Chronic kidney disease on the rise

Innovative system that improves the quality of life of patients as well as effectiveness of treatment available in Slovenia

The 14th European Peritoneal Dialysis Meeting took place in Ljubljana between 3 and 5 May 2019. Peritoneal dialysis is a form of a replacement therapy for end-stage renal disease caused by chronic kidney disease, which is increasing in the world as well as in Slovenia. It is estimated that every 10th adult is suffering from it, which means about 200,000 people in Slovenia. The international meeting will present professional findings and progress that include Baxter’s automated peritoneal dialysis system with the option of remotely monitoring and managing home therapy sessions. This innovative system improves the effectiveness of therapy and quality of patients’ life and is already successfully used in the Maribor University Medical Centre and the Slovenj Gradec General Hospital.

The end-stage renal disease is a condition where the kidneys don’t work or their function is minimal, and a replacement therapy with dialysis or transplantation is necessary for patient’s survival. In addition tohaemodialysis, patients can opt for peritoneal dialysis (PD), which allows greater autonomy and flexibility as it is performed in home care. There are two types of PD, namely the continuous ambulatory peritoneal dialysis (CAPD), which is repeatedly performed manually throughout the day by the patient, and the automated peritoneal dialysis (APD), which is carried out at night by a device while the patient is sleeping.

“Peritoneal dialysis is suitable for almost all kidney failure patients, especially for the young active patients and represents a bridge to kidney transplantation, because they don’t need to attend haemodialysis in a dialysis centre three times a week; plus for the elderly patients who are poorly mobile and have difficulties in tolerating haemodialysis or driving to a dialysis centre. Peritoneal dialysis is comparable to haemodialysis regarding surviving, but in some segments has certain advantages: longer remaining kidney function, better control fluids in the body, better regulated blood pressure, lower risk of viral infections and greater quality of life due to home treatment,” says assoc. prof. Damjan Kovač, M.D., Ph.D., President of the Slovenian Medical Association Slovenian Society of Nephrology.

Despite all the benefits, the proportion of patients treated with peritoneal dialysis in Europe is relatively low and accounts for only about 12% of all patients on dialysis treatment. At present, only about 6% of dialysis patients are treated with peritoneal dialysis in Slovenia, which is a half below the European average and far below the average of certain developed countries where peritoneal dialysis is well represented, such as Denmark (21%), New Zealand (32 %) or Canada (16%).

Baxter’s innovative APD system

Automated peritoneal dialysis can further improve the quality of life of patients as they can fully focus on their other activities during the day. Baxter’s innovative APD HOMECHIOCE CLARIAsystem with a two-way web platform called Sharesourcebrings even better treatment options. The platform enables healthcare professionals to directly access the gathered data on the performed therapy in real timeand, if necessary, to customize the dialysis program with a remote managementor eliminate any minor irregularities before they become severe. This kind of data management and monitoring ensures that the overall treatment and patient satisfactionis improved, while the number of unplanned patient visits and hospitalization is reduced.

“The advantage of using this system is telemedicine, as I can check online anytime and anywhere to see how my patient’s treatment is proceeding. In case of any problems with peritoneal dialysis, the patient in most cases doesn’t need to visit the Maribor University Medical Centre, as I can adapt the treatment remotely through the Sharesource program to suit each patient individually. It is a completely individual treatment approach,” is a description of the advantages of Baxter’s system by assoc. prof. Robert Ekart, MD, Ph.D., specialist internist, head of the Department of Dialysis at the Maribor University Medical Centre, where this innovative dialysis system has been used since July 2018, and the experience shows that most patients are very satisfied with this type of treatment.

Some of the benefits of using HOMECHOICE CLARIA with the Sharesource web-based platform:

  1. Reduced number of visits at the clinic:Doctors can devote most of their time to a proactive patient care and remote therapy management, resulting in a reduced number of unplanned patient visits at the clinic.
  2. Improved patient satisfaction and treatment success:The risk and fear of possible complications during home-based dialysis are reduced as health professionals regularly monitor the course of therapies. This improves both the patient’s satisfaction and the success of therapy, since it is possible to detect potential irregularities and eliminate them already in the initial phase.
  3. Less bureaucracy:Homechoice Claria with the Sharesource web-based platform has simplified the work of health professionals and reduced the number of their administrative tasks.
  4. Simplified logistics:Doctors have direct access to the recorded data and can thus monitor them more often. Also, the insight into the data is no longer dependent on the patient’s visit.
  5. Reduction of therapy abandonment: The trends indicate that in patients using APD with the SHARESOURCE web-based platform, the treatment abandonment is lower than in patients using non-remote management systems.

Reducing the number of hospitalizations:The trends indicate that in patients using APD with the SHARESOURCE web-based platform, the number of hospitalizations is lower than in patients using non-remote management systems.

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