ArticleBMC nephrology2025
Noninvasive assessment of volume status in patients with end-stage kidney disease using a wearable monitor and cutaneous hydration sensor.
Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFluid volume overload is a frequent cause of hospitalization for patients with end-stage kidney disease (ESKD), and disproportionately occurs during the 2-day hemodialysis gap when patients are most susceptible to poor volume control. Noninvasive, wearable devices may hold potential for at-home volume status monitoring to prevent hospitalization but clinical validation in ESKD populations is limited.
methodsA total of 17 study participants (41% female, 76% Black, median age = 68 years) were recruited for in-center testing of hydration status pre- and post-hemodialysis. Percent lung water (%LW) and skin hydration were noninvasively assessed and compared with established clinical and hemodynamic and markers of hydration status.
resultsMedian within-subject change in systolic blood pressure (-10 mmHg, p = 0.08), diastolic blood pressure (-6 mmHg, p = 0.06), weight (-1.6 kg, p < 0.0001), heart rate (-10 bpm, p = 0.09), and %LW (-1.0%, p = 0.03) declined from pre- to post-dialysis. When analyzed as a continuous measurement, %LW was not correlated with systolic blood pressure, weight, heart rate, or dyspnea score. Skin hydration demonstrated poor correlation with %LW, but statistically differed (42 vs. 23 a.u.; P = 0.03) when stratified by the broader categories of borderline-high/elevated versus normal %LW, suggesting an ability to detect abnormal fluid status.
conclusionIn this small pilot study, noninvasive assessment of %LW was sufficiently sensitive to detect pre-to-post hemodialysis change in fluid status. These results support future evaluations in larger studies of patients with ESKD. Noninvasive, wearable devices may be a feasible strategy to assess volume status in the ESKD population, an approach which could potentially be extended to at-home settings.
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