Potassium monitoring device ups QoL in dialysis patients

Using a real-time potassium monitoring device saves money and improves quality of life (QoL) in haemodialysis patients in a study presented at Kidney Week 2022.

The monthly break-even cost per patient in the base case scenario was $689.56. Hyperkalaemic events were also reduced with the use of the device in this population.

Potassium levels rise between dialysis treatments. One approach to managing hyperkalaemia in these patients is monitoring and restricting dietary intake of potassium.

“The takeaway message is, if we were to implement this continuous potassium monitoring device, if we were to avoid 10 –15 percent of all the hyperkalaemic events in this population, this scenario would be both less expensive for the system and individuals would live longer quality-adjusted life-years,” said presenting author Dr Ryan Bamforth from the Seven Oaks Hospital Chronic Disease Innovation Centre in Winnipeg, Manitoba, Canada.

Bamforth and team compared the cost and QoL linked with the use of a real-time potassium monitoring device vs usual care in patients on haemodialysis. A decision analytic microsimulation model was designed for the cost-utility analysis, which focused on the monthly break-even cost per patient and the incremental cost-effectiveness ratio of the two interventions. [Kidney Week 2022, abstract FR-PO542]

Utility estimates were derived from a systematic review and meta-analysis. Additionally, researchers applied a 25 percent reduction in hyperkalaemic events to the intervention scenario as a baseline effectiveness estimate.

Other than the monthly break-even cost per patient in the base case scenario, the device provided 0.04 additional quality-adjusted life-years. After adjusting the effectiveness estimates of hyperkalaemic reduction between 10 and 50 percent, the monthly break-even costs ranged from $265.36 to $1,387.90.

Home dialysis: the way to go?

Meanwhile, a separate study presented at Kidney Week 2022 showed that home dialysis improved health-related QoL vs other modalities in patients with chronic kidney disease prior to dialysis dependence.

Less than half of patients in the study chose home dialysis as a treatment modality.

Researchers measured the health-related QoL of 109 patients with advanced CKD who were polled at baseline and every 6 months until starting dialysis. Additionally, they were made to choose between home dialysis and peritoneal dialysis. [Kidney Week 2022, abstract FR-PO513]

Physical component scores (PCS), mental component scores (MCS) and symptoms/problems of kidney disease (SPKD) were assessed. The 41 patients who chose home dialysis had improvements in HRQoL scores prior to becoming dialysis-dependent vs those who opted for peritoneal dialysis.

PCS scores were significantly higher in patients who chose home dialysis. An 8-point higher MCS was also noted among patients who chose home dialysis at each year of follow-up. “Fewer patients are into home dialysis although that is what we pushed in our centre,” said the researchers.