Wearable Artificial Kidney Passes Test

Wearable Artificial Kidney Passes Test

8 end-stage kidney failure patients used the device for up to 8 hours, researchers say
By Ed Edelson
Posted 12/14/07

FRIDAY, Dec. 14 (HealthDay News) — The first version of an American-designed wearable artificial kidney has delivered promising results in a pilot trial, British physicians report.

Five men and three women newly diagnosed with end-stage kidney failure used the device for between four and eight hours, according to a report in the Dec. 15 issue of the journal The Lancet.
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The device resembles a large tool-belt hung with a variety of devices needed for the dialysis process. Using miniaturized components, it produced satisfactory, if small, rates of blood flow and clearance of toxins from the body, the report said.

That slow rate actually offers an advantage over standard dialysis, said Dr. Garabed Eknoyan, professor of medicine at Baylor College of Medicine, who wrote an accompanying editorial.

Dialysis now is done in three- or four-hour sessions, three times a week, Eknoyan said. “There are two major problems,” he said. “The changes occur fast, and removal occurs very fast, before the body gets a chance to accommodate, so there is discomfort with the process. If you dialyse at a lower rate for a longer period, the patient does better.”

But dialyzing at a slower rate using a standard artificial kidney has major disadvantages, Eknoyan said. “The patient is tied down to the machine,” he said. “Not every patient is willing to cope with that.”

The new device was designed by Dr. Victor Gura, a nephrologist at the University of California, Los Angeles. He is chief medical officer of Xcorporeal Inc., the company that made the device.

The discomfort and inefficiency of current dialysis treatment is becoming a bigger issue every years, said Dr. William Henry Fissell, director of the Cleveland Clinic Center for Extracorporeal Therapy.

“The population of patients requiring dialysis has been growing by 8 percent a year for a quarter-century,” Fissell said. “The United States now has 400,000 patients on maintenance dialysis.”

That increase is due to the growing ability of physicians to prolong the lives of people with the various aliments associated with cardiovascular risk factors such as diabetes and obesity, he said. Kept alive, many of those people will eventually develop kidney failure, Fissell said, and they often find current dialysis therapy unsatisfactory.

An informal network of kidney experts is working to develop better dialysis technology, and the new device is one example of the effort, Fissell said.

Major tests lie ahead, Eknoyan said. “Now that it has passed this stage of trial, we must go to the stage where people use it several times a day,” he said. “It remains to be seen how it is going to work. But the evidence is there, and the need is there that people need to dialyze more frequently.”

Researchers design model for automated, wearable artificial kidney

Researchers design model for automated, wearable artificial kidney

Published: Thursday, July 10, 2008 – 15:14 in Health & Medicine

Learn more about: david geffen school of medicine at ucla design model researchers design wearable artificial kidney

Two researchers from UCLA and the Veterans Affairs Greater Los Angeles Healthcare System have developed a design for an automated, wearable artificial kidney, or AWAK, that avoids the complications patients often suffer with traditional dialysis. The design for the peritoneal-based artificial kidney — which is “bloodless” and reduces or even eliminates protein loss and other dialysis-related problems — is summarized in an article published in the current issue of the journal Clinical and Experimental Nephrology, available online at http://dx.doi.org/10.1007/s10157-008-0050-9.

UCLA–VA has also signed an exclusive licensing agreement with the Singapore-based company AWAK Technologies Pte. Ltd. to develop a commercial wearable kidney based on the design by Martin Roberts, an assistant professor of clinical medicine at the David Geffen School of Medicine at UCLA and a dialysis consultant with the VA Healthcare System, and David B.N. Lee, a professor of medicine at the Geffen School and a consultant nephrologist at the VA.

Around 1980, an artificial kidney machine was built that incorporated many of the principles on which the new technology relies, according to Roberts. But that machine, while portable, was not wearable. The new technology would allow patients to go about their regular business while undergoing dialysis.

“What’s really new about it is the patient’s freedom,” Roberts said. “To me, as the inventor, the most important thing for the patients is their freedom. The next important thing is that because it’s working all the time instead of intermittently, you can do a much better job of treating the patient. So we expect the patient to feel better and live longer.”

Kidneys remove metabolic wastes from the body and regulate fluid volume and distribution on a continuous, around-the-clock basis. With traditional hemodialysis, patients are hooked up to a machine for four hours, three times a week. Their blood is filtered through the machine to remove toxins and is then pumped back into the body. What hemodialysis can’t do, however, is provide cleansing and fluid balance on a continuous basis; therefore, toxin levels and fluid volume tend to fluctuate, causing “shocks” to the patient’s system. The same is true of standard peritoneal-based dialysis.

In addition, hemodialysis uses anticoagulants to prevent the blood circulating outside the body from clotting. But this, too, can cause complications. Work on other wearable kidneys has been based on this hemodialysis or hemofiltration model.

The AWAK, on the other hand, would function continuously, as natural kidneys do, eliminating patient “shocks.” And because it does not involve blood circulation outside the body, it is “bloodless.” It also regenerates and reuses fluid and protein components in the spent dialysate — the fluid that has abstracted toxins from the patient’s blood and which is discarded in current practice — making it waterless and minimizing or eliminating protein loss.

“Dialysis-on-the-go, made possible by AWAK’s ‘wearability’ and automation, frees end-stage renal failure patients from the servitude that is demanded by the current dialytic regimentations,” Roberts and Lee write in the journal article.

Kerala Kidney Site

From: Jim M. <j60504@yahoo.com>
To: kidney_transplants@yahoogroups.com
Sent: Friday, February 20, 2009 2:02:37 PM
Subject: [kidney_transplants] Call To Action.

Call to Action to Support Organ Donation
NKF Calls for Action in Organ Donation “END THE WAIT!” Campaign Take
Action!

The National Kidney Foundation has just unveiled a comprehensive
action plan designed to increase the number of organs available for
donation and transplantation by removing barriers and improving the
transplant system. The NKF’s “END THE WAIT!” campaign aims to
eliminate the waiting list over the next 10 years by enacting
programs that are proven and effective to increase organ donation.
With over 25 specific recommendations, it recognizes that no single
solution will work. We must work with Congress, the Administration
and medical professionals and organizations to transform the organ
donation and transplantation system in this country.

You will play a vital role as we build consensus and support for
elements of this campaign as they are introduced in Congress.
Together, we can remove the barriers to organ donation and make the
Gift of Life more available.

The national waiting list for all organs has topped 100,000. Each
year thousands die or become too sick for a transplant before they
receive an organ. We must “END THE WAIT” for organ donation now.

Recommendations fall into four key areas:
* Improve outcomes of first transplants by extending coverage for
immunosuppressive drug coverage and providing patient education about
transplantation.
* Increase deceased donation with better hospital training to work
with potential donors and expanding the use of Extended Criteria
Donors.
* Increase the number of living donations by reimbursing all expenses
associated with donation, including lost wages, guaranteeing access
to health care and insurance coverage and offering them the best and
quickest recovery time.
* Improve the system of donation and transplantation throughout the
U.S. by eliminating regional variations and racial disparities.

More information is available on the NKF website by clicking here.

The first element of the campaign has been introduced in Congress.
Take a minute to contact your Congressperson and ask him or her to co-
sponsor H.R. 218, which would provide a tax credit up to $5000 for
unreimbursed expenses, including lost wages, associated with living
donation.

We look forward to ending the wait for organ donation with your help!

Jayne Mardock
Congressional Relations Director

Patients’ right to live

NEED TO FIGHT FOR PATIENTS RIGHTS
Sreekumar 2009feb21

Chronic patients too have a right to live. Right now the situation is not noticed by the society. Patients afflicted by debilitating diseases find themselves often abandoned. They quite often loose their jobs, in the private sector. Being incomeless, they wont be able to pay their insurance and obtain the benefits. There are few people available these days to take care of the sick ones and the expenses are very high.

Kerala Kidney Site

Father and son offer hope for kidney disease patients
Posted By KARENA WALTER, STANDARD STAFF

Last summer, St. Catharines resident Ron Simpson competed in six triathlons. This year, he’s just hoping he’ll be strong enough to check off one.

But Simpson, a 56-year-old tool setter at General Motors on Ontario Street, said giving his son a kidney last week was a “no brainer.”

“I never thought that I’d have to make that decision,” he said Thursday as he recovered at home after the Feb. 11 surgery. “It wasn’t hard.”

Jay Simpson, 35, said his dad stepped up, but not everyone is as fortunate.

On Wednesday, a day after Jay got home from the Hamilton hospital, he signed up to volunteer with the Kidney Foundation of Canada to help raise awareness.

The foundation is launching its annual door-to-door fundraising drive in March for kidney research.

“It’s an emotional and physical disease. It takes a lot out of you, but I’m proud to say I never gave up,” Jay said.

“Lots of people are discouraged. There is hope.”

Of the 1,669 people in Ontario on organ transplant waiting lists, 1,198, or 70 per cent, are waiting for kidneys, according to the Trillium Gift of Life Network.

Jay saw many other awaiting a kidney transplant as he received dialysis at the Niagara Health System’s Ontario Street hospital. Since August, after working all day in construction, he’d have his blood filtered for four hours a night, three days a week.

He was diagnosed with kidney failure in January 2006 after going to St. Catharines General for headaches. Doctors told him he had 30 per cent function left in his kidneys.

“It’s eventually going to go and it’s going to go fast,” they told him. Jay learned his other problems — fatigue, high blood pressure, frequent urination and dizziness — were all symptoms of the disease he didn’t know he had.

“I was a guy who went to the gym, I ate healthy,” Jay said. “It took me a year and a half to come to grips with it.”

Meanwhile, Jay’s parents immediately checked to see if they were compatible organ donors and found his mother, Shirley, wasn’t a match. When Ron learned he was, it took another 16 to 18 months of tests and meetings with specialists to ensure he was truly fit.

“They want to make sure you’re all right before anything,” Ron said, explaining he saw everyone from heart experts to a psychiatrist,

The Kidney Foundation of Canada says kidneys from living donors like Ron work right away, last longer and are usually healthier.

Kidney success rates from living donors are 90 to 95 per cent after a year and the kidneys last an average 15 to 20 years. Those from deceased donors have an 85 to 90 per cent success rate and last about 10 to 15 years.

The Simpson men are now recovering at home, with Jay off work for three months and Ron for two. Other than some soreness where the staples are, both say they are doing well and wanted to thank the nurses at the hospital.

Jay said he didn’t know anything about kidney failure before his experience and wants others to know the importance of signing organ-donor cards.

“A lot of people don’t know how important it is to make that decision,” Jay said.

“If something happens, you could be saving a life, just by signing a piece of paper.”