Kidney Week

Abstract: FR-PO264

Evaluation of the Efficacy of CKD Support Decision-Making Application: How It Changes Home Blood Pressure and Kidney Functions

Session Information

• CKD: Clinical, Outcomes, Trials - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Kosaka, Shiho, Tokyo Medical and Dental University, Tokyo, Japan

Shiho Kosaka,

• Hoshino, Junichi, Toranomon Hospital, Tokyo, Japan

Junichi Hoshino,

• Ubara, Yoshifumi, Toranomon Hospital, Tokyo, Japan

Yoshifumi Ubara,

• Hamada, Masami, Nagoya university, Nagoya, Japan

Masami Hamada,

• Yamanouchi, Masayuki, Toranomon Hospital, Tokyo, Japan

Masayuki Yamanouchi,

• Sekine, Akinari, Toranomon Hospital, Tokyo, Japan

Akinari Sekine,

• Sumida, Keiichi, Nephrology Center, Toranomon Hospital Kajigaya, Kawasaki, KANAGAWA, Japan

Keiichi Sumida,

Background

Disease management in patients with chronic kidney disease (CKD) is complicated. Appropriate information provision and daily self-monitoring of parameters such as blood pressure are required. Therefore, this study aimed to evaluate how a chronic kidney disease support decision-making application (CKD-SDM) app in patients with CKD affects the blood pressure, kidney functions, and disease-management knowledge at home.

Methods

This study was a randomized, controlled trial involving 54 patients with stage 3, 4, or 5 non-dialysis CKD. The intervention group was provided with a tablet equipped with the CKD-SDM app. An automated sphygmomanometer for home blood pressure monitoring (HBPM) was used in both groups for 8 weeks. The primary outcome measure is change in HBPM data from baseline to 8 weeks. Secondary outcomes are changes in renal functions and self-management knowledge level on CKD.

Results

The mean (SD) age, eGFR, and HBPM (morning and evening) of participants were 70.7±11.0 years, 37.0±14.4 ml/min per 1.73 m², and 133.7±11.5/78.3±8.9 and 130.5±13.4/76.0±8.9 mmHg, respectively. No significant differences between groups were observed at baseline. After 8 weeks, HBPM reduction in both groups were -5.8/-1.5 vs. -3.1/-0.7 mmHg in the morning and -6.1/-3.3 vs. -4.0/-1.5 mmHg in the evening, with no significant differences between the two groups. In the female intervention group, the morning systolic blood pressure (SBP) difference significantly decreased, -7.7 vs. -2.6 mmHg (p<0.05). All kidney functions were not significantly different. Similarly, the self-management knowledge level on CKD was not significantly improved in the intervention group.

Conclusion

Eight weeks of intervention with CKD-SDM app did not reduce the overall HBPM, despite the improved SBP observed in the female intervention group. In the future, we have to plan larger and long-term studies to evaluate HBPM reduction and kidney functions in patients with CKD.
Trial Registration: This study is registered in the UMIN Clinical Trial Registry (000025792).

Funding

• Government Support - Non-U.S.