#838 Development of a support system for patients on dialysis: functionality for assisting dietary therapy

Abstract Background and Aims Patients on hemodialysis are required to self-manage aspects of daily life, such as vital signs, dialysis information, and dietary intake. However, the burden of such self-management often results in nonadherence. Recent studies have emphasized the need for comprehensive kidney rehabilitation (“kidney rehab”) to mitigate the physical and psychological impacts of kidney disease, improve symptoms, and enhance life expectancy. This long-term program includes exercise therapy, dietary and fluid management, medication management, education, and psychological support, with dietary therapy serving as a core component. Dietary therapy has been shown to significantly improve the quality of life (QOL) of patients on dialysis. Despite its importance, the long-term nature of kidney rehab poses challenges to consistent adherence. Previously, we developed a regional support system for patients on dialysis that promotes the implementation and continuation of exercise therapy (see “Development of a Support System for Patients on Dialysis: Examining the Implementation and Continuation of Exercise Therapy”). Building on this system, we have now added functionality to support dietary therapy, a key element of kidney rehab. Method Figure 1 shows an example of the patient-side system display. The support system allows patients to record key dialysis-related data: Daily record: start time of dialysis, dialysate/plasma ratio, drainage volume, infusion volume, water removal volume, drainage time, drainage volume, blood pressure, and blood glucose. Drainage color check: patients can upload photos of their drainage packs. Vital signs: a button is provided for inputting daily vital signs data. Data entry is facilitated through automated input or dropdown menus to reduce errors. A Notifications section allows patients and healthcare providers to send and receive messages, ensuring efficient communication. In addition, the system integrates dietary information, enabling patients to input their meals as text or upload photos of their meals. The system automatically registers timestamps for all records. Results A trial of the enhanced support system featuring dietary therapy functionality was conducted with simulated patients on dialysis. Figure 2 shows an example of the institution-side display. Daily record: patients could log dialysis details using a dropdown menu or by selecting file uploads to avoid input errors. Input fields allowed for dialysis-related data and photos of dialysis sites to be recorded. Automated timestamps were implemented. Dietary records: patients could document their meals via text or by uploading photos. These entries were timestamped automatically, ensuring chronological accuracy. Healthcare provider access: as shown in Fig. 2, healthcare providers could review patient data, including dietary records, by selecting individual patients within the system. Notifications: The notifications section facilitated bidirectional messaging between patients and providers. New notifications were highlighted using banners for visibility. Conclusion The developed support system, designed to assist patients on dialysis, now includes functionality to support dietary therapy based on the principles of kidney rehab. This enhancement enables the sharing of dietary and dialysis records between patients and healthcare providers, aiding in better monitoring of patients’ conditions. Consequently, patients can share their dietary data consistently, regardless of dialysis days. Healthcare providers can provide timely advice on dietary habits through the Notifications feature, improving adherence to dietary therapy. This system offers a promising solution for overcoming the challenges of long-term dietary therapy adherence. This research was supported in part by Gakushin Kaken (JP20H03982).