Wearable kidneys: the next stage in the history of Nephrology

Wearable kidneys: the next stage in the history of Nephrology

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Kidney problems are some of the most complex medical conditions in modern medicine. For this reason, the researches for solving renal failure problems all the world are advancing at an incredibly fast rate. Every day, the number of patients suffering from renal failure is getting bigger (more than two million patients, actually.) The sedentary lifestyle of patients, their poor diet, the stress, pollution, etc., are some of the reasons why these medical conditions are growing. Even though doctors insist on preventing kidney problems thanks to healthier habits, the truth is that patients only search the specialists when the problem is imminent. Another solution is needed, then. It seems an easy one, but it is simply urgent: the creation of portable artificial kidneys, instead of traditional dialysis treatments, is a need and trend in the world of nephrology researches.

An artificial kidney could be a replacement for hemodialysis and peritoneal dialysis treatments and would be a better alternative than kidney transplantation (which, is quite complicated in terms of donors and compatibilities.) The key is, in simple words, to create a machine dialysis that can be carried everywhere with the least possible intrusion in the human body.

Nowadays, there are treatments in which the patient does not need to move to a medical facility to carry out a dialysis process a couple of times a week, but can carry instead of a mechanism that performs the dialysis function. This treatment is known as peritoneal dialysis. Peritoneal dialysis is a way to remove the waste from the bloodstream and, in addition, to eliminate the excess fluid thanks to the blood vessels system which is located in the walls of the abdomen (in that membrane we call ‘peritoneum.’) This type of dialysis aims to install a catheter in the abdominal cavity, filling it with a cleaning liquid, which contains a type of sugar to remove waste and excess liquid. The good thing about this procedure is that, besides staying away from hemodialysis machines, the monitoring of doctors could be carried out even more easily thanks to big data technologies.

Image courtesy of eLife – the journal at Flickr.com

Peritoneal dialysis allows patients not to be connected to a machine, and, therefore, having a little more freedom of movement. However, peritoneal dialysis requires that the patient removes the bag with the wastes, and several dialysis sessions are permanently carried out on a daily basis. There are two ways to perform peritoneal dialysis. The first one is known as continuous ambulatory and involves filling the abdomen with fluid and draining it until the cycle ends. The important thing, in this case, is to drain the liquid at four-hour intervals, and an average of three exchanges is needed. The other type of peritoneal dialysis is a continuous cycle in which the patient remains connected to a machine during the night, which carries out a cycle of an average of four exchanges.

Read also: Wearable Kidneys: Today’s Feasible Solution, by Joe Cosgrove

The creation of portable artificial kidneys could go beyond peritoneal dialysis. One of the most successful researches nowadays has been carried out at the University of Washington. Up to now, five artificial kidneys have been created, and the results seem to have been quite successful. This system consists of installing a sort of wide belt around the patient’s waist which includes a drainage system with the same characteristics of a hemodialysis machine. This system includes a vascular access system that cleans around 100 mg of blood per minute. One of the advantages is that this system is extremely clean, and none of the patients who have tried it until now have presented infection problems. The only drawbacks have been blood clots, but the researchers are currently working hard on it.

It is still a long time before these types of kidneys can get into the market and being distributed like any other medical device (such as pacemakers, for instance.) It is still necessary to spend a lot of time to monitor as many problems as possible and subsequently solving them. In order to offer this service to patients, a high-level technology is needed, which can only be achieved through the appropriate collection, processing, and interpretation of data, which, until now, is only in the experimental phase.

Another option expected in the future is an intermediate point between hemodialysis and kidney transplantation. It deals with the 3D printing of organs. It seems like magic, but it will be a reality: kidneys formed with tissue samples from patients will be printed. Patients will use these organs without waiting for a donor, and the chances of rejection are minimal. The technology that is currently being used consists of isolating biological material from patients, creating tissues in controlled spaces, and, in this way, removing the obsolete kidneys. There is still a long time for this practice to be a close possibility, but it will definitely be the general rule.

Recommended: A wearable artificial kidney for patients with end-stage renal disease

* Featured Image courtesy of PresidenciaRD at Flickr.com

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