Body-Worn Sensor for Point-of-Care Vascular Access Monitoring

Chronic kidney disease is a major challenge for healthcare systems in the UK and around the world. It is estimated that a significant proportion of NHS budget is spent on life sustaining renal replacement therapy including haemodialysis. During haemodialysis, arterial blood is filtered externally to remove toxins through a surgically created vascular access in the form of arteriovenous fistulas and grafts. The lifetime cost of the treatment and the long-term dialysis efficacy critically depends on maintaining the functions of the vascular access. Access failure is the leading cause of hospitalisation and surgery for patients on haemodialysis, with dialysis related admissions costing an estimated £75m each year. This failure is often a result of vascular narrowing which increases the risk of vascular occlusion caused by clotting. Hence, access maintenance is the key in the life-sustaining treatment for patients under haemodialysis.

Current recommendations for vascular access surveillance are focused on clinical assessment and flow-volume measurement during the hospital visits for dialysis treatment, which often only identify already established problems. Therefore, a more regular or continuous monitoring approach which enables the early identification of those patients at highest risk will improve long-term patency rates, improving quality of life while simultaneously reducing mortality rates and treatment costs.

In this project, we will develop a body-worn sensor for cardiovascular monitoring, particularly to address a long-standing clinical challenge in vascular access health surveillance. Presently, vascular access surveillance is purely hospital-visit based, which is expensive and inadequate as problems often occur outside hospitals. Our preliminary clinical studies suggest that early signs of access failure can be detected even before the first hospital visit. The outcome of this adventurous research is expected to transform not only the current clinical practice in vascular-access surveillance but also the future broader cardiovascular monitoring and homecare.