A novel system to continuously estimate intradialytic blood pressure in real time

Viramontes-Hörner, Daniela ORCID: https://orcid.org/0000-0002-4861-623X , Stewart, Paul ORCID: https://orcid.org/0000-0001-8902-1497 , Stewart, Jill ORCID: https://orcid.org/0000-0002-6482-897X , Taal, Maarten ORCID: https://orcid.org/0000-0002-9065-212X and Selby, Nicholas ORCID: https://orcid.org/0000-0003-0351-8326 (2025) A novel system to continuously estimate intradialytic blood pressure in real time. Nephrology Dialysis Transplantation . gfaf058.

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Abstract

Background: Intradialytic hypotension (IDH) is a common complication of haemodialysis that is associated with adverse patient outcomes. We have developed a new non-invasive approach to continuously estimate systolic blood pressure (SBP) in real time during haemodialysis using pressure wave sensors in the extracorporeal circuit. We sought to compare the performance of our continuous real-time SBP estimator against brachial cuff SBP measurements.

Methods: Single-centre, observational study conducted in 21 participants receiving haemodialysis with a functioning arteriovenous fistula, studied throughout two 4-h haemodialysis sessions. Time-averaged real-time SBP estimator values from the 5-s period immediately prior to each cuff measurement were compared with matched brachial cuff SBP values.

Results: Mean age was 71 ± 11 years and median dialysis vintage was 20.0 months (interquartile range 12.5–63.5). Across 522 SBP comparison data points, mean brachial cuff SBP and real-time SBP estimate were 121.8 ± 27.1 mmHg and 123.7 ± 27.9 mmHg, respectively. Brachial cuff SBP and real-time SBP estimate were significantly associated (r = 0.825; P < .001). There was a low absolute mean difference between the brachial cuff SBP and the real-time SBP estimate of –1.9 ± 16 mmHg, and no evidence of systematic bias between measurements. Across all comparison points, 95% of estimator values were within 30% of the matched brachial cuff value, and 66% within 10% of the cuff value.

Conclusions: A blood pressure estimator that runs in real time during haemodialysis using pressure wave sensors in the extracorporeal circuit and avoiding additional sensor-burden on patients has good performance in tracking intradialytic SBP when compared against brachial cuff measurements, supporting its further development and larger scale testing.

Item Type:	Article
Journal / Publication Title:	Nephrology Dialysis Transplantation
Publisher:	Oxford University Press (OUP)
ISSN:	1460-2385
Departments:	Institute of Engineering, Computing and Advanced Manufacture
Additional Information:	Professor Jill Stewart, Director of IECAM (Institute of Engineering, Computing and Advanced Manufacturing), University of Cumbria, UK. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Depositing User:	Insight Administrator
SWORD Depositor:	Insight Administrator
Date Deposited:	29 Apr 2025 09:09
Last Modified:	19 May 2025 10:00
URI:	https://insight.cumbria.ac.uk/id/eprint/8787

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