 95% CI 1.313-8.200). The presence of regional wall motion abnormality (RWMA) from echocardiogram, but not other echocardiographic and electrocardiographic findings, significantly predicted significant CAD (odds ratio 2.579, 95% CI 1.052-6.324). Initial high-sensitivity troponin T > 111 ng/L and percent of troponin change > 22% had area under the ROC curve of 0.71 (95% CI 0.52-0.89) and 0.67 (95% CI 0.50-0.85), respectively, for predicting CAD. Applying a combination of these predictors resulted in a specificity of 100%, but low sensitivity for CAD in the validation cohort.</p><p><strong>Conclusion: </strong>Most intradialytic symptoms possibly result from noncardiac etiologies, while chest pain out of the HD session should alarm the physicians for further management. Applying the suggested cardiac enzyme cut points or the presence of RWMA could prioritize at-risk patients for timed cardiologist referral.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Depression in Hemodialysis Patients: A Meta-Analysis.","authors":"Yang Li, Yu Liu, Siyu Wu, Wei He, Yunping Li, Jingjing Tian, Li Li, Wenwen Wu","doi":"10.1111/sdi.70043","DOIUrl":"https://doi.org/10.1111/sdi.70043","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is the third most disabling disease worldwide and is prevalent in patients undergoing hemodialysis. Given the greatly varied prevalence of depression in different regions, this meta-analysis was conducted to elucidate the status of depression in hemodialysis patients.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant literature on depression in hemodialysis patients from inception to July 2023. Subgroup analyses and meta-regression were subsequently performed to determine the source of heterogeneity.</p><p><strong>Results: </strong>A total of 137 cross-sectional studies were included, involving 21,608 hemodialysis patients. The random-effects analyses demonstrated that the prevalence of depression was 45.8% in hemodialysis patients (95% confidence interval [CI]: 42.0%-49.6%). Subgroup analysis of national income levels implied that high-income countries had the lowest prevalence of depression at 38.9% (95% CI: 34.1%-43.7%). Studies with a higher proportion of female hemodialysis patients reported a relatively higher prevalence of depression. Subgroup analysis by age revealed that patients under 40 years old had a depression prevalence of 50.8% (95% CI: 25.6%-76.0%), which was higher than that of other age groups. Different self-rating depression scales yielded different prevalence of depression in hemodialysis patients.</p><p><strong>Conclusion: </strong>Depressive symptoms are common in hemodialysis patients, so screening and identifying those at risk for depression and developing effective intervention strategies are of great value.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Feasibility of Virtual Reality-Based Interventions in Improving Physical Function in Patients Undergoing Hemodialysis: A Meta-Analysis.","authors":"Nese Altınok Ersoy, Gülşah Kesik","doi":"10.1111/sdi.70045","DOIUrl":"10.1111/sdi.70045","url":null,"abstract":"<p><strong>Background: </strong>Improving physical function is essential for hemodialysis patients. Virtual reality-based methods are practical, well-tolerated, and easily integrated into care.</p><p><strong>Methods: </strong>A meta-analysis aims to evaluate the effects of virtual reality-based interventions on physical function and their clinical feasibility for patients undergoing hemodialysis. Scientific literature published between January 2002 and June 2024 was searched in six databases. The standardized mean differences were determined using the upper and lower limits of 95% confidence intervals. Publication bias was evaluated using the Egger test and visualized using a funnel plot.</p><p><strong>Results: </strong>Five studies were included in this meta-analysis. The types of virtual reality-based interventions were \"treasure hunt\" video games (n = 1), Wii Fit Plus games (n = 2), and A la Caza del Tesoro (ACT) video games (n = 2). The effects of virtual reality-based interventions on various measures of physical function, including the sit-stand test, 6-min walk test, timed stand-walk test, walking speed test, and handgrip strength test, were examined; significantly beneficial effects have been observed on many parameters. Furthermore, VR-based interventions did not cause any adverse effects on hemodynamic measurements. Methodological quality analysis revealed four good quality and one medium quality study. Egger testing showed no significant publication bias.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that virtual reality-based interventions can enhance physical function and are feasible both physiological and behavioral. Nurses and other healthcare professionals can use virtual reality-based interventions to maintain or improve physical function by facilitating adherence.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"185-199"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Glucose Chlorhexidine Dressings vs. Sterile Dressings in Preventing Catheter-Related Infections During Continuous Renal Replacement Therapy: A Randomized Controlled Trial.","authors":"Xuemei Zhang, Fang Wang, Yi Zheng, Xiankun Sun, Li Lin, Xue Tang, Zhiwen Chen, Ling Zhang","doi":"10.1111/sdi.70042","DOIUrl":"10.1111/sdi.70042","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Catheter-related bloodstream infections (CRBSIs) are a major cause of complications in critically ill patients receiving continuous renal replacement therapy (CRRT), especially those with nontunneled catheters. These infections can lead to longer hospital stays, higher costs, and worse patient outcomes. Although sterile dressings are commonly used to prevent CRBSIs, antimicrobial dressings, such as those containing chlorhexidine, may offer better protection. This study aimed to compare the effectiveness of antimicrobial glucose chlorhexidine dressings and sterile dressings in preventing CRBSIs in patients receiving CRRT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective, randomized controlled, single-blind study was conducted. All participants were kept blinded to group assignment. We enrolled patients admitted to the Intensive Care Unit (ICU) of West China Hospital, Sichuan University between September 2022 and November 2023 who were scheduled for vascular catheter placement before receiving continuous renal replacement therapy (CRRT). The participants were randomly allocated to either the intervention group (receiving glucose chlorhexidine antimicrobial dressing) or the control group (receiving sterile dressing) via a random number table. The dressing was changed every 7 days for the glucose chlorhexidine antimicrobial group and every 48 h for the sterile dressing group, in accordance with the guideline. Dressings were replaced immediately if they became rolled, loose, or visibly soiled. The primary outcomes were the local infection rate at the catheter insertion site, suspected catheter-related bloodstream infections (CRBSIs), incidence of CRBSIs, length of hospital stay, ICU stay duration, and hospital mortality rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 520 patients were screened, and 410 patients were ultimately included in the study, with 205 patients in each group (glucose chlorhexidine antimicrobial dressing group and sterile dressing group). The incidence of local infection at the catheter insertion site was 40.0% in the sterile dressing group, which was significantly greater than the 15.6% reported in the glucose chlorhexidine antimicrobial dressing group (p &lt; 0.001). The total CRBSI rate in the intervention group was significantly lower (6.3%) than that in the control group (13.7%) (p = 0.014). No significant differences were found between the two groups in terms of suspected catheter-related bloodstream infections (CRBSIs), CRBSI incidence, length of hospital stay, ICU stay duration, or hospital mortality rates (p &gt; 0.05). The Cox proportional hazards model suggested that patients in the control group were at a substantially greater risk of local infections and CRBSIs over time than those in the intervention group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Glucose chlorhexidine antimicrobial dressings significantly reduce catheter insertion site infections and overall CRBSI incidence, demonstrating their c","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"177-184"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Patient Monitoring in Home Dialysis Patients: Enhancing Care for Home Hemodialysis and Peritoneal Dialysis.","authors":"Smriti Arya, Signe Zhang, Xiao Fu","doi":"10.1111/sdi.70041","DOIUrl":"10.1111/sdi.70041","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) patients on hemodialysis need continuous care, which has a minimal effect on their quality of life (QoL), as they have enormous symptomatic burdens, such as deprivation of sleep and anxiety, in addition to other consequences affecting their QoL. Moreover, managing dialysis patients is burdensome and costly. Telemedicine has recently gained popularity for electronically transferring data between patients and clinics. This has enabled remote monitoring of patients and timely intervention. Remote patient monitoring (RPM) is a noninvasive healthcare service designed to remotely manage patients' vital information and facilitate continuous data collection. The emergence of RPM has led to a transformative approach in the management of chronic conditions, particularly within the context of home dialysis for patients undergoing home hemodialysis (HHD) and peritoneal dialysis (PD).</p><p><strong>Methods: </strong>This narrative review summarizes the current literature on the use of RPM in home dialysis settings. Relevant publications addressing RPM applications in HHD and PD were reviewed, and evidence was synthesized, with a focus on current practices, clinical outcomes, key advantages, limitations, and future directions for research and implementation, underscoring the potential of RPM to enhance care delivery in home dialysis.</p><p><strong>Results: </strong>RPM enables continuous monitoring of patient health data, promoting early detection of clinical issues and timely intervention. Reported benefits include improved patient engagement, treatment adherence, QoL, mortality, and reduced rates of hemodialysis transfers and hospitalization. RPM also supports more efficient communication between patients and healthcare providers. However, several challenges to broader implementation persist, including technological limitations, concerns regarding data privacy and security, and variable acceptance and adoption among patients and healthcare professionals.</p><p><strong>Conclusions: </strong>In conclusion, RPM has the potential to enhance home dialysis care by improving clinical outcomes, patient engagement, and healthcare efficiency. Addressing technological, privacy, adoption, and regulatory challenges will be critical to its broader implementation and long-term success.</p>","PeriodicalId":21675,"journal":{"name":"Seminars in Dialysis","volume":" ","pages":"157-167"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}