Wearable sensors: can they benefit patients with chronic kidney disease?

Abstract

Introduction: This article ponders upon wearable medical measurement devices in relation to Chronic Kidney Disease (CKD) and its' associated comorbidities -and whether these might benefit CKD-patients. We aimed to map the intersection(s) of nephrology and wearable sensor technology to help technologists understand medical aspects, and clinicians to understand technological possibilities that are available (or soon will become so). Areas covered: A structured literature search on main comorbidities and complications CKD patients suffer from, was used to steer mini-reviews on wearable sensor technologies clustered around 3 themes being: Cardiovascular-related, diabetes-related and physical fitness/frailty. This review excludes wearable dialysis -although also strongly enabled by miniaturization -because that highly important theme deserves separate in-depth reviewing. Expert commentary: Continuous progress in integrated electronics miniaturization enormously lowered price, size, weight and energy consumption of electronic sensors, processing power, memory and wireless connectivity. These combined factors boost opportunities for wearable medical sensors. Such devices can be regarded as enablers for: Remote monitoring, influencing human behaviour (exercise, dietary), enhanced home care, remote consults, patient education and peer networks. However, to make wearable medical devices succeed, the challenge to fit them into health care structures will be dominant over the challenge to realize the bare technologies themselves. ARTICLE HISTORY

Big science and big data in nephrology

“…Some CKD-related parameters may be available soon, such as the level of potassium in sweat. 128,129 These parameters may enable detection of patients at risk 31 and may be used to inform treatment and prognosis, and guide clinical trials. 130 Important challenges remain to be addressed, ranging from accuracy to the lack of an adequate regulatory framework.…”

Wearable Health Devices—Vital Sign Monitoring, Systems and Technologies

“…One of these difficulties is the delay of time between the concentration of blood glucose between the actual blood glucose and the one measured in the interstitial fluid, which may lead to a less reliable estimation of insulin dosage. To contour this issue new algorithms are being developed to estimate the future blood glucose levels with a time window of around 30 min [ 52 ].…”

The Kidney Health Initiative innovation roadmap for renal replacement therapies: Building the yellow brick road, while updating the map

“…), are increasingly proposed as pathways to improve the efficiency of healthcare; however, to really achieve this, such technologies must be made extremely reliable, easy to use, cheap to produce, and compatible with existing healthcare structures. 8 The constant shrinking of size and price for electronics has already helped to make Medical Equipment much more portable or even implantable. For example, with implantable cardiac pacemakers, the addition of intelligent internal recording, storage, and periodic wireless retrieval of suspicious heart rhythm episodes and the technical condition of the pacemaker itself, has contributed to better outcomes and more manageable care (for example programmability and elective scheduling of pacemaker replacement).…”

“…Automated pattern recognition should thus unload clinicians from trivial consults and focus them on the cases where their expertise makes the difference. 8 When the ISN roadmap already contains a section about such prevention aspects, one should consider keeping the updates on these aspects in there and consider including a clear reference in the KHI RRT roadmap. • It is important that useful technologies other than dialysis should also be given due attention and discussion.…”