Kidney Week

Abstract: TH-PO1076

CKD Progression with Remote Pulmonary Artery Pressure (PAP) Monitoring in Heart Failure (HF)

Session Information

• CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Gunasekaran, Deepthi, Yale University, New Haven, Connecticut, United States

Deepthi Gunasekaran,

• Ullman, Lawrence S., Yale University, New Haven, Connecticut, United States

Lawrence S. Ullman,

• Aklilu, Abinet Mathias, Yale University, New Haven, Connecticut, United States

Abinet Mathias Aklilu,

• Turner, Jeffrey M., Yale University, New Haven, Connecticut, United States

Jeffrey M. Turner,

Background

CardioMEMS HF system is FDA approved for remote monitoring of PAP in patients with NYHA class III HF to reduce HF hospitalizations. Subgroup analysis of the CHAMPION trial with CKD patients reported a mean estimated glomerular filtration rate (eGFR) change of 1.0±14.48 ml/min/1.73m² in 6 months in the CardioMEMs group and was similar in controls. Limited data is available on the role of remote PAP monitoring on kidney function in a real-world population that includes patients with advanced CKD over longer follow up.

Methods

This is a retrospective observational study where we included patients with CKD (eGFR <60 ml/min/m² for atleast 90 days as screened by a nephrologist) and HF who were managed with the CardioMEMs HF system. Patients on dialysis, kidney and heart transplant recipients were excluded. Baseline characteristics were collected at the time of CardioMEMs implant. Outcome characteristics were collected after 2 years. Primary outcome was a composite of >40% decline in GFR, need for dialysis or transplant, and death.

Results

Baseline characteristics are summarized in table 1. Of 42 patients, 73.8% had NYHA Class III HF, 71.4% were diabetic and 90.5% were hypertensive. 20 (47.6%) reached the primary composite outcome. 9 (21.4%) had >40% decline in eGFR, 4 (9.5%) required chronic dialysis and 10 (23.8%) died. While 18 (42.9%) patients developed progression of kidney disease, 17 (40.5%) patients had an improvement in their eGFR. Of those, 10 (23.8%) improved by more than 20%. The median change in eGFR at 2-yrs was +11.81% (16.88, 34.7). Median number of hospitalizations was 5.0 (3.0,7.0).

Conclusion

In this cohort of adults at high risk for renal progression at the time of cardioMEMs insertion, we observed an improvement in eGFR despite the expected renal progression. A larger study with a control group is warranted to better understand the impact of remote PAP monitoring on CKD progression.