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The introduction of remote monitoring during automated peritoneal dialysis offers the opportunity to explore actual events during treatment in a granular manner. The Baxter Claria APD device collects treatment data each night and transmits this to a central database (Sharesource). For Australian patients receiving peritoneal dialysis using, this data is linked with ANZDATA, the national dialysis and transplant registry. This allows integration and examination about actual treatments from Sharesource with the broader data within ANZDATA.
Data from Sharesource is probabilistically linked to ANZDATA on regular (monthly) basis. For those >=18 years who received APD using Sharesource over 2021 and 2022 in Australia, we examined the characteristics of alarms and treatments actually delivered. The relationship to patient characteristics and time was explored.
In all, 3348 people were included in this analysis, who received 1077885 treatments over this period (median 281 [IQR 114-516] per person). The median [IQR] total fill volume per treatment was 8.42 [IQR 7.3-10.0], and mean 9.03 [4.19-13.9] litres. The median number of cycles was 4.3 [IQR 3.9-5.0], and median total UF per treatment 574 [333-817] ml.
Across genders, the mean total fill but not UF was significantly higher for males vs females. The nightly total fill volume (Fig 1)
The linked data provides important insights into the actual events during APD. The changes in total fill volume and UF over time may reflect either an “incremental” approach to PD prescription, or a response to a loss of residual kidney function. The variation in alarm number and frequency between patients is substantial, and will have important consequences for the patients’ experience of APD. Work examining how these parameters relate to outcome is underway,