Beneficial Impact of Troubleshooting via Telephonic Communications on Clinical Outcomes of Patients with ESKD on Peritoneal Dialysis: A 52-Week Experience from Saudi Arabia

Background: Peritoneal dialysis (PD) is one of the Home dialysis modalities that aides the patient to enjoy the comfort of home while getting the required kidney replacement therapy. However it can be associated with clinical and technical situations that can arise at any time and need assistance. An effective communications between patients and PD nursing staff is essential to achieve treatment goals. The objective of our study is to analyze the beneficial impact of telephonic communication between patients and PD nursing staff on clinical outcomes. Methods: A retrospective cohort study involving 61 adult patients receiving PD in KFSHRC Jeddah, from 1stst April 2024 till 31st march 2025. We reviewed the frequency of telephonic communications; nature of reported problems; its troubleshooting by the PD nursing staff; and its impact on outcomes including; continuity of PD therapy; hospital presentations for PD equipment malfunction; early detection and treatment of PD peritonitis; escalating PD physician appointments; and timely EMS presentations. Results: Among 61 patients (37 males [60.7%], 24 females [39.3%]), the mean age was 52.1 ± 8.4 years. Patients engaged in 968 telephonic communications; 620 (64.1%) occurring after hours and 348 (35.9%) during working hours; 621 interactions (64.2%) via text and 347 (35.8%) via phone calls. The most common reason for communication was PD equipment supply or malfunction (457 ; 47.1%), followed by clinical complaints (227; 23.4%), lab reviews and medication refills (130; 13.4%). These communications resulted in continuity of PD therapy (91%) without interruption, an 86% reduction in hospital presentations PD-associated equipment malfunction, early detection and treatment of peritonitis (83%). There was escalation of PD physician appointment by 18 ± 3.1 days (p < 0.05) and a reduction in delay in EMS presentation by 6.4 ± 2.8 hours (p < 0.05). Conclusion: Telephonic communication in PD unit can lead to successful continuity of PD therapy. It ensures timely initiation of required medical therapies; escalation of medical care by expediting early physician review and EMS presentation as needed. This translates into improved clinical outcomes; judicious and timely EMS and hospital visits; and effective resource management.