Using an interactive water bottle to target fluid adherence in pediatric kidney transplant recipients: A pilot study

Hydration is important post‐renal transplant to maintain adequate renal perfusion and graft function. Adherence to fluid recommendations is challenging given barriers to staying hydrated. There are no studies of adherence to fluid intake recommendations following pediatric renal transplant. Through this pilot study, we sought to determine whether the use of a commercially available interactive water bottle would lead to better adherence to recommended fluid intake and improved kidney functioning post‐transplant relative to standard of care. Participants included 32 youth ages 7–19 ≥1 month post‐kidney transplant randomized to the intervention (HydraCoach ® water bottle) or standard education control group. Laboratory records were reviewed for serum chemistries (Na, BUN , creatinine) at baseline and one‐month follow‐up, and participants recorded daily fluid intake for 28 days. Those in the intervention group were significantly more likely to meet or exceed their fluid target, but this did not translate into better kidney functioning. Participants in the intervention group largely reported satisfaction with the water bottle and were likely to continue its use. While an interactive water bottle providing real‐time feedback may be a promising intervention to help pediatric kidney transplant patients meet fluid goals, it did not appear to impact kidney function.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109912/1/petr12385.pd

Authorsâ reply to the letter to the editor by Sabour

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147224/1/ejp1345.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147224/2/ejp1345_am.pd

Measuring family management of transplant tasks: T he transplant responsibility questionnaire

Little is known about how parents and youth perceive their roles in post‐transplant management and how this relates to post‐transplant adherence. The goals of this study are to (1) describe a new measure, the TRQ , (2) to describe parent and child performance on the TRQ , and to (3) determine the relationship between the TRQ and adherence. We hypothesized that older youth would describe higher post‐transplant self‐care behaviors, parents would underestimate youth self‐care, and greater parent involvement would be associated with better adherence. Participants included 59 parent–child dyads. Inclusion criteria included: (i) youth aged 7–18 yr and (ii) at least three months post‐kidney or post‐liver transplant. Parents and youth completed the TRQ , and adherence was measured by s.d. of sequential immunosuppressant blood levels. Youth perceived greater levels of self‐care than their parents perceived. Older youth reportedly engaged in more self‐care than younger youth. Less than 25% of the sample was non‐adherent, and non‐adherence was unrelated to performance on the TRQ . The TRQ may have utility as a clinical tool to address areas for improvement in youth self‐care. The high degree of parental involvement likely explains the high degree of adherence in this sample.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97501/1/petr12064.pd