The implantable artificial kidney.
The confluence of an increasing prevalence of end-stage renal disease (ESRD), clinical trial data suggestive of benefit from quotidian dialysis, and ongoing cost/benefit reanalysis of healthcare spending have stimulated interest in technological improvements in provision of ESRD care. For the last decade, our group has focused on enabling technologies that would permit a paradigm shift in dialysis care similar to that brought by implantable defibrillators to arrhythmia management. Two significant barriers to wearable or implantable dialysis persist: package size of the dialyzer and water requirements for preparation of dialysate. Decades of independent research into highly efficient membranes and cell-based bioreactors culminated in a team effort to develop an implantable version of the University of Michigan Renal Assist Device. In this review, the rationale for the design of the implantable artificial kidney is described.
Fissell
William H
WH
Department of Nephrology, Cleveland Clinic, Cleveland, Ohio 44195, USA. fisselw@ccf.org
Roy
Shuvo
S
D019149:Bioreactors; D015314:Dialysis Solutions / Q000737:chemistry; D017583:Hemodiafiltration / Q000295:instrumentation; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007688:Kidneys, Artificial; D008567:Membranes, Artificial; D010539:Permeability; D017582:Renal Replacement Therapy / Q000295:instrumentation*
D015314:Dialysis Solutions; D008567:Membranes, Artificial