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Kidney Week

Abstract: SA-PO484

Smart Water Bottle Technology and Adherence to Fluid Prescription in ADPKD Patients

Session Information

  • ADPKD: Clinical Studies
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

  • 1001 Genetic Diseases of the Kidney: Cystic

Authors

  • Elue, Kendall I., University of Chicago, Chicago, Illinois, United States
  • Gwede, Michael, University of Chicago, Chicago, Illinois, United States
  • Madhwala, Amina, Touro College Of Osteopathic Medicine, Naperville, Illinois, United States
  • Kanabolo, Diboro L., University of Chicago, Chicago, Illinois, United States
  • McGill, Rita L., University of Chicago, Chicago, Illinois, United States
  • Zisman, Anna L., University of Chicago, Chicago, Illinois, United States
  • Chapman, Arlene B., University of Chicago, Chicago, Illinois, United States
Background

The Vasopressin (V) V2 receptor antagonist, Tolvaptan, slows cyst growth and loss of kidney function in autosomal dominant polycystic kidney disease (ADPKD). Water intake inhibits V secretion and may have similar benefits. Using smartphone technology, the water bottle (HidrateSpark© (SB)) reminds individuals to drink at specific times and documents volume and time of fluid intake. We sought to determine if SB and dietary recommendations (DR) improved fluid prescription adherence versus DR alone.

Methods

SB was tested to known volumes for accuracy and 24-hour urine volume (24UV) (mean % error= -3.69%, p=NS), precision (relative uncertainty=0.0035), limit of detection (15 mL), between bottle reproducibility (p=0.94), and inter and intra-operator reliability (0.005% variability, p=0.97; p=0.216) were calculated. Subjects were randomized to receive DR or DR/SB and prescribed a 20% increase in fluid intake from their most recent 24UV or 3 liters/day, whichever was greater. All subjects received DR at 6 weeks and completed 24UV at 6 and 12 weeks. DR and DR/SB groups were analyzed for significance utilizing chi-square analysis methods comparing the proportion that met fluid goals and a t-test comparing mean fluid intake.

Results

With 36 subjects enrolled, 15 DR and 15 DR/SB completed the study. Target fluid intake in DR and DR/SB were 3460.88±416.3 and 3661.5±752.5 mL (p=NS). At 6 weeks, 40 and 67% of DR and DR/SB subjects met fluid goals (p=0.143). At week 12, 40 and 80% of DR and DR/SB subjects met fluid goals (p<0.03). At 6 and 12 weeks, DR/SB fluid intake was greater than DR (p=0.026; p=0.006). DR/SB subjects used SB 88.25% and 80.5% of days between 0-6 and 6-12 wks. DR/SB patients met or exceeded their fluid prescription on 41% of days.

Conclusion

DR/SB subjects attained their fluid prescriptions more often than DR subjects. Additionally, DR/SB patients displayed greater adherence and fluid intake with longer use of the bottle. However, day-to-day adherence was less than ideal. This indicates that use of a smart water bottle increases hydration, provides the potential for ongoing feedback, and can potentially lead to sustained behavioral change in ADPKD patients.