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How can we advance in renal replacement therapy techniques?

Ana Castro1, Mauro Neri2, Akash Nayak Karopadi3

  • 1Department of Nephrology, Dialysis and Transplantation, Oporto Hospital Centre, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal; International Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy.

Nefrologia
|March 9, 2019
PubMed
Summary

Portable artificial kidney devices offer a promising alternative for End-Stage Renal Disease (ESRD) patients, demonstrating safety and efficacy in clinical trials for solute clearance and fluid removal.

Keywords:
Acceso vascularCalidad de vida relacionada con la saludDispositivo de ultrafiltración portátilEnd-Stage Renal DiseaseEnfermedad renal crónica terminalHealth-related quality of lifeRenal replacement therapyRiñón Artificial PortátilTerapia de sustitución renalVascular accessWearable Artificial KidneyWearable Ultrafiltration device

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Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Medical Devices

Background:

  • End-Stage Renal Disease (ESRD) poses a significant global health challenge, with increasing prevalence necessitating advanced treatment options.
  • Maintenance dialysis, primarily in-centre hemodialysis, has limitations and a prognosis that requires improvement.
  • The growing number of ESRD patients worldwide underscores the need for innovative renal replacement therapies.

Purpose of the Study:

  • To review the evolution and clinical trials of Wearable Artificial Kidney (WAK) and Wearable Ultrafiltration (WUF) systems.
  • To highlight the technical features, clinical advantages, and economic aspects of portable renal replacement therapy (RRT) devices.
  • To discuss the potential of portable RRT to address unmet clinical needs in ESRD management.

Main Methods:

  • Review of historical development and technological advancements in portable RRT.
  • Analysis of key human studies and clinical trials involving WAK and WUF systems.
  • Examination of technical specifications, solute clearance, and fluid removal capabilities.

Main Results:

  • Three significant human studies have been conducted with WAK and WUF devices.
  • These portable RRT devices have demonstrated undeniable safety and efficacy in solute clearance and fluid removal.
  • While requiring further technological improvement, initial trials show promise for portable RRT.

Conclusions:

  • Portable RRT devices like WAK and WUF represent viable alternatives for ESRD patients.
  • These devices show potential to improve health-related quality of life by meeting individual patient needs.
  • Future RRT techniques must evolve towards personalized solutions for optimal patient outcomes.