Evaluation of a system for sorbent‐assisted peritoneal dialysis in a uremic pig model

Gelder, Maaike K. van; Vries, Joost C de; Simonis, Frank; Monninkhof, Anneke S.; Hazenbrink, Diënty H. M.; Ligabue, Giulia; Giovanella, Silvia; Joles, Jaap A.; Verhaar, Marianne C.; Rubio, Bajo; Selgas, Rafael; Cappelli, Gianni; Gerritsen, Karin G.F.

doi:10.14814/phy2.14593

Cited by 7 publications

(14 citation statements)

References 32 publications

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“…In the first clinical trials, urea, creatinine, and phosphate clearance were achieved, comparable with that of automated PD. 72 Intraperitoneal glucose concentration was maintained during dialysis, enabling efficient ultrafiltration, and no adverse events or patients' discomfort were observed. 73 Wearable devices for continuous flow PD may be a serious alternative to conventional PD that could enhance blood purification efficiency and offer patients more freedom in everyday life.…”

Section: Wearable Systems For Dialysis (Wak)mentioning

confidence: 98%

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

et al. 2022

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Background: Chronic kidney disease (CKD) is a major cause of early death worldwide. By 2030, 14.5 million people will have end-stage kidney disease (ESKD, or CKD stage 5), yet only 5.4 million will receive kidney replacement therapy (KRT) due to economic, social, and political factors. Even for those who are offered KRT by various means of dialysis, the life expectancy remains far too low.Observation: Researchers from different fields of artificial organs collaborate to overcome the challenges of creating products such as Wearable and/or Implantable Artificial Kidneys capable of providing long-term effective physiologic kidney functions such as removal of uremic toxins, electrolyte homeostasis, and fluid regulation. A focus should be to develop easily accessible, safe, and inexpensive KRT options that enable a good quality of life and will also be available for patients in less-developed regions of the world.Conclusions: Hence, it is required to discuss some of the limits and burdens of transplantation and different techniques of dialysis, including those performed at home. Furthermore, hurdles must be considered and overcome to develop wearable and implantable artificial kidney devices that can help to improve the quality of life and life expectancy of patients with CKD.

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Section: Wearable Systems For Dialysis (Wak)mentioning

confidence: 98%

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

et al. 2022

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“…In total, 21 records were included for review. 11,12,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]…”

Section: Selectionmentioning

confidence: 99%

“…23 Thirteen studies (62%,) applied dialysate regeneration, either directly with the peritoneal dialysate circuit passing a purification unit based on (modified) REcirculation DialYsis (REDY) 38 technology (n = 4) 12,[20][21][22] or indirectly using a secondary dialysate circuit separated from the primary peritoneal dialysate circuit by a (hemo)dialysis membrane (n = 9). 11,19,25,26,[29][30][31][32][33] In three studies, the secondary dialysate circuit contained a sorbent unit, comprising either only activated carbon 33 or a combination of activated carbon and ion exchangers. 39 Importantly, small solute clearance with CFPD appears to increase at higher dialysate flow rates (Figure 1, Table S2).…”

Section: Baseline Characteristicsmentioning

confidence: 99%

“…Of note, all studies which reported both a (fixed) Qd and clearance were included. [12][13][14][15]17,[19][20][21][22][24][25][26]31,32 Each data point represents the mean clearance for creatinine (circles) or urea (squares) at the reported mean effective dialysate flow rate (Qd). If a single study reported data for differing flow rates, each flow rate is displayed as a separate data point in this figure peritoneal dialysate outflow slightly higher than the inflow rate.…”

Section: Safetymentioning

confidence: 99%

“…We included CFPD performed via a single‐lumen catheter with alternate in‐ and outflow of fluid with continuous rapid cycling since for the enhancement of the MTAC of uremic solutes, we deemed the direction of the flow (patient in or out) irrelevant, as both result in a net flow of dialysate passing the peritoneal membrane. In total, 21 records were included for review 11,12,18–37 …”

Section: Selectionmentioning

confidence: 99%

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Evidence on continuous flow peritoneal dialysis: A review

Vries

Gelder

Cappelli

et al. 2022

Seminars in Dialysis

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Clinical application of continuous flow peritoneal dialysis (CFPD) has been explored since the 1960s, but despite anticipated clinical benefits, CFPD has failed to gain a foothold in clinical practice, among others due to the typical use of two catheters (or a dual‐lumen catheter) and large dialysate volumes required per treatment. Novel systems applying CFPD via the existing single‐lumen catheter using rapid dialysate cycling may solve one of these hurdles. Novel on‐demand peritoneal dialysate generation systems and sorbent‐based peritoneal dialysate regeneration systems may considerably reduce the storage space for peritoneal dialysate and/or the required dialysate volume. This review provides an overview of current evidence on CFPD in vivo. The available (pre)clinical evidence on CFPD is limited to case reports/series with inherently nonuniform study procedures, or studies with a small sample size, short follow‐up, and no hard endpoints. Small solute clearance appears to be higher in CFPD compared to conventional PD, in particular at dialysate flows ≥100 mL/min using two single‐lumen catheters or a double‐lumen catheter. Results of CFPD using rapid cycling via a single‐lumen catheter are too preliminary to draw any conclusions. Continuous addition of glucose to dialysate with CFPD appears to be effective in reducing the maximum intraperitoneal glucose concentration while increasing ultrafiltration efficiency (mL/g absorbed glucose). Patient tolerance may be an issue since abdominal discomfort and sterile peritonitis were reported with continuous circulation of the peritoneal dialysate. Thus, well‐designed clinical trials of longer duration and larger sample size, in particular applying CFPD via the existing catheter, are urgently required.

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On the Fisher Identifiability of Coupled Transport Processes in Animal Hypoxia Experiments

Abdelazim,

Fathy

2023

IEEE Control Syst. Lett.

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Evaluation of a system for sorbent‐assisted peritoneal dialysis in a uremic pig model

Cited by 7 publications

References 32 publications

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

Evidence on continuous flow peritoneal dialysis: A review

On the Fisher Identifiability of Coupled Transport Processes in Animal Hypoxia Experiments

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