Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

Stauss, Madelena; Htay, Htay; Kooman, Jeroen P.; Lindsay, Thomas F.; Woywodt, Alexander

doi:10.3390/s23031361

Cited by 3 publications

(1 citation statement)

References 90 publications

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“…These devices use different techniques to assess BP levels, including pulse transit time, pulse wave analysis, photoplethysmography, and applanation tonometry [114] . Multiple or continuous BP measurements recorded for days, weeks, or months can be obtained from cuffless BP technologies within wearable devices and smartphones [115] . In CKD patients, these devices can provide detailed information including early detection of hypotensive episodes, thus avoiding complications such as falls and intradialytic complications in patients treated with home dialysis.…”

Section: Newer Technologies For Bp Measurement Monitoring and Predictionmentioning

confidence: 99%

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

Okpechi¹,

Ringrose²,

Padwal³

et al. 2023

Conn Health

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Hypertension is a major cause of cardiovascular disease worldwide and a major cause of morbidity and mortality in patients with chronic kidney disease (CKD). The Systolic Blood pressure Intervention Trial (SPRINT) demonstrated that blood pressure (BP) measurement techniques may have an impact on the achievement of outcomes. Home BP monitoring (HBPM) has several advantages over office BP recordings, including avoidance of white-coat reaction, ability to diagnose white-coat and masked hypertension, detection of BP variability, and better ability to predict cardiovascular morbidity and mortality, all of which commonly occur in CKD. The addition of telemonitoring and management support to HBPM allows remote monitoring, especially when close contact is difficult (e.g., patients in remote/rural areas, pandemic, natural disaster, or patients treated with home dialysis). Although there are few studies that have assessed the efficacy of home BP telemonitoring (HBPT) in patients with CKD, these studies suggest the benefits of HBPT for BP control and even limited evidence that it may improve kidney function. This review, using limited available evidence, assesses the roles of HBPT in patients with CKD, barriers to HBPT implementation in the care of patients with CKD, and discusses newer technologies that can be leveraged in the management of hypertension in patients with CKD.

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Section: Newer Technologies For Bp Measurement Monitoring and Predictionmentioning

confidence: 99%

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

Okpechi¹,

Ringrose²,

Padwal³

et al. 2023

Conn Health

View full text Add to dashboard Cite

show abstract

Ten tips to carry out video consultations in nephrology

Woywodt,

Payne,

Huuskes

et al. 2024

Clinical Kidney Journal

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Video consultations have seen increasing use in nephrology since the COVID-19 pandemic with an aim to address constraints in F2F outpatient capacity and also patients’ concerns around risks of infection when attending healthcare facilities. Nephrologists have learned through experience to use video consultations for providing routine follow up but also for ad-hoc triage of unwell patients. Advantages of video consultations include convenience, cost savings through avoiding clinic overheads, and reducing the carbon footprint of care. The latter is increasingly relevant as nephrologists consider climate change and its implications. Video consultations are not a panacea to overcome challenges in nephrology and risks also exist for example when it comes to redesigning pathways and maintaining access to F2F assessments when required. It is equally important to consider practical aspects such as reimbursement, prescribing, and documentation. Some clinicians may wish to carry out video consultations from home to save time spent in commute but this, too, requires careful thought. Another consideration is the digital divide and support should be provided for patients who are less IT literate or who have no access to the digital world. Patients with special needs such as those with visual or hearing impairment and those with language issues also require consideration. We view video consultations as a developing and growing part of the portfolio of renal care. We see their main role in providing routine follow up to stable and IT literate outpatients, particularly where there is provider continuity and where care is provided across a large geographical area.

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Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

Huang,

Wang,

Bai

et al. 2024

BMC Nephrol

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Background Physical inactivity is prevalent among individuals with chronic kidney disease (CKD) and is linked to unfavorable outcomes. In recent years, daily steps have emerged as a prominent target for interventions in clinical trials. The present study endeavors to scrutinize the effectiveness and/or efficacy of various interventions on daily steps in patients with full-spectrum CKD. Methods In December 2022, a systematic search was conducted across three databases, namely PubMed, Embase, and Web of Science, and subsequently updated in June 2023. The inclusion criteria included randomized controlled studies, quasi-experimental studies, and single-arm trials that assessed an intervention’s impact on objectively measured daily steps in patients with chronic kidney disease. The Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool was used to assess the risk of bias in non-randomized controlled trials (RCT), while the Cochrane revised tool (ROB-2) was utilized for RCTs. Results Seventeen studies were deemed eligible for inclusion in this review, with a focus on examining the efficacy and/or effectiveness of exercise training-based interventions (n = 10), daily step goal-oriented interventions (n = 4), mobile health (mHealth) interventions (n = 1), different dialysis modalities (n = 1), and a “Sit Less, Interact, Move More” intervention (n = 1). The studies exhibit variability in their characteristics and assessment tools, reflecting the findings’ heterogeneity. The results indicate that increasing physical activity levels remain challenging, as only a limited number of studies demonstrated significant improvements in participants’ daily step counts from baseline to endpoint. Conclusion Clinical trials with daily steps as an outcome are still lacking in the CKD population. Well-designed clinical trials that objectively assess the physical activity of CKD patients are needed.

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Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

Cited by 3 publications

References 90 publications

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

Telemonitoring in hypertension management for patients with chronic kidney disease: a narrative review

Ten tips to carry out video consultations in nephrology

Objectively measured daily steps as an outcome in a clinical trial of chronic kidney disease: a systematic review

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