Presentation Authors: Thomas Stout*, Minneapolis, MN, James Lingeman, Amy Krambeck, Indianapolis, IN, Mitchell Humphreys, Scottsdale, AZ, Anna Zisman, Chicago, IL, Sarah Elfering, Michael Borofsky, Minneapolis, MN
Introduction: High dietary fluid intake is a cornerstone of kidney stone prevention; yet, is challenging to achieve. There is interest in using smart water bottles for this purpose but sparse data exists as to whether such technology leads to better outcomes relative to standard counseling. We sought to assess whether the addition of a smart water bottle to standard dietary fluid recommendations leads to improved urine volume.
Methods: IRB approval was obtained to offer voluntary enrollment into a prospective randomized controlled trial comparing the effect of standard dietary fluid recommendations (DR) to standard DR with addition of a smart water bottle (SB) on 24 hour urine (24 hr U) volume. Eligible participants included those over age 18 with a history of nephrolithiasis and low urine volume ( < 1.5L) in the past 6 months. All subjects received a handout with strategies to achieve a goal urine output of 2.5 L/day. The intervention arm also received a smart water bottle (HidrateSpark, Minneapolis MN) with a sensor that recorded daily fluid intake, synced to the userâ€™s smartphone, and provided periodic reminders to drink. All patients completed a baseline survey to assess barriers to achieving adequate fluid intake. They then repeated a 24hr U at 6 weeks and a repeat survey at 12 weeks.
Results: 77 subjects (38 DR, 39 SB) have been enrolled to date. Baseline demographics between groups are similar (table 1). Among all participants at baseline, the main reported factor limiting sufficient fluid intake is not remembering to drink (58%). 62% report being very motivated to increase fluid intake. Follow up 24Hr U are available for 42 patients (23 DR, 19 SB). Both groups have shown increases in 24 hr U volume with mean increase being greater in the SB cohort (1.3L vs 0.8L). Among follow up survey respondents, both cohorts report subjective increases in fluid intake (cups/day) (0.75 SB vs 1.11 DR). Fewer patients in the SB arm report not remembering to drink as the main factor limiting sufficient fluid intake compared to the DR arm (38 vs. 76%).
Conclusions: Difficulty remembering to drink is a common barrier in achieving sufficient fluid intake for stone formers. Addition of a smart bottle to dietary recommendations may lead to greater increases in 24 Hr U volumes and less difficulty remembering to drink.
Source of Funding: HidrateSpark