We investigated the feasibility and effectiveness of a telemedicine system for monitoring pediatric patients undergoing automated peritoneal dialysis (APD) at home. The system uses modem-based communication between the patient's cycler and a computer in the dialysis unit, which allows data transmission and storage, and live patient-physician interaction by ISDN lines, modem, microphone with stereo speakers, and digital cameras for private video-conferencing and image capture. Two children aged 10 and 12 years, who live 1500 and 40 km from the dialysis unit, respectively, have been using the system for 7 months. All of the APD treatment data were stored and examined; 122 televisits were performed. The APD data show that both patients have complied with their dialysis prescription. The telemedicine system broadens patient/physician interchange and increases the quality of care and the life of children on peritoneal dialysis.