Improvement of Blood Pressure, Anemia, and CKD-MBD Management in Peritoneal Dialysis Patients: Insights from the Smart Peritoneal Dialysis Care Program (SPDC) at a Single Center

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Improvement of Blood Pressure, Anemia, and CKD-MBD Management in Peritoneal Dialysis Patients: Insights from the Smart Peritoneal Dialysis Care Program (SPDC) at a Single Center

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Co-author 1

Yilin Zeng 498104587@qq.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 2

Hongyu Li lihongyu@gdph.org.cn Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China *

Co-author 3

Zongpei Jiang 2459243548@qq.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 4

Li Fan lfan6262@163.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 5

Lili Deng 491423309@qq.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 6

Jia Deng 1019495263@qq.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 7

Jinlian Jian jane_jinlian@163.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 8

Huaban Liang banba608@163.com Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 9

Zhiming Ye yezhiming@gdph.org.cn Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Department of Nephrology, Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases Guangzhou China -

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

A patient-centered follow-up system is crucial for maintain physiologic homeostasis undergoing peritoneal dialysis (PD). This study evaluates the Smart PD Care (SPDC) program—a novel digital follow-up strategy integrating cloud-based remote monitoring, multidisciplinary team engagement, and patient collaboration—by comparing laboratory and clinical outcomes before and after its implementation.

Methods

In this single-center, pre-post retrospective cohort study, 125 PD patients at Guangdong Provincial People’s Hospital were enrolled from March 2021 to July 2024. We assessed changes in blood pressure, anemia, calcium, phosphate and iPTH levels, alongside medication usage, following SPDC initiation. Statistical analysis (t-tests, chi-square) compared pre-SPDC baseline data with post-SPDC outcomes.

Results

Post-SPDC, systolic blood pressure decreased from 141.1 ± 18.4 mmHg to 134.3 ± 16.0 mmHg (P < 0.05), with 65% attaining target SBP (<140 mmHg) versus 51% pre-SPDC, alongside increased antihypertensive use. Hemoglobin (Hb ≥110 g/L) improved from 38% to 53% (P < 0.05), linked to expanded roxadustat use and reduced erythropoiesis-stimulating agent reliance. Calcium, phosphate, and iPTH levels remained stable (pre- vs. post-SPDC: 65% vs. 61%, 60% vs. 53%, 53% vs. 55%, respectively; P < 0.05), reflecting optimized mineral metabolism management via sevelamer, calcimimetics, and low-calcium dialysate.

Conclusion

The SPDC program improved anemia management, and metabolic outcomes in PD patients through structured remote monitoring and multidisciplinary care. Its success highlights the potential of digital health integration to enhance home-based dialysis management, particularly in resource-limited settings.

Kewords