Opportunities and challenges of remote monitoring implementation in peritoneal dialysis: A scoping review
https://doi.org/10.52235/lp.v7i4.884
Keywords:
remote patient monitoring, telemedicine, peritoneal dialysisAbstract
Background: Peritoneal dialysis (PD) offers several advantages over hemodialysis but faces challenges related to patient monitoring and limited clinical oversight. Remote monitoring (RM) has the potential to improve monitoring effectiveness, yet it remains underutilized and warrants further investigation.
Objective: This scoping review aims to identify the types of RM implementation, opportunities, and challenges in PD patients.
Methods: A systematic literature search was conducted in PubMed, ScienceDirect, ProQuest, and Scopus on 24 August 2024 to identify original research published between August 2014 and August 2024. The search combined terms related to PD and remote care, including “peritoneal dialysis,” “continuous ambulatory peritoneal dialysis,” “telemonitoring,” “remote monitoring,” “telemedicine,” and “remote consultation.” Original research articles describing the implementation of RM in PD patients aged 18 years and older were included. Retrieved records were exported to Rayyan for screening and study selection, with two review teams evaluating titles, abstracts, and full texts. Disagreements in study selection and data extraction were resolved through consensus and team discussion. Data were mapped according to the seven domains of the Model for Assessment of Telemedicine (MAST).
Results: A total of 23 studies were included, identifying five types of RM implementation. Data coding identified 132 opportunity items and 56 challenge items across the MAST domains. Cloud-based software supporting automated peritoneal dialysis was the most frequently represented RM modality, appearing in 12 studies, whereas telephone-based monitoring was represented in two studies. Across all included evidence, clinical effectiveness accounted for the largest proportion of both reported opportunities (40%) and challenges (43%). Several MAST domains, including safety, organizational aspects, sociocultural and ethical considerations, and legal issues, were less frequently reported.
Conclusion: RM has been implemented through several approaches in PD care and shows reported opportunities and challenges across multiple domains, particularly clinical effectiveness. However, interpretation of these findings should consider the heterogeneity of the included evidence, unequal representation of RM modalities, and limited reporting across several MAST domains.
Downloads
References
Agarwal, S., & Wilkie, M. (2019). Remote Patient Management in Peritoneal Dialysis: Opportunities and Challenges. Contributions to Nephrology, 197, 54 – 64. https://doi.org/10.1159/000496309
Alipour, J., & Hayavi-Haghighi, M. H. (2021). Opportunities and Challenges of Telehealth in Disease Management during COVID-19 Pandemic: A Scoping Review. Applied Clinical Informatics, 12(4), 864–876. https://doi.org/10.1055/s-0041-1735181
Amici, G., D’Angela, D., Lo Cicero, A., Romanini, D., Martino, F. K., & Spandonaro, F. (2021). Pilot health technology assessment study: organizational and economic impact of remote monitoring system for home automated peritoneal dialysis. International Urology and Nephrology, 53(9), 1933–1940. https://doi.org/10.1007/s11255-021-02816-8
Biebuyck, G. K. M., Neradova, A., de Fijter, C. W. H., & Jakulj, L. (2022). Impact of telehealth interventions added to peritoneal dialysis-care: a systematic review. BMC Nephrology, 23(1). https://doi.org/10.1186/s12882-022-02869-6
Boikanyo, K., Zungeru, A. M., Sigweni, B., Yahya, A., & Lebekwe, C. (2023). Remote patient monitoring systems: Applications, architecture, and challenges. Scientific African, 20, e01638. https://doi.org/https://doi.org/10.1016/j.sciaf.2023.e01638
Cao, F., Hong, F., Ruan, Y., & Lin, M. (2023). Factors Influencing the Choice of Automated Peritoneal Dialysis Treatment by Patients Receiving Home Peritoneal Dialysis. Patient Preference and Adherence, 17, 2797–2804. https://doi.org/10.2147/PPA.S423443
Cao, F., Li, L., Lin, M., Lin, Q., Ruan, Y., & Hong, F. (2018). Application of instant messaging software in the follow-up of patients using peritoneal dialysis, a randomised controlled trial. Journal of Clinical Nursing, 27(15–16), 3001–3007. https://doi.org/10.1111/jocn.14487
Chaiyachati, K. H., Shea, J. A., Ward, M., Nelson, M. N., Ghosh, M., Reilly, J., Kelly, S., Chisholm, D. L., Barbati, Z., Hemmons, J. E., Abdel-Rahman, D., Ebert, J. P., Xiong, R. A., Snider, C. K., Lee, K. C., Friedman, A. B., Meisel, Z. F., Kilaru, A. S., Asch, D. A., … Morgan, A. U. (2023). Patient and clinician perspectives of a remote monitoring program for COVID-19 and lessons for future programs. BMC Health Services Research, 23(1), 698. https://doi.org/10.1186/s12913-023-09684-1
Chang, M.-Y., Chi, P.-J., Wang, H.-H., Lee, Y.-C., Ho, L.-C., Wu, C.-F., Chen, C.-Y., Liou, H.-H., & Hung, S.-Y. (2023). Evaluation of the Impact of Remote Monitoring Using the Sharesource Connectivity Platform on Adherence to Automated Peritoneal Dialysis in 51 Patients. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 29, e939523. https://doi.org/10.12659/MSM.939523
Chaudhuri, S., Han, H., Muchiutti, C., Ryter, J., Reviriego-Mendoza, M., Maddux, D., Usvyat, L. A., Chatoth, D., Kooman, J. P., Maddux, F. W., & Larkin, J. W. (2020). Remote Treatment Monitoring on Hospitalization and Technique Failure Rates in Peritoneal Dialysis Patients. Kidney360, 1(3), 191 – 202. https://doi.org/10.34067/KID.0000302019
Cho, Y., Bello, A. K., Levin, A., Lunney, M., Osman, M. A., Ye, F., Ashuntantang, G. E., Bellorin-Font, E., Gharbi, M. B., Davison, S. N., Ghnaimat, M., Harden, P., Htay, H., Jha, V., Kalantar-Zadeh, K., Kerr, P. G., Klarenbach, S., Kovesdy, C. P., Luyckx, V., … Johnson, D. W. (2021). Peritoneal Dialysis Use and Practice Patterns: An International Survey Study. American Journal of Kidney Diseases : The Official Journal of the National Kidney Foundation, 77(3), 315–325. https://doi.org/10.1053/j.ajkd.2020.05.032
Corzo, L., Wilkie, M., Vesga, J. I., Lindholm, B., Buitrago, G., Rivera, A. S., & Sanabria, R. M. (2022). Technique failure in remote patient monitoring program in patients undergoing automated peritoneal dialysis: A retrospective cohort study. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 42(3), 288–296. https://doi.org/10.1177/0896860820982223
Cuevas-Budhart, M. A., Trejo-Villeda, M. A., Cabrera Delgado, M., Hernandez-Franco, B., Ávila Díaz, M., Ramos-Sanchez, A., & Paniagua, R. (2023). Remote monitoring as a surveillance method in patients on automated peritoneal dialysis for preventing complications and COVID-19 contagion. Journal of Infection and Public Health, 16(10), 1619–1624. https://doi.org/10.1016/j.jiph.2023.07.019
Dey, V., Jones, A., & Spalding, E. M. (2016). Telehealth: Acceptability, clinical interventions and quality of life in peritoneal dialysis. SAGE Open Medicine, 4. https://doi.org/10.1177/2050312116670188
Eyolfson, K. (2019). Use of Sharesource in Remote Patient Management in Peritoneal Dialysis: A Canadian Nurse’s Perspective. Contributions to Nephrology, 197, 84 – 98. https://doi.org/10.1159/000496997
Farias, F. A. C. de, Dagostini, C. M., Bicca, Y. de A., Falavigna, V. F., & Falavigna, A. (2020). Remote Patient Monitoring: A Systematic Review. Telemedicine Journal and E-Health : The Official Journal of the American Telemedicine Association, 26(5), 576–583. https://doi.org/10.1089/tmj.2019.0066
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth Benefits and Barriers. The Journal for Nurse Practitioners : JNP, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013
García, M. A. M., Fernández Rosales, M. S., López Domínguez, E., Hernández Velázquez, Y., & Domínguez Isidro, S. (2018). Telemonitoring system for patients with chronic kidney disease undergoing peritoneal dialysis: Usability assessment based on a case study. PloS One, 13(11), e0206600. https://doi.org/10.1371/journal.pone.0206600
Gebhardt, A. T., & Mishra, A. (2019). Two-Way Patient Monitoring in PD: Technical Description of Sharesource. Contributions to Nephrology, 197, 17 – 27. https://doi.org/10.1159/000496314
Gultom, M., Widani, N. L., & Supardi, S. (2021). PENGARUH TELENURSING TERHADAP KUALITAS HIDUP PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) DI RS PGI CIKINI JAKARTA. Medika Respati : Jurnal Ilmiah Kesehatan, Vol 16, No 1 (2021), 1–12. https://medika.respati.ac.id/index.php/Medika/article/view/409/pdf
Gupta, R., Woo, K., & Yi, J. A. (2021). Epidemiology of end-stage kidney disease. Seminars in Vascular Surgery, 34(1), 71–78. https://doi.org/10.1053/j.semvascsurg.2021.02.010
Harrington, D. M., Myers, L., Karen, E., Bhise, V., Nayak, K. S., & Rosner, M. H. (2014). The use of a tablet computer platform to optimize the care of patients receiving peritoneal dialysis: A pilot study. Blood Purification, 37(4), 311 – 315. https://doi.org/10.1159/000365440
John, O., & Jha, V. (2019). Remote Patient Management in Peritoneal Dialysis: An Answer to an Unmet Clinical Need. Contributions to Nephrology, 197, 99 – 112. https://doi.org/10.1159/000496305
Jonny, Violetta, L., & Kusumaningrum, V. F. (2022). Peritoneal dialysis in Indonesia: Current status, challenges and prospects. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 42(4), 428–433. https://doi.org/10.1177/08968608211034985
Kidholm, K., Ekeland, A. G., Jensen, L. K., Rasmussen, J., Pedersen, C. D., Bowes, A., Flottorp, S. A., & Bech, M. (2012). A model for assessment of telemedicine applications: mast. International Journal of Technology Assessment in Health Care, 28(1), 44–51. https://doi.org/10.1017/S0266462311000638
Latif, S., Rana, R., Qadir, J., Ali, A., Imran, M. A., & Younis, M. S. (2017). Mobile Health in the Developing World: Review of Literature and Lessons From a Case Study. IEEE Access, 5, 11540–11556. https://doi.org/10.1109/ACCESS.2017.2710800
Lew, S. Q., Sikka, N., Thompson, C., & Magnus, M. (2019). Impact of remote biometric monitoring on cost and hospitalization outcomes in peritoneal dialysis. Journal of Telemedicine and Telecare, 25(10), 581 – 586. https://doi.org/10.1177/1357633X18784417
Magnus, M., Sikka, N., Cherian, T., & Lew, S. Q. (2017). Satisfaction and improvements in peritoneal dialysis outcomes associated with telehealth. Applied Clinical Informatics, 8(1), 214 – 225. https://doi.org/10.4338/ACI-2016-09-RA-0154
Makhija, D., Alscher, M. D., Becker, S., D’Alonzo, S., Mehrotra, R., Wong, L., McLeod, K., Danek, J., Gellens, M., Kudelka, T., Sloand, J. A., & Laplante, S. (2018). Remote monitoring of automated peritoneal dialysis patients: Assessing clinical and economic value. Telemedicine and E-Health, 24(4), 315 – 323. https://doi.org/10.1089/tmj.2017.0046
Manani, S. M., Baretta, M., Giuliani, A., Virzì, G. M., Martino, F., Crepaldi, C., & Ronco, C. (2020). Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life. Journal of Nephrology, 33(6), 1301–1308. https://doi.org/10.1007/s40620-020-00812-2
Manani, S. M., Crepaldi, C., Giuliani, A., Virzì, G. M., Garzotto, F., Riello, C., De Cal, M., Rosner, M. H., & Ronco, C. (2018). Remote Monitoring of Automated Peritoneal Dialysis Improves Personalization of Dialytic Prescription and Patient’s Independence. Blood Purification, 46(2), 111–117. https://doi.org/10.1159/000487703
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143. https://doi.org/10.1186/s12874-018-0611-x
Nerbass, F. B., Vodianitskaia, R. M., Ferreira, H. C., Sevignani, G., Vieira, M. A., & Calice-Silva, V. (2023). Increase in peritoneal dialysis-related hospitalization rates after telemedicine implementation during the COVID-19 pandemic. Nefrología (English Edition), 43(2), 239–244. https://doi.org/https://doi.org/10.1016/j.nefroe.2022.11.023
Novelia, E., Nugraha, R. R., & Thabrany, H. (2017). Cost effectiveness analysis between hemodialysis and peritoneal dialysis. Jurnal Ekonomi Kesehatan Indonesia, 1(3).
Nygård, H. T., Nguyen, L., & Berg, R. C. (2022). Effect of remote patient monitoring for patients with chronic kidney disease who perform dialysis at home: a systematic review. BMJ Open, 12(12). https://doi.org/10.1136/bmjopen-2022-061772
Polanco, E., Aquey, M., Collado, J., Campos, E., Guzman, J., Cuevas-Budhart, M. A., Divino-Filho, J. C., & Ramos-Sanchez, A. (2021). A COVID-19 pandemic-specific, structured care process for peritoneal dialysis patients facilitated by telemedicine: Therapy continuity, prevention, and complications management. Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy, 25(6), 970–978. https://doi.org/10.1111/1744-9987.13635
Rezaee, R., Moazzen, H., Ezzatzadegan, S., & Ahmadi Marzaleh, M. (2022). Mobile Health Could Be a Solution in Overcoming Challenges of Care in Patients Who Need Peritoneal Dialysis. Shiraz E-Medical Journal, 23(8), e121368. https://doi.org/10.5812/semj-121368
Rosner, M. H., Lew, S. Q., Conway, P., Ehrlich, J., Jarrin, R., Patel, U. D., Rheuban, K., Robey, R. B., Sikka, N., Wallace, E., Brophy, P., & Sloand, J. (2017). Perspectives from the Kidney Health Initiative on Advancing Technologies to Facilitate Remote Monitoring of Patient Self-Care in RRT. Clinical Journal of the American Society of Nephrology : CJASN, 12(11), 1900–1909. https://doi.org/10.2215/CJN.12781216
Sanabria, M., Buitrago, G., Lindholm, B., Vesga, J., Nilsson, L.-G., Yang, D., Bunch, A., & Rivera, A. (2019). Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 39(5), 472–478. https://doi.org/10.3747/pdi.2018.00287
Sanabria, M., Vesga, J., Lindholm, B., Rivera, A., & Rutherford, P. (2022). Time on Therapy of Automated Peritoneal Dialysis with and without Remote Patient Monitoring: A Cohort Study. International Journal of Nephrology, 2022, 8646775. https://doi.org/10.1155/2022/8646775
Shah, S. S., Safa, A., Johal, K., Obika, D., & Valentine, S. (2021). A prospective observational real world feasibility study assessing the role of app-based remote patient monitoring in reducing primary care clinician workload during the COVID pandemic. BMC Family Practice, 22(1), 248. https://doi.org/10.1186/s12875-021-01594-7
Sriyuktasuth Aurawamon, Chuengsaman, P., Kusakunniran, W., Khurat, A., & Rattana-umpa, N. (2023). Telehealth Service for Patients Receiving Continuous Ambulatory Peritoneal Dialysis: A Pilot Study. Siriraj Medical Journal, 75(1 SE-Original Article), 46–54. https://doi.org/10.33192/smj.v75i1.260529
Tabuti, N. I. M., Pellizzari, C., Carrascossi, H., Calice-Silva, V., Figueiredo, A., Moreno Gordon, G., Biangini, G., Rodrigues, M. E., Dias, D. B., da Silva, D. R., & De Moraes, T. P. (2022). Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study. Jornal Brasileiro de Nefrologia, 44(4), 473 – 481. https://doi.org/10.1590/2175-8239-JBN-2021-0113
Thilly, N., Chanliau, J., Frimat, L., Combe, C., Merville, P., Chauveau, P., Bataille, P., Azar, R., Laplaud, D., Noël, C., & Kessler, M. (2017). Cost-effectiveness of home telemonitoring in chronic kidney disease patients at different stages by a pragmatic randomized controlled trial (eNephro): rationale and study design. BMC Nephrology, 18(1), 126. https://doi.org/10.1186/s12882-017-0529-2
Thurlow, J. S., Joshi, M., Yan, G., Norris, K. C., Agodoa, L. Y., Yuan, C. M., & Nee, R. (2021). Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. American Journal of Nephrology, 52(2), 98–107. https://doi.org/10.1159/000514550
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Uchiyama, K., Morimoto, K., Washida, N., Kusahana, E., Nakayama, T., Itoh, T., Kasai, T., Wakino, S., & Itoh, H. (2022). Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial. International Urology and Nephrology, 54(10), 2673 – 2681. https://doi.org/10.1007/s11255-022-03178-5
WHO. (2016a). Framework for the Implementation of a Telemedicine Service. In Pan American Organization, World Health Organization (Issue May).
WHO. (2016b). Framework for the Implementation of a Telemedicine Service.
Wood, E., McCarthy, K., & Roper, M. (2019). Remote monitoring of peritoneal dialysis: evaluating the impact of the Claria Sharesource system. Journal of Kidney Care, 4(1), 16–24. https://doi.org/10.12968/jokc.2019.4.1.16
Yeter, H. H., Akcay, O. F., Ronco, C., & Derici, U. (2020). Automated Remote Monitoring for Peritoneal Dialysis and Its Impact on Blood Pressure. Cardiorenal Medicine, 10(3), 198–208. https://doi.org/10.1159/000506699
Yeter, H. H., Karacalik, C., Eraslan, E., Akcay, O. F., Derici, U., & Ronco, C. (2020). Effect of remote patient management in peritoneal dialysis on haemodynamic and volume control. Nephrology (Carlton, Vic.), 25(11), 856–864. https://doi.org/10.1111/nep.13751
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Gaviota Khalish, Sri Mulyani, Ika Setyasari, Dinar Nandini Mahardhika, Ayu Fitri Lestari
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
