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Continuous monitoring of blood pressure by analyzing the blood flow sound of arteriovenous fistula in hemodialysis patients

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Abstract

Background

Patients with end-stage renal disease undergoing hemodialysis (HD) have an elevated risk of cardiovascular disease-related morbidity and mortality. To prevent from such a life-threatening event, the continuous blood pressure (BP) monitoring system may contribute to detect BP decline in early stages and may help to do appropriate disposal. Our research team has introduced an electronic stethoscope (Asahi Kasei Co, Ltd., Tokyo, Japan), which translates sound intensity of Arteriovenous Fistula (AVF) to BP data using the technique of Fourier transformation that can predict continuous BP non-invasively. This study, we investigated whether electronic stethoscope-guided estimated BP (e-BP) would actually reflect systolic BP measured by sphygmomanometer (s-BP), and whether e-BP could predict fall of BP during HD.

Methods

Twenty-six patients who underwent HD treatment in our hospital were evaluated prospectively. We obtained sound intensity data from the electronic stethoscope which was equipped with the return line of HD. Then, the data were translated into e-BP data to be compared with s-BP. Correlation of total of 315 data sets obtained from each method was examined. An accuracy of diagnosis of intra-dialytic hypotension (IDH) was evaluated.

Results

Total of 315 data sets were obtained. A close correlation was observed between e-BP and s-BP (r = 0.887, p < 0.0001). Sensitivity and positive predictive value of predicted-BP for detection of IDH was 90 and 81.3%, respectively.

Conclusions

Electronic stethoscope-guided BP measurement would be helpful for real-time diagnosis of BP fall in HD patients. Further investigations are needed.

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Acknowledgements

The authors gratefully acknowledge the work of past and present members of our department of our hospital. We also wish to thank the timely technically help given by Elekio, Asahi Kasei Co., Ltd., Tokyo, Japan.

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Authors and Affiliations

  1. Department of Nephrology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-Ku, Tokyo, Japan

    Yuka Kamijo, Noriyuki Kounoue, Keisuke Ono, Keizo Maeda, Akane Yanai, Kazuya Honda, Ryuji Tsujimoto, Mai Yanagi & Yoshitaka Ishibashi

  2. Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan

    Yuka Kamijo, Eiichiro Kanda & Masayuki Yoshida

  3. Department of Nephrology, Tokyo Kyosai Hospital, 2-3-8 Nakameguro, Meguro-ku, Tokyo, Japan

    Eiichiro Kanda

  4. Division of Medical Engineering Technology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-Ku, Tokyo, Japan

    Hayato Horiuchi

Authors
  1. Yuka Kamijo
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  2. Eiichiro Kanda
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  3. Hayato Horiuchi
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  4. Noriyuki Kounoue
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  5. Keisuke Ono
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  6. Keizo Maeda
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  7. Akane Yanai
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  8. Kazuya Honda
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  9. Ryuji Tsujimoto
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  10. Mai Yanagi
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  11. Yoshitaka Ishibashi
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  12. Masayuki Yoshida
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Corresponding author

Correspondence to Yuka Kamijo.

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The authors declare no conflict of interest associated with this manuscript.

Human and animal rights (with IRB approval number)

All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional research committee at which the studies were conducted (IRB approval number 380) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kamijo, Y., Kanda, E., Horiuchi, H. et al. Continuous monitoring of blood pressure by analyzing the blood flow sound of arteriovenous fistula in hemodialysis patients. Clin Exp Nephrol 22, 677–683 (2018). https://doi.org/10.1007/s10157-017-1499-1

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  • DOI: https://doi.org/10.1007/s10157-017-1499-1

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