Winning Solution: A Non-Invasive, Wearable Telehealth Device to Detect Thrombosis and Monitor Vascular Access Health of Arteriovenous Fistulas and Grafts in Hemodialysis Patients

A patent vascular access is crucial for successfully performing hemodialysis. Patients with kidney failure undergoing dialysis treatment have heightened risks of acute arteriovenous fistula (AVF) and graft (AVG) clotting (thrombosis) exposing them to significant morbidity, mortality, and financial burdens. In most cases, hemodialysis vascular access clotting resulting in a nonfunctional AVG/AVF happens in the nonhealthcare setting and is usually not detected until the patient is seen at the next hemodialysis appointment. This results in a lost window of opportunity for early recognition and timely intervention to salvage the hemodialysis access. Studies have demonstrated poor access outcomes in patients who undergo delayed thrombectomy (clot removal) after access clotting and better outcomes in those undergoing early salvage. Currently, there are no wearable devices available to detect hemodialysis vascular access clotting in real time to expedite time to intervention.

Our wearable device aims to identify hemodialysis access clotting in real time and will help increase patient awareness and reduce complications associated with hemodialysis vascular access clotting. The device uses a small sensor to monitor the patient’s vascular access in real time and sends the acquired data to a local microcontroller for signal processing. A machine learning algorithm then classifies the input data to identify hemodialysis vascular access clotting and automatically alerts the patient and their health care team. This non-invasive device will expedite time to intervention, cut financial costs, morbidity and mortality associated with AVF/AVG clotting related complications and ultimately improve delivery of care.

Vinay Narasimha Krishna, MD, FASN is a board-certified nephrologist specializing in diseases of the kidney. He has comprehensive experience in the management of a broad spectrum of acute and chronic kidney disorders, with advanced knowledge of hemodialysis vascular access dysfunction management.

Mohammad Rafiqul Haider received his B.S. and M.S. degrees from Bangladesh University of Engineering and Technology (BUET). He received his Ph.D. in Electrical and Computer Engineering from the University of Tennessee at Knoxville in 2008. He is currently an Associate Professor in UAB’s Department of Electrical and Computer Engineering.

Steven D. Gardner received the B.S. degree in electrical engineering from Auburn University, Auburn, AL, USA, in 2016, and the M.S. degree in electrical and computer engineering from The University of Alabama at Birmingham (UAB), Birmingham, AL, USA, in 2018, where he is currently pursuing the Ph.D. degree with the Department of Electrical and Computer Engineering.