Continuous renal replacement therapy for end-stage renal disease. The wearable artificial kidney (WAK).
Daily dialysis offers many benefits but is difficult to implement. CRRT allows dialysis 24/7 but is not suitable for ESRD patients. Thus, the need for a miniaturized ambulatory CRRT device those patients can wear permanently. We report the feasibility, safety and efficiency in uremic pigs, of such a wearable artificial kidney (WAK) that can be worn as a belt, operated with batteries, and weights less than 5 lbs. We used a hollow fiber dialyzer with a surface area of 0.2 sqm. Dialysate was continuously regenerated by a series of cartridges containing several sorbents allowing the use of approximately 375 ml of dialysate. The device includes reservoirs with heparin and electrolytes. Average fluid removal was 100 ml/hr. The Creatinine was 25 ml/min. In 8 hrs the total Creatinine removed was 1 gr, Urea 12 gr, P0.8 gr and K 72 mEq. Weekly st kt/v was extrapolated to approximately 7. There were no side effects. The WAK can be operated safely and continuously 168 hr/week. This would allow for all the advantages of daily dialysis and reduce morbidity and mortality in the ESRD population. It will also reduce cost and manpower utilization.
Gura
Victor
V
Cedars Sinai Medical Center, UCLA, and Geffen School of Medicine, Beverly Hills, Calif., USA.
Beizai
Masoud
M
Ezon
Carlos
C
Polaschegg
Hans-Dietrich
HD
D000818:Animals; D003404:Creatinine / Q000097:blood; D004867:Equipment Design; D005240:Feasibility Studies; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007688:Kidneys, Artificial; D011188:Potassium / Q000097:blood; D017582:Renal Replacement Therapy; D012449:Safety; D013552:Swine; D014508:Urea / Q000097:blood
D014508:Urea; D003404:Creatinine; D011188:Potassium