Remote monitoring of renal transplant recipients

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Abstract

Objective. Analysis of the results of remote monitoring of renal transplant recipients (RTRs).

Material and methods. A retrospective study based on the results of remote monitoring and questionnaires returns of 52 RTRs followed-up at the Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 using the TRANSPLANTNET service from 2019 to 2022 was conducted.

Results. The patients differed in terms of the period of returns to the questionnaires: in early-term patients after renal allotransplantation (RAT) (group 1), the response period was shorter and amounted to 9.9 [6.3; 21.1] months compared with late-term patients after RAT (group 2) – 18.0 [14.2; 31.9] months (P<0.05). In group 1, symptoms of trembling in the limbs or throughout the body, as well as irritability and aggression, were detected 2 times more often. These symptoms have been associated with blood tacrolimus levels. So, in the presence of trembling in the limbs or throughout the body, the mean tacrolimus C0 level was 11.3±3.4 ng/ml, and in the absence of tremors, it was 7.8±2.5 ng/ml (P<0.05). The mean tacrolimus C0 level in patients with irritability/aggression was 11.2±3.0 ng/ml, without these symptoms – 7.9±2.9 ng/ml (P<0.05).

Conclusion. Remote monitoring makes it possible to detect serious symptoms in patients after RAT, which can lead to the development of RT dysfunction if left untreated. The possibility of feedback from patients allows to give timely recommendations for additional examination and correction of ongoing therapy to eliminate these symptoms.

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About the authors

Ekaterina S. Ivanova

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Author for correspondence.
Email: katerineiv@mail.ru
ORCID iD: 0000-0001-7407-5695

Cand.Sci. (Med.), Nephrologist, Nephrology Department № 1, City Clinical Hospital №52 of the Moscow Healthcare Department

Russian Federation, Moscow

Oleg N. Kotenko

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: olkotenko@yandex.ru
ORCID iD: 0000-0001-8264-7374

Cand.Sci. (Med.), Chief External Expert in Nephrology of the Moscow Healthcare Department, Head of the Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Irina G. Kargalskaya

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: kargalska@yandex.ru

Analyst at the Educational Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Vladimir E. Vinogradov

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: vino-gradoff@yandex.ru
ORCID iD: 0000-0002-2499-4770

Head of the Consultative and Diagnostic Nephrology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Vitaly A. Berdinsky

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: vitaly.berdinsky@yandex.ru
ORCID iD: 0000-0001-5966-0415

Head of the Nephrology Department № 4, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Lyudmila Y. Artyukhina

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: arlyu-1404@yandex.ru
ORCID iD: 0000-0003-3353-1636

Cand.Sci.(Med.), Head of the Nephrology Department № 1, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

Nadiya F. Frolova

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: nadiya.frolova@yandex.ru
ORCID iD: 0000-0002-6086-5220

Cand. Sci (Med.), Deputy Chief Physician for Nephrological Care, City Clinical Hospital № 52 of the Moscow Healthcare Department

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. The results of the questionnaires and measurements of the patient: a) the "heat map" of the patient, b) the results of measurements of blood pressure, pulse, temperature and medication of the patient

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3. Fig. 2. Decrease in the percentage of patients completing questionnaires in different groups

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4. Fig. 3. The number of patients of different groups according to the presence of symptoms from the questionnaire "General monitoring after kidney transplantation"

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5. Fig. 4. The number of patients of different groups according to the presence of a symptom from the questionnaire "Control of the nervous system"

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6. Fig. 5. The number of patients of different groups according to the presence of symptoms from the questionnaire "Control of the emotional background"

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7. Fig. 6. The number of patients in different groups by the presence of symptoms from the questionnaire "Control of depression"

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8. Fig. 7. Tacrolimus CO level depending on the presence or absence of trembling in the limbs or throughout the body (a) and irritability/aggression (b)

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