Wearable Monitoring system for an arteriovenous fistula (AVF)

End stage renal disease (ESRD) in the UK is estimated at around 500 cases per million people and around 20% of cases progress to dialysis each year. It is estimated that these figures will double by 2030\. Current Medical opinion is that the best and most efficient method of providing haemodialysis is by creating an arteriovenous fistula (AVF) and circulating the blood through there.

However, the process for creating a fistula takes around 6 weeks and has a high failure rate (30-40%) and even once successfully created, fistulas will deteriorate over time resulting in longer dialysis times for the patient as flow rates drop and eventual failure meaning further surgery at that point. The medical reasons for what cause fistulas to fail are still fairly unknow and whilst several current strategies revolve around the creation of stents or other medical devices, it has been shown that one successful approach is the management of this process by monitoring of the blood flow through the fistula. In this way, problems can be identified early, and plans made to circumvent them.

Currently, monitoring of flow is done by a combination of Doppler ultrasound \\ ultrasound dilution but requires the patient to attend an appointment and is a one-off reading so is limited in its effectiveness and is costly. This project is to design a wearable non-invasive monitoring system utilising new technologies to monitor the status of a patients' arteriovenous fistula (AVF). This will give real time monitoring and enable an early identification of any issues either with the maturation of the AVF prior to dialysis or throughout its lifespan during the dialysis process. This is key as early identification of issues will result in better patient management leading to both financial savings and better use of dialysis equipment \\ personnel as potential problems can then be planned around in advance.