Assessment of the perceptions of health-related quality of life in Greek patients undergoing automated peritoneal dialysis with remote monitoring: A qualitative study.

BACKGROUND: This study aimed to explore in depth the lived experience and quality of life outcomes in patients receiving automated peritoneal dialysis (APD) treatment. METHODS: The study adhered to the standards of the Consolidated Criteria for Reporting Qualitative Research. A total of 19 APD patients were recruited and assessed using in-depth semi-structured interviews on various aspects of life with respect to APD modality. The interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis. RESULTS: Study findings generated five superordinate themes: (a) treatment-free daily routine, (b) sleep disturbances, (c) remote care, (d) limitations of peritoneal dialysis, and (e) the dimension of chronic disease. Further analysis of the material revealed the relationship of these themes with individual patient characteristics. CONCLUSIONS: Overall, our findings suggest that APD characteristics contribute to the perceptions of quality of life in patients under dialysis considerably.

Automated Peritoneal Dialysis With Remote Patient Monitoring: Clinical Effects and Economic Consequences for Poland.

OBJECTIVES: Remote patient monitoring (RPM) of patients treated with automated peritoneal dialysis (APD) at home allows clinicians to supervise and adjust the dialysis process remotely. This study aimed to review recent scientific studies on the use of RPM in patients treated with APD and based on extracted relevant data assess possible clinical implications and potential economic value of introducing such a system into practice in Poland. METHODS: A systematic literature review was performed in the MEDLINE, EMBASE, and Cochrane databases. The model of clinical effects and costs associated with APD was built as a cost-effectiveness analysis with a 10-year time horizon from the Polish National Health Fund perspective. Cost-effectiveness analysis compared 2 strategies: APD with RPM versus APD without RPM. RESULTS: Thirteen publications assessing the clinical value of RPM among patients with APD were found. The statistical significance of APD with RPM compared with APD without RPM was identified for the main clinical outcomes: frequency and length of hospitalizations, APD technique failure, and death. An incremental cost-effectiveness ratio was equal to €27 387 per quality-adjusted life-year. The obtained incremental cost-effectiveness ratio is below the willingness-to-pay threshold for the use of medical technologies in Poland (€36 510 per quality-adjusted life-year), which means that APD with RPM was a cost-effective technology. CONCLUSIONS: RPM in patients starting APD is a clinical option that is worth considering in Polish practice because it has the potential to decrease the frequency of APD technique failure and shorten the length of hospitalization.

[Fungal peritonitis in patients on peritoneal dialysis]. / Grzybicze zapalenie otrzewnej u chorych ze schylkowa niewydolnoscia nerek leczonych dializa otrzewnowa.

UNLABELLED: Fungal peritonitis is a serious complication causes significant morbidity and mortality for patients on peritoneal dialysis. We reviewed our fungal peritonitis cases to analyse clinical features, treatment and predisposing factors. METHODS: Records of all peritonitis episodes were reviewed. Fungal peritonitis was diagnosed based on positive fungal culture in suitable media of the effluent. RESULTS: Between January 2001 and June 2006, 98 patients were treated with peritoneal dialysis. During this period 102 peritonitis episodes was noticed, four of them (3,9%) was caused by fungi. The most common pathogen was Candida sp. Preceding treatment with broad-spectrum antibiotics was revealed in all cases, three of them due to bacterial peritonitis. One patient died due to sepsis, three was moved to hemodialysis. CONCLUSIONS: Fungal peritonitis is rare, but serious complication it patients treated with peritoneal dialysis. Preceding broad-spectrum antibiotic therapy is the main risk factor for the development of this complication. Early Tenckhoff catheter removal and prophylaxis (antifungal treatment, education, coexisting diseases treatment) may be beneficial for peritoneal dialysis patients with fungal peritonitis.