Page 30 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint

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Chapter 2
RESULTS
Study population
During period of inclusion, 42 patients received a kidney from a living donor. Of the 34 eligible patients, 32 gave informed consent. Two patients dropped out because of serious medical complications following surgery. Thirty patients received the self-monitoring equipment and started performing self- measurements after a mean of 8 (SD=3) days after transplantation. One patient was lost to follow-up (see supplementary data figure 1 for the study flow chart). Characteristics of the study population are shown in table 2. The majority of patients were female, married or living together and of Dutch origin. Just over half was transplanted prior to initiation of dialysis (preemptive).
The baseline questionnaire was completed by 30 (100%) and the follow-up measure by 25 (83%) patients. Although the number of patients who did not complete the follow-up questionnaire was too low to conduct formal analyses, non-responders to the follow-up questionnaire seemed to perceive more disadvantages of performing and interpreting self-measurements at baseline than responders. The ten patients that were interviewed seemed representative of the total study population (i.e., no differences were observed regarding sociodemographics, internet experience, satisfaction and opinions about self-monitoring (data not shown). Patient quotes that reflect questionnaire results are given in table 3.
Clinical data
Mean level of creatinine and mean eGFR measured at baseline was 132 (SD 35) and 51 (SD 19), respectively. Mean level of creatinine and mean eGFR at follow-up was 134 (SD 37) and 49 (SD 11), respectively. Mean arterial pressure (MAP) was 101 (SD 7) at baseline and improved over time (see table 2). Twenty-one out of 30 patients (70%) were prescribed antihypertensive treatment at discharge after transplantation. For one patient, baseline antihypertensive treatment could not be traced. The remaining patients (n=8) did not use any antihypertensive medication at baseline. Mean number of antihypertensive prescriptions was 1.28 per patient (ranging from 0 to 3).
During period of inclusion, three patients experienced an episode of acute rejection (at 26, 84 and 90 days post-transplantation, respectively). For two of these patients, a steep increase in blood level creatinine was visible in the self-measured creatinine values preceding hospital admittance for rejection treatment. The third patient did not self-monitor creatinine in the week preceding diagnosis of acute rejection. It therefore remains unclear whether this specific rejection could have been detected at home.