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

Background: 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. Funding: Government Support – Non-U.S.