Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges.

Autor: Ramada DL; Advanced Organ bioengineering and Therapeutics, Faculty of Science and Technology, Technical Medical Centre, University of Twente, P.O Box 217, 7500, AE Enschede, The Netherlands., de Vries J; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands., Vollenbroek J; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.; BIOS Lab on a Chip Group, MESA + Institute, University of Twente, Hallenweg 15, 7522, NH Enschede, The Netherlands., Noor N; Advanced Organ bioengineering and Therapeutics, Faculty of Science and Technology, Technical Medical Centre, University of Twente, P.O Box 217, 7500, AE Enschede, The Netherlands., Ter Beek O; Advanced Organ bioengineering and Therapeutics, Faculty of Science and Technology, Technical Medical Centre, University of Twente, P.O Box 217, 7500, AE Enschede, The Netherlands., Mihăilă SM; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands., Wieringa F; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.; Department of Autonomous Therapeutics, IMEC, Eindhoven, The Netherlands.; European Kidney Health Alliance (EKHA), WG3 'Breakthrough Innovation', Brussels, Belgium., Masereeuw R; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands., Gerritsen K; Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands., Stamatialis D; Advanced Organ bioengineering and Therapeutics, Faculty of Science and Technology, Technical Medical Centre, University of Twente, P.O Box 217, 7500, AE Enschede, The Netherlands. d.stamatialis@utwente.nl.; European Kidney Health Alliance (EKHA), WG3 'Breakthrough Innovation', Brussels, Belgium. d.stamatialis@utwente.nl.
Jazyk: angličtina
Zdroj: Nature reviews. Nephrology [Nat Rev Nephrol] 2023 Aug; Vol. 19 (8), pp. 481-490. Date of Electronic Publication: 2023 Jun 05.
DOI: 10.1038/s41581-023-00726-9
Abstrakt: Haemodialysis is life sustaining but expensive, provides limited removal of uraemic solutes, is associated with poor patient quality of life and has a large carbon footprint. Innovative dialysis technologies such as portable, wearable and implantable artificial kidney systems are being developed with the aim of addressing these issues and improving patient care. An important challenge for these technologies is the need for continuous regeneration of a small volume of dialysate. Dialysate recycling systems based on sorbents have great potential for such regeneration. Novel dialysis membranes composed of polymeric or inorganic materials are being developed to improve the removal of a broad range of uraemic toxins, with low levels of membrane fouling compared with currently available synthetic membranes. To achieve more complete therapy and provide important biological functions, these novel membranes could be combined with bioartificial kidneys, which consist of artificial membranes combined with kidney cells. Implementation of these systems will require robust cell sourcing; cell culture facilities annexed to dialysis centres; large-scale, low-cost production; and quality control measures. These challenges are not trivial, and global initiatives involving all relevant stakeholders, including academics, industrialists, medical professionals and patients with kidney disease, are required to achieve important technological breakthroughs.
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
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