Body Weight Telemetry Is Useful to Reduce Interdialytic Weight Gain in Patients with End-Stage Renal Failure on Hemodialysis

Abstract

Lacking compliance with liquid intake restrictions is one of the major problems in patients on hemodialysis and causes an increased mortality. In 120 patients on hemodialysis with an average interdialytic weight gain (IWG) exceeding 1.5 kg on at least 2 days during the 4 weeks preceding the intervention, the effect of telemetric body weight measurement (TBWM) on IWG, ultrafiltration rate, and blood pressure was evaluated over a period of 3 months. Patients of the telemetric group (TG) were supplied with automatic scales, which transferred the weight via telemetry on a daily basis. In the case of IWG of more than 0.75 kg/24 h, a telephonic contact was made as required, and in the case of an IWG of more than 1.5 kg, telephonic contacting was obligatory along with the advice of a liquid intake restriction to 0.5 L/day until the next dialysis. The patients of the control group (CG) received standard treatment without telemetric monitoring. We examined specific data of the second interdialytic interval (IDI2) and the average within 1 week. The average difference of IWG between TG and CG was not significant before the start of the study but 0.2 kg (p=0.027) (IDI2)/0.27kg (p=0.001) (WP) at the end of the study, respectively. The average difference in the ultrafiltration rate within 1 week was 19.0 mL/h (p=0.282) (IDI2)/8.2 mL/h (p=0.409) before the start of the study but 28.4 mL/h (p=0.122) (IDI2)/30.9 mL/h (p=0.004) at the end of the study, respectively. Thus, TBWM is a feasible method for optimizing the IWG and reducing the ultrafiltration rate. AbstractLacking compliance with liquid intake restrictions is one of the major problems in patients on hemodialysis and causes an increased mortality. In 120 patients on hemodialysis with an average interdialytic weight gain (IWG) exceeding 1.5 kg on at least 2 days during the 4 weeks preceding the intervention, the effect of telemetric body weight measurement (TBWM) on IWG, ultrafiltration rate, and blood pressure was evaluated over a period of 3 months. Patients of the telemetric group (TG) were supplied with automatic scales, which transferred the weight via telemetry on a daily basis. In the case of IWG of more than 0.75 kg/24 h, a telephonic contact was made as required, and in the case of an IWG of more than 1.5 kg, telephonic contacting was obligatory along with the advice of a liquid intake restriction to 0.5 L/day until the next dialysis. The patients of the control group (CG) received standard treatment without telemetric monitoring. We examined specific data of the second interdialytic interval (IDI2) and the average within 1 week. The average difference of IWG between TG and CG was not significant before the start of the study but 0.2 kg (p = 0.027) (IDI2)/0.27kg (p = 0.001) (WP) at the end of the study, respectively. The average difference in the ultrafiltration rate within 1 week was 19.0 mL/h (p = 0.282) (IDI2)/ 8.2 mL/h (p = 0.409) before the start of the study but 28.4 mL/h (p = 0.122) (IDI2)/30.9 mL/h (p = 0.004) at the end of the study, ...

Information Technology-based Interventions for Health Care Support in Patients with Chronic Kidney Disease: A Systematic Review

“…This study reviewed the 13 selected articles from various countries. Overall, 12 out of the 13 studies (92%) indicated that using technology-based interventions was effective at supporting health care in CKD patients (An, 2011;Blakeman et al, 2014;Cicolini et al, 2014;Cottrell, Chambers, & Connell, 2012;Cueto-Manzano et al, 2015;Gordon et al, 2016;McGillicuddy et al, 2013;Neumann et al, 2013;Ogna et al, 2014;Ong et al, 2016;Rifkin et al, 2013;Welch et al, 2013). This review contained several studies on chronic kidney disease: stage 3-4 chronic kidney disease (Cottrell et al, 2012), kidney transplant (Cueto-Manzano et al, 2015;McGillicuddy et al, 2013) and patients undergoing hemodialysis (Ogna et al, 2014;Welch et al, 2013).…”

“…The number of samples varied between 20-436 respondents. This systematic review included several study designs including RCTs (Blakeman et al, 2014;Gordon et al, 2016;McGillicuddy et al, 2013;Neumann et al, 2013;Ogna et al, 2014;Rifkin et al, 2013;Sevick et al, 2015), experimental queries (An, 2011;Cottrell et al, 2012) and pilot studies (Cueto-Manzano et al, 2015;Welch et al, 2013) which are intended to get a broad picture of the coverage of IT-based interventions. Some of the information technology-based interventions used in this study included smartphone/PDA, computers and internet/web (Cueto-Manzano et al, 2015;McGillicuddy et al, 2013;Ong et al, 2016;Sevick et al, 2015;Welch et al, 2013).…”

“…Overall, 12 out of the 13 studies showed that the use of information technology-based interventions was effective at improving self-health management in patients with chronic kidney disease as indicated by the positive results in the clinical, compliance and knowledge values (An, 2011;Blakeman et al, 2014;Cicolini et al, 2014;Cottrell et al, 2012;Cueto-Manzano et al, 2015;Gordon et al, 2016;McGillicuddy et al, 2013;Neumann et al, 2013;Ogna et al, 2014;Ong et al, 2016;Rifkin et al, 2013;Welch et al, 2013) . The study (3 out of 10) used telematics devices as interventions (Neumann et al, 2013;Ogna et al, 2014;Rifkin et al, 2013), four studies used PDAs and smartphone technology (applications/software/ SMS) (Cueto-Manzano et al, 2015;Neumann et al, 2013;Ong et al, 2016;Sevick et al, 2015;Welch et al, 2013), two studies used interactive messaging services (Cottrell et al, 2012), 1 study used a combination of smartphones with electronic devices (McGillicuddy et al, 2013), and 1 study used the web and e-mail (An, 2011;Blakeman et al, 2014;Gordon et al, 2016). Most studies reported high values of satisfaction and acceptance of the interventions, as well as effective results related to managing patient health.…”

Interventional Decentralized Telemonitoring: Bridging the Gap Between Patient's Device and Physician's Needs in Well Selected Indications

“…Wednesday to Friday) as well as the average weekly IWG were significantly reduced as compared to controls. Required ultrafiltration rate and systolic blood pressure at the start of dialysis were reduced, while there was a tendency of a rise in diastolic blood pressure after 3 months of TBPM [44].…”

An Open Platform for Seamless Sensor Support in Healthcare for the Internet of Things

“…There has been research focused on monitoring and controlling medical conditions such as high blood pressure [8,9,10], diabetes [11,12], weight loss [13,14] and Chronic Obstructive Pulmonary Disease (COPD) [15,16,17]. Using new Information and Communication Technologies (ICT) in healthcare scenarios, such as wearable sensors, mobile devices and cloud computing, provides an opportunity for continuously monitoring health behaviors, which allows building a story around a person.…”