Three Years Outcome Comparison of Remote Monitoring Versus Conventional Automated Peritoneal Dialysis in Incident APD Patients: A Retrospective Study From Taiwan

AIM: The efficacy of the remote monitoring of automated peritoneal dialysis (RM-APD) with Sharesource platform versus conventional APD outcomes in East Asia remains limited. METHODS: This study analysed data from incident APD patients at Taichung Veterans General Hospital between 2010 and 2021. Patients were categorised into RM-APD (n = 77, initiated March 2019-Dec 2021) and conventional APD groups (n = 100, initiated Jan 2010-Dec 2017). Follow-up for both groups extended to censoring, studied outcomes, or the end of the observation period (Dec 2018 for conventional APD and Dec 2022 for RM-APD), with a maximum follow-up of 3 years. Outcomes included death, technique survival, peritonitis incidence and hospitalisation rates using Cox proportional hazard models. RESULTS: Among 452 patients undergoing peritoneal dialysis, 177 were included after exclusions. Mean age was 49 years in RM-APD and 46 years in conventional APD groups. After mean follow-up of 2.05 years, no significant differences were found in mortality, technique survival rates, or hospitalisation rates between groups. However, RM-APD showed significantly lower peritonitis incidence compared to conventional APD (HR = 0.39, 95% CI: 0.17-0.90, p < 0.05). The conventional APD group had 3 relapse peritonitis and 2 transfer to HD, while the RM-APD group had none. CONCLUSIONS: RM-APD using Sharesource platform significantly reduces peritonitis incidence compared to conventional APD in Taiwan. While mortality and technique survival were similar, improved peritonitis outcomes suggest RM-APD can enhance care quality and safety for incident APD patients in clinical practice. Further prospective studies are warranted to validate these findings.