Telemedicine and Clinical Outcomes in Peritoneal Dialysis: A Propensity-Matched Study

被引：13

作者：

Xu, Xiao ^{[1
]}

Ma, Tiantian ^{[1
]}

Tian, Xue ^{[1
]}

Li, Shaomei ^{[2
]}

Pei, Huaying ^{[2
]}

Zhao, Jinghong ^{[3
]}

Zhang, Ying ^{[3
]}

Xiong, Zibo ^{[4
]}

Liao, Yumei ^{[4
]}

Li, Ying ^{[5
]}

Lin, Qiongzhen ^{[5
]}

Hu, Wenbo ^{[6
]}

Li, Yulin ^{[6
]}

Zheng, Zhaoxia ^{[7
]}

Duan, Liping ^{[7
]}

Fu, Gang ^{[8
]}

Guo, Shanshan ^{[8
]}

Zhang, Beiru ^{[9
]}

Yu, Rui ^{[9
]}

Sun, Fuyun ^{[10
]}

Ma, Xiaoying ^{[10
]}

Hao, Li ^{[11
]}

Liu, Guiling ^{[11
]}

Zhao, Zhanzheng ^{[12
]}

Xiao, Jing ^{[12
]}

Shen, Yulan ^{[13
]}

Zhang, Yong ^{[13
]}

Du, Xuanyi ^{[14
]}

Ji, Tianrong ^{[14
]}

Wang, Caili ^{[15
]}

Deng, Lirong ^{[15
]}

Yue, Yingli ^{[16
]}

Chen, Shanshan ^{[16
]}

Ma, Zhigang ^{[17
]}

Li, Yingping ^{[17
]}

Zuo, Li ^{[18
]}

Zhao, Huiping ^{[18
]}

Zhang, Xianchao ^{[19
]}

Wang, Xuejian ^{[19
]}

Liu, Yirong ^{[20
]}

Gao, Xinying ^{[20
]}

Chen, Xiaoli ^{[21
]}

Li, Hongyi ^{[21
]}

Du, Shutong ^{[22
]}

Zhao, Cui ^{[22
]}

Xu, Zhonggao ^{[23
]}

Zhang, Li ^{[23
]}

Chen, Hongyu ^{[24
]}

Li, Li ^{[24
]}

Wang, Lihua ^{[25
]}

机构：

[1] Peking Univ, Peking Univ First Hosp, Inst Nephrol,Minist Hlth, Dept Med,Renal Div,Minist Educ,Key Lab Renal Dis, Beijing, Peoples R China

[2] Hebei Med Univ, Dept Med, Renal Div, Hosp 2, Shijiazhuang, Hebei, Peoples R China

[3] Army Med Univ Third Mil Med Univ, Xinqiao Hosp, Chongqing Clin Res Ctr Kidney & Urol Dis, Dept Nephrol,Key Lab Prevent & Treatment Chron Ki, Chongqing, Peoples R China

[4] Peking Univ, Dept Med, Renal Div, Shenzhen Hosp, Shenzhen, Guangdong, Peoples R China

[5] Hebei Med Univ, Dept Med, Renal Div, Hosp 3, Shijiazhuang, Hebei, Peoples R China

[6] Peoples Hosp Qinghai Prov, Renal Div, Dept Med, Xining, Qinghai, Peoples R China

[7] Handan Cent Hosp, Dept Med, Renal Div, Handan, Hebei, Peoples R China

[8] Peking Haidian Hosp, Dept Med, Renal Div, Beijing, Peoples R China

[9] China Med Univ, Dept Med, Renal Div, Shengjing Hosp, Jilin, Jilin, Peoples R China

[10] Cangzhou Cent Hosp, Dept Med, Renal Div, Cangzhou, Hebei, Peoples R China

[11] Anhui Med Univ, Dept Med, Renal Div, Affiliated Hosp 2, Hefei, Anhui, Peoples R China

[12] Zhengzhou Univ, Dept Med, Renal Div, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China

[13] Beijing Miyun Dist Hosp, Dept Med, Renal Div, Beijing, Peoples R China

[14] Harbin Med Univ, Dept Med, Renal Div, Affiliated Hosp 2, Harbin, Heilongjiang, Peoples R China

[15] BaoTou Med Coll, Dept Med, Renal Div, Affiliated Hosp 1, Neimenggu, Peoples R China

[16] Peoples Hosp Langfang, Dept Med, Renal Div, Langfang, Hebei, Peoples R China

[17] Peoples Hosp Gansu, Dept Med, Renal Div, Lanzhou, Gansu, Peoples R China

[18] Peking Univ Peoples Hosp, Dept Med, Renal Div, Beijing, Peoples R China

[19] Pingdingshan First Peoples Hosp, Dept Med, Renal Div, Pingdingshan, Henan, Peoples R China

[20] First Peoples Hosp Xining, Dept Med, Renal Div, Xining, Qinghai, Peoples R China

[21] Taiyuan Cent Hosp, Dept Med, Renal Div, Taiyuan, Shanxi, Peoples R China

[22] Cangzhou Peoples Hosp, Dept Med, Renal Div, Cangzhou, Hebei, Peoples R China

[23] First Hosp Jilin Univ, Dept Med, Renal Div, Changchun, Jilin, Peoples R China

[24] Peoples Hosp Chuxiong Yi Autonomous Prefecture, Dept Med, Renal Div, Chuxiong, Yunnan, Peoples R China

[25] Shanxi Med Univ, Dept Med, Renal Div, Hosp 2, Jinzhong, Shanxi, Peoples R China

[26] Beijing Boai Hosp, China Rehabil Res Ctr, Dept Med, Renal Div, Beijing, Peoples R China

[27] Beijing Dongzhimen Hosp, Dept Med, Renal Div, Beijing, Peoples R China

[28] Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China

来源：

AMERICAN JOURNAL OF NEPHROLOGY | 2022年 / 53卷 / 8-9期

关键词：

Peritoneal dialysis; Telemedicine; Remote patient management; Mortality; Technique survival; PATIENT-DOCTOR CONTACT; CHRONIC KIDNEY-DISEASE; HEART-FAILURE; HEMODIALYSIS; CARE; MANAGEMENT; TIME; INTERVENTIONS; METAANALYSIS; FREQUENCY;

D O I：

10.1159/000525917

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Telemedicine (TM) has shown to provide potential benefits on clinical outcomes in patients with chronic kidney disease but limited evidences published in the peritoneal dialysis (PD) population. This study aimed to explore the long-term effects of TM on the mortality and technique failure. Methods: The Peritoneal Dialysis Telemedicine-assisted Platform Cohort Study (PDTAP Study) was conducted prospectively in 27 hospitals in China since 2016. Patient and practice data were collected through the doctor-end of the TM app (Manburs) for all participants. TM including self-monitoring records, on-line education materials, and real-time physician-patient contact was only performed for the patient-end users of the Manburs. The primary outcome was all-cause mortality. The secondary outcomes were cause-specific mortality and all-cause and cause-specific permanent transfer to hemodialysis. Results: A total of 7,539 PD patients were enrolled between June 2016 and April 2019, with follow-up till December 2020. Patients were divided into two cohorts: TM group (39.1%) and non-TM group (60.9%). A propensity score was used to create 2,160 matched pairs in which the baseline covariates were well-balanced. There were significantly lower risks of all-cause mortality (HR 059 [0.51, 0.67], p < 0.001), CVD mortality (HR 0.59 [0.49, 0.70], p < 0.001), all-cause transfer to hemodialysis (0.57 [0.48, 0.67], p < 0.001), transfer to hemodialysis from PD-related infection (0.67 [0.51, 0.88], p= 0.003), severe fluid overload (0.40 [0.30, 0.55], p < 0.001), inadequate solute clearance (0.49 [0.26, 0.92], p = 0.026), and catheter-related noninfectious complications (0.41 [0.17, 0.97], p = 0.041) in the TM group compared with the non-TM group. Conclusion: This study indicated real-world associations between TM usage and reduction in patient survival and technique survival through a multicenter prospective cohort. (C) 2022 S. Karger AG, Basel

引用

页码：663 / 673

页数：11

共 44 条

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