The Complicating Effects of Patient Limb Position on the Development of a Localised Impedimetric-Based Hydrational Index for the Remote Monitoring of Home-Based Dialysis Patients

Bioimpedance measurements have been used to assess the effects of haemodialysis on patients and to help determine when the desired “dry weight” has been achieved and hence the optimum moment to stop the procedure.In the present research project we seek to develop a localised (on the calf), integrated measurement system capable of transmitting hydration-related impedimetric data, periodically between dialysis sessions, from patients undergoing home-based treatment to a remote monitoring clinic.We have found that the effects of the subject simply lying or sitting down gives rise to fluid changes in the calf which appear as significant and as long lasting as those due to the haemodialysis procedure itself.If correct, these preliminary findings will necessitate careful consideration of these two, possibly competing, effects on the determination of, for example, the moment the desired “dry weight” has been achieved during clinical haemodialysis treatments.Measures are being taken to address this problem in our own remote monitoring of the wellbeing of home-based dialysis patients.