Kidney Week

Abstract: SA-PO406

Noninvasive Blood Pressure Monitoring in Patients on Chronic Hemodialysis

Session Information

• Hemodialysis and Frequent Dialysis - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Lee, Frank, University of California Irvine School of Medicine, Irvine, California, United States

Frank Lee

• Truong, Tai, Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, California, United States

Tai Truong, MD

• Li, Whitney, University of California Irvine School of Medicine, Irvine, California, United States

Whitney Li

• Cabush, Abigail, Vena Vitals, Irvine, California, United States

Abigail Cabush

• Chaudhari, Akhil, Vena Vitals, Irvine, California, United States

Akhil Chaudhari, PhD

• Kumar, Parth, Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, California, United States

Parth Kumar, MD

• Tantisattamo, Ekamol, Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, California, United States

Ekamol Tantisattamo, MD, MPH, FASN

• Lau, Wei Ling, Division of Nephrology, Department of Medicine, University of California-Irvine, Irvine, California, United States

Wei Ling Lau, MD, FASN

Background

Intradialytic hypotension (IDH) during hemodialysis is associated with adverse outcomes including cerebral ischemia and increased cardiovascular and all-cause mortality. Standard blood pressure (BP) monitoring is done every 30 min via an inflatable cuff, and data is lacking to guide optimal frequency of intradialytic BP measurements. Variability in cuff size, the patient’s sitting position, and location of cuff placement (arm vs leg) may affect BP readings. Here, we present pilot data from a study evaluating a noninvasive continuous BP sensor during outpatient hemodialysis treatments.

Methods

The non-invasive BP sensor patch (AcuPulse) was provided by Vena Vitals, Inc. (Irvine, CA). The sensor detects pressure changes via conformal electrodes within a flexible silicone patch. Nineteen adults at the Fresenius Kidney Care Dialysis Center of Orange were enrolled for data collection. The BP sensor was secured over the radial or dorsalis pedis artery sites, to capture a continuous waveform during hemodialysis. Standard arm cuff BP readings were collected every 30 minutes for the duration of the hemodialysis treatment, with additional BP rechecks done per discretion of the dialysis staff. BP waveforms were analyzed and graphed on MATLAB.

Results

From the 19 subjects, 10 had usable datasets for analysis. Average age was 56 years and 7 of the 10 subjects were male. Excluded datasets were due to missing BP cuff readings (n=3), weak waveform due to improper device setup (n=1), signal artifact due to BP sensor placed on the same arm as BP cuff (n=1), and excessive motion artifact (n=4). Preliminary data shows that the BP sensor waveform tracks BP cuff measurements closely (example shown in Figure). The sensor detected IDH prior to the standard BP cuff in 3 subjects.

Conclusion

Our results demonstrate that a non-invasive sensor has potential utility for continuous BP monitoring during dialysis treatments, for timely detection of IDH. Technological refinements are ongoing to optimize sensor fidelity and to adjust for motion artifact.