Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.
All 3 experts were familiar with but had not used this technology before.
All 3 experts said that the technology is novel but of uncertain safety and efficacy. One expert said that the ability to measure flow rate is innovative. The experts agreed that there are no other similar technologies currently available to the NHS.
Two experts said that RenalSense Clarity RMS may improve accurate measurement and documentation of urine output. One expert also said that it can lead to early detection of not only acute kidney injury but also dehydration or underlying causes of AKI such as haemorrhage or sepsis. One expert felt unable to comment based on the limited evidence available.
Two experts suggested patient groups that would particularly benefit from using this technology. These included people who are critically ill, people at risk of having fluid overload, people with electrolyte disorders, people with drug toxicity and people who are elderly.
One expert said that the technology can be used on any patient in the intensive care unit (ICU). Another expert noted that this includes many thousands of patients, including most patients admitted to the ICU, high dependency unit, renal units or after major surgery.
Two experts said that this technology has the potential to change the current pathway and may lead to improved outcomes through earlier detection of AKI and dehydration. However, 1 expert noted that there is little evidence to support this. One expert said that it may impact on time spent by nursing staff monitoring urine output. Furthermore, 1 expert said that urine output documentation is generally poor, it is often incomplete and prone to error.
All experts agreed that RenalSense Clarity RMS costs more than standard care. However, 1 expert said that if the technology would reduce the incidence of severe AKI, the need for renal replacement therapy and length of hospital stay, then there could be overall cost savings.
Experts said that relatively few changes are needed to the clinical facilities to use the technology. One expert noted that the technology needs to be compatible with the NHS trusts' information technology systems and have specific areas for charging batteries.
Two experts said that training is needed to use the technology safely and effectively. One expert said that poor training can lead to potential harm.
Two experts said that the technology has the potential to replace current standard care. However, the technology costs more than standard care so 1 expert said that it may only be used in specific settings and with complex and high‑risk patients. Another expert said because of the high cost, this would be in addition to standard care.
One expert raised issues with the usability stating that a wireless connection would be expected and may lead to the potential for more remote monitoring.
The experts expressed some concerns about the cost, efficacy and safety of the technology. One expert is unsure if it is better than standard care and will improve hard clinical outcomes. Another expert is concerned about the technology not being used appropriately and that there should be clear guidelines about which patients it may be suitable for and why. This expert also said that the technology is expensive and needs to show cost versus benefit.
Two experts agreed that further research is needed including a large clinical trial comparing RenalSense Clarity RMS to a urometer in the ICU focusing on relevant clinical outcomes. One expert said the setting should include trauma surgical wards or acute medical wards because this is where people with AKI are.