title: Present status and perspectives of bioartificial kidneys.
abstract: Currently, hemodialysis is not adequate as a renal replacement therapy because it provides intermittent treatment and does not provide the metabolic function of renal tubules. The next generation of artificial kidney should replace intermittent hemodialysis with continuous hemofiltration and provide the full metabolic function of renal tubules. The current decade has witnessed the development of bioartificial kidneys using artificial membranes and renal tubular epithelial cells. Active transport and metabolic functions were confirmed in the confluent monolayers of tubular cells on artificial membranes. Bioartificial kidneys have succeeded in improving the prognosis of patients with multiple organ dysfunction, presumably by lowering plasma cytokine levels in patients. For successful treatment of chronic renal failure using bioartificial kidneys, it is necessary to overcome some technical hurdles such as improving the antithrombogenic properties of the surface of artificial membranes and prolonging the function of renal tubule cells on an artificial membrane. Transfection of functional protein genes into renal tubule cells enables bioartificial tubule devices to increase their transport capacity and metabolic functions such as digoxin secretion and water transport. The development of wearable roller pumps is also essential for the clinical application of a continuous treatment system.
authors.affiliation: Division of Nephrology, Department of Medicine, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan. asait@is.icc.u-tokai.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
authors.forename: Tun
authors.initials: T
authors.lastname: Aung
authors.forename: Koji
authors.initials: K
authors.lastname: Sekiguchi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Duc M
authors.initials: DM
authors.lastname: Vu
authors.forename: Miho
authors.initials: M
authors.lastname: Inagaki
authors.forename: Genta
authors.initials: G
authors.lastname: Kanai
authors.forename: Reika
authors.initials: R
authors.lastname: Tanaka
authors.forename: Hajime
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kakuta
mesh_terms: D035843:Biomedical Research / Q000639:trends*; D006801:Humans; D007688:Kidneys, Artificial; D051437:Renal Insufficiency / Q000628:therapy