Artificial Kidney Technology Moves Forward

If ESRD patients face increasing difficulty getting a kidney transplant in coming years, they may see an artificial kidney as the next best alternative.
If ESRD patients face increasing difficulty getting a kidney transplant in coming years, they may see an artificial kidney as the next best alternative.

As a venue for announcing important medical developments, Kidney Week never disappoints. Hundreds of studies presented at the 2015 conference in San Diego, as in previous years, have the potential for influencing clinical practice and moving nephrology forward in a major way. One of those studies was a small exploratory trial of a wearable artificial kidney (WAK).

The study, by Victor Gura, MD, of Cedars-Sinai Medical Center in Los Angeles, and colleagues, was a 24-hour trial of a device that the investigators described as a miniaturized hemodialysis machine based on dialysate-regenerating sorbent technology. Their study included 7 patients with end-stage renal disease. According to the investigators, all patients remained hemodynamically stable and experienced no serious adverse events over the 24-hour study period. Fluid removal was consistent with prescribed ultrafiltration, Dr. Gura's group stated in a poster presentation. 

Five patients completed the planned 24 hours of study treatment; 2 completed 4 hours and 10 hours. Of the 7 patients, 6 ambulated while wearing the WAK. Patients ate a normal diet during the study, with ad lib ingestion of water and without restricting salt, phosphate, or potassium-rich foods, Dr. Gura and his colleagues noted.

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“All patients reported that they would switch to the WAK if the device were commercially available,” the authors wrote. 

The commercial availability of a wearable or implantable articial kidney is likely years away, but the promising findings by Dr. Gura's group provide a reason for optimism because of the potential life-changing ramifications for ESRD patients. Many of these patients must adjust their work schedules or plan their recreational and social activities around dialyzing sessions, especially those receiving thrice-weekly in-center dialysis. 

Currently, the only treatment that can free ESRD patients from dialysis is a kidney transplant. Only a fraction of patients receive one, however, in part because of a shortage of donor kidneys. The total number of kidney transplants over the past decade has leveled off, according to the U.S. Renal Data System 2015 Annual Data Report. The unadjusted transplant rate per 100 dialysis patient years has been declining while the percentage of prevalent dialysis patients wait-listed for a kidney transplant has been increasing, the report noted. 

If ESRD patients face increasing difficulty getting a kidney transplant in coming years, they may see an artificial kidney as the next best alternative. Although nothing will replace having a real human kidney—even with the problems associated with immunosuppressive medications—a portable or implantable unit that enables ESRD patients to dialyze anywhere would likely do wonders for their quality of life.

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