Clinical utility of remote monitoring–derived cycle waveform interpretation for troubleshooting automated peritoneal dialysis: a three-case report

Background: Remote patient monitoring (RPM) is being increasingly used in automated peritoneal dialysis (APD). However, most studies have focused on summary parameters such as ultrafiltration volume and treatment completion, and the clinical utility of cycle waveform interpretation remains underexplored. Case presentation: We report three APD cases in which RPM-enabled cycle waveform monitoring guided clinical decision-making. In Case 1, prolonged drainage and infusion suggested mechanical obstruction, later confirmed as fallopian tube entrapment. In Case 2, repeated drainage delays indicated catheter malposition. In Case 3, shortened treatment duration reflected intentional early discontinuation. In all cases, targeted surgical or behavioral interventions resulted in immediate waveform normalization. The present case series provided the following key insights: (1) cycle profiles serve as sensitive, real-time indicators of dysfunction and recovery, and (2) RPM supports not only technical troubleshooting but also behavioral modification. These findings extended the current literature by showing that a detailed waveform analysis can provide objective evidence of intervention efficacy. Conclusion: RPM-derived waveform interpretation is a practical, actionable tool for troubleshooting APD and optimizing patient care.