Medical-alert bracelets tied to lower risk for CKD progression

  • Clin J Am Soc Nephrol
  • 6 Jun 2019

  • International Clinical Digest
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Takeaway

  • Medical-alert accessories help reduce progression of chronic kidney disease (CKD) but fail to reduce safety events, according to data from a pilot study.

Why this matters

  • “One might consider medical-alert accessories as a useful solution to the problem of under-recognized CKD, but it may also serve as a behavior prompt directing patients to best practices in self-care and disease management,” the authors write.

Study design

  • Prospective study of 350 patients with stage II-V predialysis CKD (stage III, 66%-69%); 108 received a medical-alert bracelet/necklace indicating diagnosis and safe practices.
  • Follow-up (annual appointments, twice-yearly calls) continued until end-stage renal disease (ESRD), death, or study withdrawal.
  • Funding: National Institute of Diabetes and Digestive and Kidney Disease, University of Maryland.

Key results

  • Median follow-up: 4.33 and 3.08 years for medical-alert and observation arms, respectively (ESRD, n=41; deaths, n=56).
  • Groups had similar incidence (per 100 patient-visits) of class 1 (108.7 vs 100.6; P=.13) and class 2 safety events (38.3 vs 41.2; P=.23).
  • Crude ESRD risk was lower in the medical-alert arm (2.2 vs 3.3 per 1000 patient-months; HR=0.42; P=.02).
  • In adjusted analysis, wearing the medical alert accessory was tied to a 62% reduced risk for ESRD (HR=0.38; 95% CI, 0.16-0.94).
  • Hospitalization and death rates did not differ between groups.

Limitations

  • Nonrandomized design
  • Limited sample size.