The ever-increasing incidence of end-stage renal disease (ESRD) has already become a major burden to health budgets and a threat to public health nationwide in Taiwan. According to the United States Renal Data System Annual Data Report in 2015, the prevalence and incidence of ESRD in Taiwan are the highest in the world. Moreover, for the population of 82 thousand ESRD patients receiving hemodialysis treatments, the total cost is up to NT$34.2 billion annually out of the National Health Insurance (NHI) program budget. This project is to design a wearable medical device which can measure and monitor the fluid dynamics of the dialysis access using sensor of phonoangiography (PAG) for exploring vascular pitch pattern and sensor of Photoplethysmography (PPG) for estimating the flow volume as a double checking of the AV access condition. We use arteriovenous access (AVA) stenosis detector based on phonoangiography technique and autoregressive model to detect access stenosis and simultaneously estimate the status of AVA life cycle by tracking and obtaining changes in frequency spectra domain. It helps hemodialysis patients to be aware earlier of the dysfunction of AVA and reminds them to make a return visit. The purpose of the complement deployment of vital sign sensors is to improve the prognosis and optimize overall health by providing analysis of physiological signals, including water content index, pulse oximetry, and blood pressure at the same time. With these sensors, the concept of holistic hemodialysis patient care (HHPC) might be proved.
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