Providing Better Care for Kidney Patients

Authorities in the field of providing care for patients with severe kidney disease presented at the CIMIT Forum on Jan. 15 at Simches Research Center of Massachusetts General Hospital.

The title of the Forum was “The Quest for a Wearable Kidney and Renal Assist Devices: Will Nanotechnology Make a Difference.”

Nearly 400,000 patients in the U.S. have end-stage kidney disease requiring dialysis or transplantation. Health officials agree there is a scarcity of organs, so dialysis remains the major therapy.

Wearable dialysis units have been discussed for close to 40 years, and yet experts say little progress as been name. Now the advent of nanotechnology has infused new hope into this area of medicine.

Dr. Theodore Steinman, of Beth Israel Deaconess Medical Center, who is clinical professor of medicine at Harvard Medical School, spoke on “Continuously Functioning Artificial Nephron: The Promise of Nanotechnology.”

He suggested that nanotechnology researchers are getting close to developing a human nephron filter that mimics the function of the human glomerulus and tubule.

Compared to current technology, the newest nano-membranes will be two to three times greater in efficiency than current dialyzers, and will be more compact and lightweight so as to be adaptable for portable use. The goal for the future is to make such a device implantable.

Greg Erman, an entrepreneur who launched a company called Renalworks Medical Corp. to develop renal-care devices, said that progress has been slow in aiding dialysis patients despite the need. He said that developing a small, “wearable” dialysis unit has not been successful due to issues including infection and efficiency.

Erman said that that developing the implantable unit could be the best route aiding kidney-failure patients, given the complexity of the kidney and its functions.

     

The Impact of Chronic Kidney Disease

Chronic Kidney Disease (CKD) affects 26 million people in the United States, and around 400,000 of these patients have end-stage renal disease requiring dialysis or transplantation.  The yearly cost of treating end-stage renal disease is around $27 billion, and the quality of life for patients with the disease is usually very low.  Designing a wearable dialysis machine could significantly improve patient outcomes, but many challenges must be overcome first.  The kidney is a complex organ that processes 180 liters of blood each day to eliminating wastes and toxins, to regulating the body’s water volume, and to control electrolyte levels.  In addition to these tasks, the kidney is also an endocrine organ that produces important hormones such as active vitamin D and erythropoietin.  Over the last sixty years, the design of dialysis machines has been improved, but the basic technology has remained unchanged.  Although commercial efforts to design wearable dialysis machines have yet to be successful, the need for such machines is so pressing that researchers are hopeful about the future.

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