The Effect of a Novel Follow-up Mode Integrating Specialist Nurse-Led Care and an Intelligent Platform on Peritoneal Dialysis Patients.

Purpose: To evaluate the effect of a novel follow-up mode integrating specialist nurse-led care and an intelligent platform on fluid volume management in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD). Patients and Methods: A pre- and post-observational clinical cohort of 80 PD patients (Shanghai General Hospital South, Mar 2020-Mar 2021) evaluated the 12-month impact of the novel mode on fluid volume overload (FVL), cardiac function, laboratory indicators (including biochemical parameters and electrolytes), and clinically relevant complications (peritonitis, exit-site/tunnel infection and catheter displacement). Results: After 12 months of follow-up using the novel mode, significant improvements were observed compared to the traditional follow-up approach. Specifically, levels of B-type natriuretic peptide (BNP) (144.12±14.21 vs 631.01±104.21 pg/mL, P < 0.001), systolic blood pressure (SBP) (136.99±12.04 vs 145.34±15.22 mmHg, P < 0.001), and diastolic blood pressure (DBP) (79.03±6.35 vs 84.87±8.17 mmHg, P < 0.01) were significantly lower in patients managed with the novel mode. Additionally, blood calcium (2.24±0.52 vs 2.18±0.02 pg/mL, P < 0.05), phosphorus (1.96±0.07 vs 1.80±0.06 mmol/L, P < 0.01), parathyroid hormone (PTH) (409.28±43.49 vs 250.84±23.26 pg/mL, P < 0.001), and albumin (38.89±0.60 vs 36.25±0.51 pg/mL, P < 0.001) levels were higher following implementation of the novel mode. FVL and cardiac function also showed significant improvement over the 12-months follow-up period. Notably, compared with the preceding 12-month control period, the platform-based follow-up reduced clinically relevant infectious complications from 10.3% to 3.8% (McNemar mid-p = 0.077). Conclusion: The novel follow-up mode effectively reduced fluid volume overload and improved cardiac function, offering clinical benefits for PD patients.