Introduction:
End-Stage Kidney disease (ESKD) has multi systems impact on patients and they require many interventions to manage their clinical state and maintain a reasonable quality of life. They warrant regular investigations to manage anaemia, metabolic state, fluid status and preserving a functioning dialysis access till they have renal transplantation. These interventions are intrusive, invasive and require repeated visits to their hospital and other clinical sites where the service provided. Remote measurement of the parameters will reduce the burden to patients and also the travel involved can reduce the impact of carbon emission to the local communities.
The Alio SmartPatch™ represents a breakthrough in anaemia management in Chronic Kidney disease and it's a FDA- cleared device, the SmartPatch offers improvement over existing technologies by enabling real- time, non-invasive, and remote monitoring of multiple health parameters such as Heart rate, SaO2, Haemoglobin, Haematocrit, fluid status and the world’s first non-invasive monitoring of abnormal potassium via a functioning AV access.
In this study, we aims to evaluate the distance travelled between various sites needed to have their care for ESKD and assess the impact of using alio smartpatch and point of care ultrasound in reducing the travel need, thereby the impact on carbon emission.
Methods:
The data was obtained from a prospective, open-labeled, non-randomized study performed to compare Haemoglobin, Haematocrit and Potassium results from the SmartPatch with the laboratory results during the same haemodialysis session. Adults with capacity to consent and receiving haemodialysis via an arteriovenous fistula (AVF) or arteriovenous graft (AVG) in either upper limb were enrolled in this study. The SmartPatch was placed over the AV access site prior to the pre-dialysis blood draw. Skin color was classified using the Massey scale: light tones (1) to very dark tones (10). For this analysis, the pigmentation scale was divided into three categories: light (types 1–2), medium (types 3–5), and dark (types 5). The study was performed in United Kingdom, United States and Jordan.
The distance travelled by the patient who participated in this study in single centre was measured and carbon emission calculation was performed using Greenhouse Gases Equivalencies Calculator.
Results:
A total of 21 patients from single UK site were selected for this analysis. There was consistent cost-savings was found in all study patients whom did self-care in the dialysis centre or required nursing or medical input to offer them appropriate care.
The average travel distance for dialysis - 14.5 miles (three times a week) and we included for three unexpected visits / year. The calculation for annual Carbon footprint / Patient (Metric tons (MT) CO2) for Blood & Access latency visits is 0.08 and when combined with haemodialysis, it;s 0.62. For the study cohort, the blood & access review amounts to 1.68 MT and with HD, 13.02.
The study centre dialyses 1100 patients and integrating remote monitoring device such as alio smartpatch will lead to 88MT and with HD -682 MT and to demonstrate the the impact, a flight from London to New York results in 6.2 MT.
Conclusions:
This proof of concept study demonstrates the impact of remote measurement of clinical parameters, Hb, Hct K+ and measuring latency of AV access using a alio smartpatch in the cost incurred by the care providers and notable reduction in the carbon emission. We aim to measure the impact from the other clinical sites and As CKD prevalence increases across the globe, these technologies will help the care providers to offer an effective and timely care to their patients.
I have potential conflict of interest to disclose.
I am an advisor for the team developed the smartpatch
I did not use generative AI and AI-assisted technologies in the writing process.