Well-functioning vascular access (VA) is essential for hemodialysis treatment in patients with end-stage renal disease (ESRD). However, continuous and accurate monitoring of blood flow to assess high-flux VA during hospitalization or at home is not feasible for either clinical instruments or wearable sensors. Here, we report the design and preclinical validation of a high-precision, long-term, epidermal blood flow sensor that self-adapts to unavoidable sensor-mounting deviations on the skin and is compatible with individual tissue differences. Specifically, the technology is based on thermal dissipation of the skin, and improves the signal-to-error ratio surpassing 4 times when measuring high-flux blood (100–600 mL/min). In preclinical validation, the sensor is compared with the Doppler ultrasound and demonstrate a blood flow resolution of 10–50 mL/min. Furthermore, it is highly-integrated and wearable, measuring 36 × 50 mm². The sensor paves the way for accurate, convenient, high-flux blood monitoring, offering significant potential to extend the lives of patients with ESRD.

功能良好的血管通路 （VA） 对于终末期肾病 （ESRD） 患者的血液透析治疗至关重要。然而，在住院期间或在家中连续准确地监测血流以评估高通量 VA 对于临床仪器或可穿戴传感器来说都是不可行的。在这里，我们报告了高精度、长期、表皮血流传感器的设计和临床前验证，该传感器可以自我适应皮肤上不可避免的传感器安装偏差，并与个体组织差异兼容。具体来说，该技术基于皮肤的散热，在测量高通量血液 （100-600 mL/min） 时，信错比提高了 4 倍以上。在临床前验证中，将传感器与多普勒超声进行比较，显示血流分辨率为 10-50 mL/min。此外，它还高度集成且可穿戴，尺寸为 36 × 50 毫米²。该传感器为准确、便捷、高通量的血液监测铺平了道路，为延长 ESRD 患者的生命提供了巨大的潜力。