Remote monitoring after hospital discharge may reduce AKI complications, not readmissions
Click Here to Manage Email Alerts
Key takeaways:
- Results showed 73% of patients had one AKI remote monitoring alert.
- Most remote alerts were related to fluid status.
AKI remote patient monitoring after hospital discharge can help manage kidney health complications, data show, but the practice may not lower the risk of hospital return.
“Despite the increased risk of complications after an AKI event, recent evidence suggested that 30% of AKI survivors lacked appropriate follow-up after hospital discharge, which has been linked to poor outcomes,” Mariam Charkviani, MD, a nephologist at the Mayo Clinic division of nephrology and hypertension in Rochester, Minnesota, wrote with colleagues. “Without monitoring, AKI survivors could experience cardiac and pulmonary edema due to incomplete AKI recovery or intravascular volume depletion due to the use of high-dose diuretics or post-AKI polyuria,” as well as other potential life-threatening abnormalities.
Researchers evaluated 40 patients on remote monitoring after discharge who were initially hospitalized at the Rochester-based Mayo Clinic with AKI and not on home dialysis following their hospital stay. The 13-month program used a multidisciplinary approach that included home vital sign and symptom tracking and weekly in-center lab assessments.
Matching patients in a 1:3 ratio to historical controls, researchers aimed to find the risk of unplanned hospital readmission or ED visits within 6 months.
Results showed 73% of patients had one AKI remote monitoring alert, most of which were related to fluid status. Of patients with stage 3 AKI, the risk of unplanned readmission or ED visit within 6 months post-discharge was similar compared with controls.
Charkviani and colleagues also found that the risk of an ED visit without hospitalization was significantly higher in the AKI remote monitoring group (HR = 1.95; 95% CI, 1.05-3.62).
Unplanned readmission or ED visit risk was higher for patients with a baseline eGFR below 45 mL/min/1.73 m2 who had remote monitoring (HR = 2.24; 95% CI, 1.19-4.20) vs. those with a baseline eGFR of at least 45 mL/min/1.73 m2 (HR = 0.69; 95% CI, 0.29-1.67).
“Based on these data, advocating for routine AKI remote patient monitoring program participation for AKI survivors would be premature,” the researchers wrote.
“Continued exploration of digital health tools is needed to understand their impact on patient outcomes and to identify specific subgroups of AKI survivors who may benefit the most from this resource,” they added.
Collapse
Read more about
Click Here to Manage Email Alerts