Abstract: FR-PO112
Development and Feasibility of a Remote Patient Monitoring Program for AKI Survivors
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Charkviani, Mariam, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Ferguson, Jennifer A., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Kashani, Kianoush, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Mara, Kristin C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- May, Heather P., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Philpot, Lindsey M., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Reddy, Swetha, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Rosedahl, Jordan K., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Barreto, Erin F., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
One-third of acute kidney injury (AKI) survivors lack appropriate follow-up after hospital discharge. Remote patient monitoring (RPM) may improve post-discharge care quality. We report an AKI RPM program's development and preliminary feasibility.
Methods
Mayo Clinic launched an AKI RPM program in October 2021 for individuals who experienced AKI with a nephrology consultation during a hospitalization. Once enrolled, patients were discharged with RPM technology (e.g., blood pressure cuff, scale), and vital signs and symptoms were monitored daily. In-center laboratory assessments were scheduled weekly. RPM nurses evaluated the data daily and adhered to prespecified protocols for alerts and care escalation management. Patients were followed for up to three months. Individuals graduated from the AKI RPM program if they remained dialysis independent, with a stable creatinine for 2 consecutive weeks, and no urgent or emergent results in the prior week. Feasibility was defined as the proportion of enrolled patients who submitted at least one set of vitals or symptom data after program initiation.
Results
Of the 50 people approached, 41 (82.0%) were enrolled in RPM. The median (IQR) baseline eGFR was 37 (28, 60) mL/min/1.73m2, and 83% experienced stage 3 AKI. The length of time in the program was 31 (28, 38) days. Eight (20%) patients were lost to follow-up or withdrew. Thirty (73%) individuals had at least 1 RPM alert, most for weight gain or edema. Six emergency department referrals were made for AKI RPM patients. Among the 33 patients who graduated from the AKI RPM program, 25 (76.0%) were referred to nephrology for evidence of chronic kidney disease. 17 (68%) of those individuals completed a nephrology visit within 90 days of program graduation.
Conclusion
The AKI RPM workflow was feasible and addressed a vital gap for AKI care after discharge. Digital health solutions such as RPM offer a unique opportunity to bridge the care transition from hospital to home, increase access to quality care for the most vulnerable AKI survivors, and direct the attention of nephrologists to patients most likely to benefit from specialty consultation.