Benefits and Challenges of Telemedicine Utilization in PD Management in Low-Resource Settings

Peritoneal dialysis (PD) is a cost-effective and home-based kidney replacement therapy, particularly relevant in low- and middle-income countries (LMICs). However, outcomes remain suboptimal due to limited access to specialized care, delayed complication detection, and workforce constraints. Telemedicine has emerged as a potential strategy to address these challenges.

This integrative narrative review aimed to synthesize current evidence on telemedicine interventions in PD management, focusing on clinical effectiveness, implementation strategies, and applicability in resource-limited settings. A structured literature search was conducted in PubMed, Scopus, and Google Scholar for studies published between 2010 and 2025. Eligible studies included observational studies, clinical trials, and implementation reports evaluating telemedicine modalities such as remote patient monitoring (RPM), mobile health (mHealth), teleconsultation, and tele-education in PD populations.The evidence indicates that RPM-enabled automated PD is associated with significant reductions in all-cause mortality, cardiovascular events, hospitalization rates, and technique failure. Additional benefits include improved treatment adherence, enhanced fluid management, and earlier detection of complications. Cost-related data suggest reductions in healthcare utilization (direct costs) and patient-related burden such as travel and productivity loss (indirect costs), although formal economic evaluations remain limited. Implementation in LMICs is feasible but requires adaptation to local infrastructure, digital literacy, and health system capacity.

Telemedicine-supported PD, particularly RPM, is associated with consistent clinical benefits and improved care delivery. Successful implementation in low-resource settings depends on user-centered design, workforce training, sustainable financing models, and supportive regulatory frameworks.