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Robot-Assisted Kidney Transplantation
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A peritoneal-based automated wearable artificial kidney.

David B N Lee1, Martin Roberts

  • 1Laboratory for Artificial Kidney Innovation and Development (LAKID), Sepulveda Ambulatory Care Center and Nursing Home, VA Greater LA Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. dbnlee@ucla.edu

Clinical and Experimental Nephrology
|April 4, 2008
PubMed
Summary

A novel automated wearable artificial kidney (AWAK) offers a "bloodless" and "waterless" dialysis solution. This peritoneal-based system regenerates dialysate, potentially improving patient outcomes and freeing them from current dialysis regimens.

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Area of Science:

  • Biomedical Engineering
  • Nephrology
  • Materials Science

Background:

  • Current hemodialysis and hemofiltration require anticoagulation and face complications from blood-artificial membrane interactions.
  • Existing wearable kidney technologies are limited by extracorporeal circulation and potential immunologic issues.

Purpose of the Study:

  • To introduce a peritoneal-based automated wearable artificial kidney (AWAK) that eliminates extracorporeal circulation and water usage.
  • To demonstrate AWAK's capacity for continuous dialysate regeneration and reuse, including autologous protein recycling.

Main Methods:

  • Development of a sorbent-based assembly for regenerating both aqueous (AqC) and protein (PrC) components of spent dialysate.
  • Integration of regenerated components for continuous recycling into the peritoneal cavity.
  • Incorporation of additional sorbents for removing middle molecular weight uremic toxins.

Main Results:

  • Regenerated dialysate (AqC) mimics commercial peritoneal dialysate but with bicarbonate and physiological pH.
  • Recycled protein component (PrC) minimizes protein loss and offers potential for enhanced ultrafiltration and toxin removal.
  • High dialysate flow rate (96 L/day) achieved through continuous regeneration.

Conclusions:

  • AWAK represents a significant advancement in wearable artificial kidney technology, offering a 'bloodless' and 'waterless' alternative.
  • Continuous regeneration and recycling enable steady-state metabolic-biochemical and fluid balance, improving patient quality of life.
  • The 'dialysis-on-the-go' capability of AWAK liberates end-stage renal failure patients from the constraints of current dialysis modalities.