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I previously blogged about Metyos, the Paris, France-based company developing a wear-on device much like the Libre 3 to aid in detecting CKF earlier. In researching the company, I dropped down on their website and filled out a brief questionnaire indicating that I would participate in developing their new product. In a follow-up, I filled out a detailed history-based questionnaire, followed by an invitation to participate in a video conservation with a Metyos rep. That conservation took place this past Friday and was with the CEO/Cofounder, Alexandre Boulanger – lead picture.

The start of the conversation centered on how I learned of my impending kidney failure and  the timeline of the failure. We then shifted to a picture of what they currently envision as their delivery system. It was at this point that I hit a snag. Unlike Abbott’s Libre 3 system for glucose readings which is a “one and done” every two weeks, Metyos’ system lasts eight days, and at that time the user must use a tool to replace a sensor in a receiver which remains attached to the user. In addition, at some interval not discussed, the user must wear a cuff-like device to charge the sensor’s battery. Ok so far?

Here’s the deal. The average age of those experiencing CKF tends to be upwards. Kidney disease can develop at any time, but those over the age of 60 are more likely than not to develop kidney disease. As people age, so do their kidneys. According to recent estimates from researchers at Johns Hopkins University, more than 50 percent of seniors over the age of 75 are believed to have kidney disease.

An herein lies the problem. Without insulting anyone, seniors in general are less apt to be comfortable with technology-based solutions. They tend to lose dexterity and just might find it difficult to manipulate the delicate touch required to change sensors. Not stated before, but like the Libre 3 system, the Metyos system uses a smartphone for analysis and display. Seniors in general shy away from smartphones and even if they have them, do not use the vast majority of their bells and whistles. For instance, my wife has three sisters all over 75 who don’t use the text function of their phones but you better believe they take pictures of grands and great-grands.

Lastly, I know for 100% certainty that FDA approval of the Abbott Libre 3 system to be covered by Medicare was held up until such time as Abbott developed a stand-alone reader for the Libre 3. When my first shipment of Libre 3 sensors was delivered from a third-party vendor, I received a reader with the shipment.

The Metyos system is set up to measure potassium (K) as a predictor of CKF. I was not familiar with this and quizzed Perplexity with the following results:

Potassium (K+) levels are an important predictor of adverse clinical outcomes in patients with chronic kidney disease (CKD). Several studies have demonstrated the following key points:

  • There is a U-shaped association between serum potassium levels and the risks of mortality and major adverse cardiac events (MACE) in CKD patients

. Both low (<4.0 mmol/L) and high (>5.0-5.5 mmol/L) potassium levels are associated with increased mortality and MACE risk compared to normal potassium levels (4.0-5.0 mmol/L). Hyperkalaemia (serum K+ >5.0-5.5 mmol/L) is associated with an increased risk of renin-angiotensin-aldosterone system inhibitor (RAASi) discontinuation in CKD patients, exhibiting a J-shaped relationship. RAASi medications are important for slowing CKD progression. Spending more time in a hyperkalaemic state (higher percentage of follow-up time with K+ ≥5.0, 5.5 or 6.0 mmol/L) is associated with increased risks of mortality and MACE across various cardiorenal disease populations, including CKD. High variability in serum potassium levels over time is also an independent predictor of increased MACE risk in CKD and other cardiorenal diseases, though not consistently associated with mortality risk. Other important predictors of adverse outcomes in CKD include older age, male sex, lower estimated glomerular filtration rate (eGFR), history of MACE, and RAASi usage

  • .

In summary, both high and low serum potassium levels, increased time spent in hyperkalemia, and high potassium variability are significant predictors of mortality, cardiovascular events, and RAASi discontinuation risk in CKD patients. Maintaining normokalemia is crucial for improving outcomes in this population.