INTRODUCTION
Hemodialysis is one of the treatments available for end
stage renal failure. Some years ago, a high percentage of
uremic patients was treated by home hemodialysis (HD).
However, today the proportion of patients treated by home
HD is very low, despite the reports that this treatment
modality has lower mortality and offers better quality of life
(1-3).
Today’s technical advances encourage the expansion of
home HD. Telemedicine is a new development and covers
medical activities including treatment and education (4-6).
However, research on the effectiveness of telemedicine is
somewhat limited and the number of patients receiving
services that use this technology remains relatively low
(7). The goal of this research is to combine home HD with
telematics monitoring services for supporting uremic
patients who need home or satellite HD treatment.
MATERIALS AND METHODS
For the clinical trials of our research project, two ERGO
TN-401 Hemodialysis machines (HDM) were installed in
Artificial Kidney and Dialysis
The International Journal of Artificial Organs / Vol. 22 / no. 10, 1999 / pp. 679-683
Telemedicine technology and applications for home
hemodialysis
B. AGROYANNIS
1
, C. FOURTOUNAS
1
, G. ROMAGNOLI
2
, M. SKIADAS
3
, C. TSAVDARIS
4
, C. CHASSOMERIS
5
,
H. TZANATOS
1
, I. KOPELIAS
1
, D. LYMBEROPOULOS
5
, J. PSARRAS
4
1
Department of Nephrology, Aretaieon University Hospital, Athens - Greece
2
Azienda Ospedaliera di Padova, Padova - Italy
3
ERGO S.A., Athens - Greece
4
National Technical University of Athens, Athens
5
University of Patras - Greece
©
by Wichtig Editore, 1999 0391-3988/679-05 $02.50/0
ABSTRACT: Home hemodialysis (HD) for the treatment of patients with end-stage renal disease
(ESRD) was first put into practice about 30 years ago. In this paper we describe the application of
telematics monitoring services (TMS) for supporting patients who need home or satellite HD (SHD).
For the clinical trials two modified HD machines were located in the renal unit and a central control
station (UNIX workstation with multimedia PC-terminal) was located in another room of the hospital.
Bi-directional communication between modified HD machines and central control station was
managed via ISDN (Integrated Services Digital Network) links.
Using these HD-machines 150 HD sessions were performed in nine patients over a period of five
months. This system enabled on-line remote supervision of the HD machine-related functions (air in
the blood, leak of blood, low conductivity etc.) and the clinical condition of patients through
measurement of blood pressure (BP), pulse rate, PO
2
(pulse oxymetry) and electrocardiogram
(ECG) from the central control station (CCS). The user checked the type of alarm/warning, its
appearance on HD machines and multimedia terminal units (MTU), the action of the protective
system and the appearance of consultative messages from CCS on the remote terminal unit RTU.
According to the data collected, the disturbances of HD machine function were visible and audible in
the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated
complications were observed, all data and alarms/warnings were transmitted correctly and patients
had adequate HD treatment. (Int J Artif Organs 1999; 22: 679-83)
KEY WORDS: Home hemodialysis, Telematics application, Telemonitoring, ISDN
Agroyannis 679 12-11-1999 10:01 Pagina 679