Utilisation of telemedicine to assess energy expenditure and stability in older people with chronic kidney disease

Chronic kidney disease (CKD) and falls are common in older people. Whilst aggressive blood pressure (BP) control is the main treatment, its effects are unknown. We have been evaluating a new technology capable of energy and stability monitoring in a patientpsilas home environment. 5 participants wore a portable monitor during modification of BP therapy. This small device, worn on the waist, contains two accelerometers allowing measurement of the force and direction of movement. No significant problems were reported. Data were collected on 89% of days. Energy expenditure appears lower during BP therapy reintroduction, than after withdrawal. 710 stability events were recorded. This well-tolerated system can provide high resolution data on both energy and stability. Although not significant, the reduction in energy expenditure may relate to changes in overall well being. Further work will evaluate the relevance of the large number of events seen.