Wearable devices may have a future in kidney care, but challenges remain
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Wearable devices may play a significant role in the future of kidney care, according to a presenter at the International Conference on Dialysis.
Although wearable kidneys have received attention in recent years through the KidneyX competition and ongoing research, Jeroen Kooman, PhD, a professor at Maastricht University Medical Centre in The Netherlands, has his eye on different devices.
“In present day, there are many physiological variables which can be measured relatively easily by wearable devices, but it also has to be stressed that most of these devices are made for the consumer market,” Kooman said in the presentation. “Obviously if we are going to implement them in routine clinical practice, they have to be validated in our own patient population.”
For example, dysrhythmias can be detected by commercial smart watches, which are able to conduct electrocardiogram recordings on users, Kooman said. Among patients on dialysis, atrial fibrillation can often occur during a session; yet nurses do not usually measure heart rate or electrocardiography unless a patient complains, according to Kooman. With a wearable device, heart abnormalities could be detected during sessions.
Similarly, Kooman referenced a study in which participants wore a tracker that measured changes in heart rate, physical activity and respiration and was able to predict a participant’s risk for COVID-19.
“This does not circumvent usability testing, but it could identify patients who are more prone to having an infection that could lead to earlier detection,” Kooman said.
Sensors and personal area networks could improve patient participation, shared decision-making, personalized care, integration of multiple physiological signals and early detection and action.
However, Kooman said challenges that remain include whether patients would accept the devices and patients’ digital literacy. Additionally, the technologies would need to be validated, while focusing on unknown consequences and potential accountability, regulatory and ethical issues. Data overload and the medicalization of technologies would also need to be considered.
“What our future needs are devices ... specifically validated in patients with kidney disease,” Kooman said. “We would need advanced analytical tools for interpretation of complex physiological variables. We should have clear user interfaces for patients and for health care providers. We should start observational studies and intervention trials to show their potential benefit. And of course, from the beginning, we should have a lot of awareness for regulatory and ethical issues.”
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Kooman J. Wearables: Potential applications in patients with kidney disease. Presented at: International Conference on Dialysis; Sept. 21-22, 2022; (virtual meeting).
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