Abstract: SA-PO472
Association of Connected Cycler Use with Rate of Transition from Peritoneal Dialysis to In-Center Hemodialysis
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hurtado, Miranda, DaVita Inc, Denver, Colorado, United States
- Zywno, Meredith L., DaVita Inc, Denver, Colorado, United States
- Weinhandl, Eric D., Davita Clinical Research, Minneapolis, Minnesota, United States
- Naljayan, Mihran V., DaVita Inc, Denver, Colorado, United States
Background
Attrition from home dialysis is an ongoing challenge, sometimes attributable to the difficulty of assessing prescription adherence in real time. With increasing use of remote monitoring platforms, we aimed to assess whether the use of an internet-connected automatic peritoneal dialysis cycler (CC), which transmits treatment data to the dialysis provider on a daily basis, was associated with lower rate of transition to in-center hemodialysis (ICHD).
Methods
The study population included all peritoneal dialysis (PD) patients who began treatment in a large dialysis provider organization between July 2021 and December 2022 and initiated use of a CC [Homechoice Claria or Amia, Baxter International] within 30 days of first documented treatment. Patient data were obtained from electronic medical records and initiation of CC was ascertained from electronic treatment records. Matched pairs of CC PD patients and non-CC PD patients were constructed, based on clinical and demographic factors, to address measurable confounding. Patients were followed from 30 days after PD initiation until the earliest of transition to ICHD, death, kidney transplant, or end of study follow-up. Kaplan-Meier estimation and Cox regression were used to compare technique survival in CC and non-CC patients; death and transplantation were classified as censoring events.
Results
The study cohort included 5,308 pairs of CC and non-CC PD patients. Mean age was 60.5 years, and 41% of patients were female. Among CC patients, 5% experienced transition to ICHD after 90 days, compared to 10% of non-CC patients. After 360 days, 18% of CC patients experienced transition to ICHD, compared to 25% of non-CC patients. CC patients had a 16% lower rate of transition to ICHD, compared to non-CC patients (HR: 0.84, 95% CI: 0.78, 0.91).
Conclusion
The use of a CC for peritoneal dialysis was associated with a significantly lower risk of transition to ICHD. Broader use of this technology may facilitate improvement in retention of patients undergoing PD.