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

To create an artificial kidney, researchers are seeking to combine engineered structures with engineered tissue.  Current designs being investigated involve microfluidic networks in which each tube is coated with endothelial tissue.  These networks are designed to have smooth flow patterns, and the endothelial tissue helps reduce the chance of clot formation.  In a device being developed by Jeffrey Borenstein of Draper Labs, blood is filtered through a thin, engineered membrane in order to improve the clearance of middle-sized molecules relative to clearance rates obtained by current dialysis machines.  Modeling blood flow and metabolite diffusion in the blood has been and will continue to be very important to the project.           

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