Pitfalls of Wearable Artificial Kidney

Vanholder, Raymond; Ringoir, S

doi:10.1177/039139889001301101

Cited by 3 publications

References 4 publications

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Membraneless Dialysis – Is It Possible?

Leonard¹,

Cortell²,

Vitale³

2005

Contributions to Nephrology

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Direct contact between uremic blood and a fluid capable of receiving uremic toxins is possible. Such contact by itself is, however, not beneficial because the selection of molecules that are removed is dependent on diffusion coefficients in blood. This selection is inadequate and would result in the exhaustion of a patient's albumin pool before useful reduction in the urea pool was achieved. Direct contact that is accomplished by sandwiching blood between two layers of a sheathing fluid, followed by diafiltration of the sheathing fluid through conventional membranes and recirculation of the sheathing fluid, is possible. This adaptation of membraneless transport of molecules from blood eliminates almost all contact of blood with solid artificial surfaces and the subsequent diafiltration and recirculation of the sheathing fluid allows precise control of what is removed from the system. Slightly hyperosmotic protein is carried back by the recirculating sheathing fluid. Only solutes and water that pass the diafilter, which operates on a cell-free fluid, are able to leave the system. The system depends strongly on the ability to keep cells out of the sheathing fluid. Preliminary results and earlier reports indicate that this separation is possible and more precise measurements are underway. A quantitative design of a wearable dialyzer based on a circulating sheathing fluid is presented.

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Membraneless Dialysis – Is It Possible?

Leonard¹,

Cortell²,

Vitale³

2005

Contributions to Nephrology

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Current Technological Approaches for a Wearable Artificial Kidney

Kim¹,

Ronco²

2011

Hemodialysis

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A wearable artificial kidney (WAK) is a device that continuously supports renal function during ambulation or social activities out of hospital. With the aim of improving dialysis patients' quality of life, WAK systems have been in development for several decades. Technological evolutions in dialysis membrane and dialysate regeneration have been paving the way to wearability, and the possibility of implantation, for renal replacement therapies. However, at present, there are many technical issues confronting the attempts to apply WAK systems in clinical practice. Here, we have reviewed the necessary technical requirements and the WAKs currently being developed that are trying to meet these. Aside from technical issues, ethical, legal and economic aspects should be also considered together, in order to minimize trial and error in the development of the WAK. Continuous follow- up, integration with emerging new technologies, and multidisciplinary approaches involving clinicians, engineers, economists and social scientists are required for the realization of WAK in clinical practice.

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A wearable artificial kidney: technical requirements and potential solutions

Kim

Garzotto

Nalesso

et al. 2011

Expert Review of Medical Devices

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Recently, new approaches for miniaturization and transportability of medical devices have been developed, paving the way for wearability and the possibility of implantation, for renal replacement therapies. A wearable artificial kidney (WAK) is a medical device that supports renal function during ambulation or social activities out of hospital. With the aim of improving dialysis patients' quality of life, WAK systems have been developed for several decades. However, at present there are a lot of technical issues confronting the attempt to apply WAK systems in clinical practice. This article focuses on technical requirements and potential solutions for WAKs and reviews up-to-date approaches related to dialysis membrane, dialysate regeneration, vascular access, patient-monitoring systems and power sources for WAKs.

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Pitfalls of Wearable Artificial Kidney

Cited by 3 publications

References 4 publications

Membraneless Dialysis – Is It Possible?

Membraneless Dialysis – Is It Possible?

Current Technological Approaches for a Wearable Artificial Kidney

A wearable artificial kidney: technical requirements and potential solutions

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