A New Method for Continuous Relative Blood Volume and Plasma Sodium Concentration Estimation During Hemodialysis

Objective: Non-invasive sensing and reliable estimation of physiological parameters are important features of hemodialysis machines, especially for therapy customization (biofeedback). In this paper, we present a new method for joint estimation of two important hemodialysis-related physiological parameters-relative blood volume and plasma sodium concentration. Methods: Our method makes use of a non-invasive sensor setup and a mathematical estimator. The estimator, based on the Kalman filter, allows merging data from multiple sensors, newly designed as well as onboard, with modeling knowledge about the hemodialysis process. The system was validated on in vitro hemodialysis sessions using bovine blood. Results: The estimation error we obtained (0.97 ± 0.73% on relative blood volume and 0.47 ± 0.19 mM on plasmatic sodium) proved to be comparable with that of the reference data for both parameters-the system is sufficiently accurate to be relevant in a clinical context. Conclusion: Our system has the potential to provide accurate and important information on the state of a patient undergoing hemodialysis, while only low-cost modifications to the existing onboard sensors are required. Significance: Through improved knowledge of blood parameters during hemodialysis, our method will allow better patient monitoring and therapy customization in hemodialysis.