Potassium Imbalance in Chronic Kidney Disease (CKD)
The Huge Burden of Potassium in CKD
Potassium imbalance has long been recognised as a potential “silent killer”, as it can be asymptomatic and can cause abnormal heart rhythms and sudden death1.
- 40-50% of Chronic Kidney Disease (CKD) patients suffer from hyperkalemia (serum potassium level above the normal range), compared to 2-3% in the general population2.
- Dyskalemia (serum potassium level above or below the normal range) is associated with higher risk of mortality in CKD patient, which is 2-7 times higher than in general population3.
- Developed countries spend more than 2–3% of their health care budgets on End Stage Kidney Disease treatment therapy4.
- Hyperkalemia contributes to high healthcare utilization and costs, primarily driven by inpatient care and dialysis costs5.
CardioRenal breakthrough solution is a connected device that is intended to allow frequent self blood potassium quantitative measurement by the patient at home:
- The procedure is minimally invasive, and the results are available in less than 5 minutes.
- The device is easy-to-use and connected to the cloud allowing treating physicians to access patient data whenever they want.
Product under development not approved for sales
Dyskalemia occurs frequently in CKD patients as it is a common secondary effect of CKD medical treatment (RAASi, diuretics). While renin-angiotensin-aldosterone system inhibitors (RAASi) drugs are beneficial for these patients, they are also the most prominent cause of hyperkalaemia2.
CKD patients with hyperkalaemia risks are also recommended to have a low potassium diet, meaning low intake of healthy food such as fruits, vegetables... This diet regimen may deprive patients from the beneficial effects of potassium-rich diets, leading to malnutrition and poor quality of life6.
The Life-saving drugs RAASi are generally under-dosed or discontinued by physiscians because of fears for hyperkalemia. The sub-optimal dose is associated with higher adverse outcomes, including CKD progression and progression to End Stage Renal Disease, and mortality7.
|Patient (%)||Patient with mortality (%)|
|At optimal dose||19-26||4.1|
|At suboptimal dose||58-65||8.2|
Monitoring strategies and measurement methods allowing more frequent potassium testing6.
Strategies that can maintain the use of beneficial medications (i.e. RAASi) while controlling potassium balance2.
Methods that can evaluate the impact of dietary potassium on serum concentration in people with CKD6.What patients say about Potassium monitoring:
“A trustable home potassium test, because I have very unstable potassium levels and have to control my potassium at the hospital several times a week”.
“Are there any new developments in the home potassium meters? It gets very frustrating having to wait for blood work to come back in order for the Doctor to give me an IV potassium drip”.
“I am very interested in a home potassium meter/test. Monthly we have to get his blood work done. Having a test for home use would be incredibly helpful to see when he is starting to get high again. Kidney failure patients, and heart failure patients definitely have a need for it” .
What if we could improve potassium management thanks to frequent minimally invasive measurement of blood potassium ?
By allowing more frequent potassium measurement by the patients, physicians migth have a clearer view of their patient clinical status and optimize their drug treatment.
Product under development not approved for sales
Heart failure management
The Huge Burden Of Heart Failure Disease
After discharge from a Heart Failure hospitalization, patients are at an unacceptably high risk of recurrent hospitalizations or death.
- One major origin of post discharge events is the residual patient congestion that is not optimally alleviated at discharge.1
- In fact, many patients leave hospital before their diuretic therapy is optimized.
- Another important fact is that patients are discharged before lifesaving renin angiotensin antagonists and mineralocorticoid receptor antagonists could be optimized to reach the highest tolerable doses.2
Optimizing heart failure patient treatment at home by using:
- Artificial Intelligence
- Data analysis
Guidelines recommend optimizing pharmacotherapy to improve outcomes for patients with heart failure (grade 1, level of evidence A)
Optimizing medications belonging to the RAAS inhibitor class (ACE-Is, ARBs and MRAs) have been proven to improve survival and reduce hospitalizations in patients with heart failure.2 In addition, optimizing diuretics reduces volume overload, eases the signs and symptoms of pulmonary congestion and keeps patients out of hospital.2
The concerns for raising serum potassium levels, worsening renal function, or inadequate decongestion limit the way these medicines are utilized and dosed.3 Complicating the management of patients with heart failure is the fact that physicians do not have simple, patient-friendly tools to easily keep track of these issues with their patients at home.
We know that optimizing care through disease management programs improves outcomes in patients with heart failure. Up until recently, the focus has been on monitoring pulmonary congestion so that physicians can
optimize diuretic doses and reduce admissions.4
But this is only part of the solution ... We also need to be monitoring serum potassium and renal function so that physicians can optimize not just the dose of a diuretic, but also optimize doses of ACE-I, ARB or MRA. With such a complete view of the status of their HF patient overtime, physicians would feel safe and confident so as to optimize medication precisely to each patient status.
If there was a way to reliably, simply and cost-effectively monitor serum potassium, renal function and the degree of congestion in our heart failure patients at home, could we then optimize the use of these life-saving medicines? With a more comprehensive approach like this, we may be able to reduce not just hospital readmissions, but we may also be able to improve the quality of life and survival of HF patients.
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Chief Executive Officer
Maurice BerengerChief Executive Officer
Guilhem HenrionChief Technical Officer
Julie PapillonOperations Director
Daphné LaporteQRA Manager
Fengjuan WANGInnovation Manager
Moez KarouiCloud Application Manager
Yohann ThomasR&D manager
David RabaudIndustrialisation project leader
Gabriel LemercierR&D project leader
David LefebvreIndustrialization Manager
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