Imtiaz Rameez, Atkinson Katherine, Guerinet Julien, Wilson Kumanan, Leidecker Julie, Zimmerman Deborah
University of Ottawa, Ottawa, ON, Canada.
mHealth Research Team, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Perit Dial Int. 2017 Nov-Dec;37(6):613-618. doi: 10.3747/pdi.2017.00050. Epub 2017 Sep 28.
Hyperphosphatemia is associated with adverse outcomes in patients treated with peritoneal dialysis (PD). We have shown that a fixed meal phosphate binder dosing schedule is not appropriate. The purpose of this study was to evaluate the beta version of OkKidney, a phosphate counting app that matches meal phosphate content with binder dose.
A convenience sample of adult patients treated with PD completed a pre-survey that included the technology readiness index (TRI 2.0). After a short information session, patients used OkKidney for 30 days. Pre- and post-intervention serum calcium, serum phosphate, and calcium carbonate binder intake were collected and compared using a paired -test. A post-intervention survey using a 5-point Likert scale was used to gather patient feedback.
Ten patients (5M, 5F) completed the study protocol. Participants were 55 ± 17 years old, predominately Caucasian, retired (60%), and owned a smartphone (70%). The median TRI score was 3.66 (max 5), indicating a moderate level of readiness. The post-survey results indicated a favorable rating for ease of use (μ = 4.4 ± 0.84) and usefulness (μ = 4.3 ± 0.68) of OkKidney. The average serum phosphate ( = 0.99) and calcium ( = 0.68) were not different pre-/post-intervention, but calcium carbonate intake tended to decrease ( = 0.12).
Patients reported a positive experience with OkKidney. Further patient-specific adjustments of the binder dose to meal phosphate content may be required to demonstrate a statistically significant decrease in phosphate levels. We believe a larger trial is warranted to investigate the clinical implications of this app.
高磷血症与接受腹膜透析（PD）治疗的患者的不良预后相关。我们已经表明，固定餐次的磷结合剂给药方案并不合适。本研究的目的是评估OkKidney的测试版，这是一款将餐食磷含量与结合剂剂量相匹配的磷计数应用程序。
以接受PD治疗的成年患者为便利样本，完成一项包括技术准备指数（TRI 2.0）的预调查。在简短的信息介绍会后，患者使用OkKidney 30天。收集干预前后的血清钙、血清磷和碳酸钙结合剂摄入量，并使用配对t检验进行比较。使用5分李克特量表进行干预后调查，以收集患者反馈。
10名患者（5名男性，5名女性）完成了研究方案。参与者年龄为55±17岁，主要是白种人，已退休（60%），且拥有智能手机（70%）。TRI评分中位数为3.66（满分5分），表明准备程度中等。调查后结果显示，OkKidney在易用性（μ = 4.4±0.84）和实用性（μ = 4.3±0.68）方面获得好评。干预前后的平均血清磷（ = 0.99）和钙（ = 0.68）没有差异，但碳酸钙摄入量有下降趋势（ = 0.12）。
患者对OkKidney有积极体验。可能需要根据患者具体情况进一步调整结合剂剂量与餐食磷含量，以证明磷水平有统计学意义的下降。我们认为有必要进行更大规模的试验来研究这款应用程序的临床意义。
