Comparison of Remote Controlled Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis During COVID-19 Pandemic

Abstract

Objectives: We aimed to show the possible effect of the peritoneal dialysis (PD) modality on the mood and clinical outcomes of the patients during the first official quarantine period applied to control the Coronavirus disease-2019 (COVID-19) in Turkey. Materials and Methods: With the start of quarantine, in our center, we started doing the patient visits by phone. At the end of the quarantine, the patients were asked to complete a questionnaire in order to reveal whether they felt safe or alone, their anxiety status, and their preferred method of communicating with the team. In addition, volume status, biochemical parameters, blood pressure and medications in December 2019 were reviewed and compared with those in June 2020. Results: A total of 60 patients, 32 of whom were female, with a mean age of 53.4±16 years were included in the study. While there were 24 (40%) patients who underwent remote controlled outpatient peritoneal dialysis (RK-APD), there were 36 (60%) patients who underwent continuous APD (CAPD). According to the survey results, 15 (25%) patients did not experience any anxiety, while 45 patients stated that they had varying degrees of anxiety. 85% of the patients reported that they were very pleased that they could continue their dialysis treatment at home. While 69.4% of the patients who underwent CAPD were worried that they could not be followed as closely during the quarantine, 70.8% of the patients who underwent RK-APD stated that they felt safe because their treatment was monitored by the team through the system. While there was only an increase in the daily amount of ultrafiltration in RK-APD patients (December 2019 and June 2020; 1,365 vs 1,514 mL, p=0.026), no difference was observed in CAPD patients. CAPD patients tended to communicate with nurses more frequently. While these interviews were done frequently via WhatsApp messages in CAPD patients (20, 37% vs 5, 18.5%; p=0.008), they were in the form of audio phone calls (22, 81%) in APD patients. Conclusion: In conclusion, during the COVID-19 outbreak, maintaining dialysis with PD treatment at home, regardless of the modality, is a safe and effective method and has positive effects on patient satisfaction.

Keywords

• Continuous Ambulatory Peritoneal Dialysis
• Automated Peritoneal Dialysis
• COVID-19
• Telemedicine

COVID-19 Pandemisi Sırasında Uzaktan Kontrollü Aletli Periton Diyalizi ile Sürekli Ayaktan Periton Diyalizi Uygulayan Hastaların Karşılaştırılması

Abstract

Amaç: Koronavirüs hastalığı-2019 (COVID-19) salgınını kontrol altına almak için uygulanan ilk resmi karantina süresinden beri uygulanmakta olan periton diyalizi (PD) tedavi modalitesinin hastaların duygudurumuna ve tedavi üzerine etkisini göstermek amaçlanmıştır. Gereç ve Yöntem: Merkezimizde salgın sebebiyle karantina başlamasıyla birlikte poliklinik kontrolleri yerine telefon ile vizit yapılmaya başlandı. Karantina bitiminde hastaların tedavi şekillerinin, kendilerini güvende ya da yalnız hissetmelerine ve kaygı durumlarına etkisi yanında ekip ile iletişim tercihlerini ortaya koyup karantina başlangıcındaki durum ile kıyaslamak için hastalara bir anket uygulandı. Ayrıca, Aralık 2019’daki volüm durumu, biyokimyasal parametreler, kan basıncı ve ilaçları gözden geçirilerek Haziran 2020’deki durum ile kıyaslandı. Bulgular: Ortalama yaşları 53,4±16 olan 32’si kadın toplam 60 hasta çalışmaya dahil edildi. Uzaktan kontrollü ayaktan periton diyalizi (UK-APD) uygulanan 24 (%40) hasta var iken, sürekli APD (SAPD) uygulanan 36 (%60) hasta mevcuttu. Anket sonuçlarına göre, 15 (%25) hasta hiç kaygı yaşamazken 45 hasta değişen düzeylerde kaygılandıklarını belirtti. Hastaların %85’i diyaliz tedavilerini evde sürdürebildikleri için çok memnun olduklarını bildirdi. SAPD uygulanan hastaların %69,4’ü, karantina boyunca yakın takip edilemiyor oluşlarından kaygı duyarken, UK-APD uygulanan hastaların %70,8’i ekip tarafından sistem üzerinden tedavilerinin izleniyor oluşundan dolayı güvende hissettiklerini belirttiler. UK-APD hastalarında sadece günlük ultrafiltrasyon miktarında artış gözlenirken (Aralık 2019 ve Haziran 2020; 1.365 vs 1.514 mL, p=0,026), SAPD hastalarında fark gözlenmedi. SAPD hastalarının hemşireler ile daha fazla görüşme eğiliminde olduğu, bu görüşmelerin SAPD hastalarında sıklıkla WhatsApp mesajı (20, %37 vs 5, %18,5; p=0,008), APD hastalarında ise sesli telefon görüşmesi (22, %81) şeklinde olduğu görüldü. Sonuç: COVID-19 salgını süresince, modalitesi fark etmeksizin evde PD tedavisi ile diyalizi sürdürmek güvenilir ve etkin bir yöntem olup hasta memnuniyetine de olumlu etkileri mevcuttur.

Keywords

• Sürekli Ayaktan Periton Diyalizi
• Aletli Periton Diyalizi
• COVID-19
• Teletıp

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