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Objective We have previously used a 12-lead, signal-processed ECG to calculate blood potassium levels. We now assess the feasibility of doing so with a smartphone-enabled single lead, to permit remote monitoring. Patients and methods Twenty-one hemodialysis patients held a smartphone equipped with inexpensive FDA-approved electrodes for three 2 min intervals during hemodialysis. Individualized potassium estimation models were generated for each patient. ECG-calculated potassium values were compared to blood potassium results at subsequent visits to evaluate the accuracy of the potassium estimation models. Results The mean absolute error between the estimated potassium and blood potassium 0.38 ± 0.32 mEq/L (9% of average potassium level) decreasing to 0.6 mEq/L using predictors of poor signal. Conclusions A single-lead ECG acquired using electrodes attached to a smartphone device can be processed to calculate the serum potassium with an error of 9% in patients undergoing hemodialysis. Summary A single-lead ECG acquired using electrodes attached to a smartphone can be processed to calculate the serum potassium in patients undergoing hemodialysis remotely.

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