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Lee H, Liu KH, Yang YH, Liao JD, Lin BS, Wu ZZ, Chang AC, Tseng CC, Wang MC, Tsai YS. Advances in uremic toxin detection and monitoring in the management of chronic kidney disease progression to end-stage renal disease. Analyst 2024; 149:2784-2795. [PMID: 38647233 DOI: 10.1039/d4an00057a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Patients with end-stage kidney disease (ESKD) rely on dialysis to remove toxins and stay alive. However, hemodialysis alone is insufficient to completely remove all/major uremic toxins, resulting in the accumulation of specific toxins over time. The complexity of uremic toxins and their varying clearance rates across different dialysis modalities poses significant challenges, and innovative approaches such as microfluidics, biomarker discovery, and point-of-care testing are being investigated. This review explores recent advances in the qualitative and quantitative analysis of uremic toxins and highlights the use of innovative methods, particularly label-mediated and label-free surface-enhanced Raman spectroscopy, primarily for qualitative detection. The ability to analyze uremic toxins can optimize hemodialysis settings for more efficient toxin removal. Integration of multiple omics disciplines will also help identify biomarkers and understand the pathogenesis of ESKD, provide deeper understanding of uremic toxin profiling, and offer insights for improving hemodialysis programs. This review also highlights the importance of early detection and improved understanding of chronic kidney disease to improve patient outcomes.
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Affiliation(s)
- Han Lee
- Laboratory of Engineered Materials for Biomedical Applications, Department of Materials Science and Engineering, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.
| | - Kuan-Hung Liu
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
| | - Yu-Hsuan Yang
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
| | - Jiunn-Der Liao
- Laboratory of Engineered Materials for Biomedical Applications, Department of Materials Science and Engineering, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.
| | - Bo-Shen Lin
- Laboratory of Engineered Materials for Biomedical Applications, Department of Materials Science and Engineering, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan.
| | - Zheng-Zhe Wu
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
| | - Alice Chinghsuan Chang
- Center for Measurement Standards, Industrial Technology Research Institute, No. 321, Kuang Fu Road, Section 2, Hsinchu 300, Taiwan.
| | - Chin-Chung Tseng
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
| | - Ming-Cheng Wang
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
| | - Yau-Sheng Tsai
- Center for Clinical Medicine Research, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City, 701, Taiwan.
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2
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Tkachenko H, Hetmański T, Włodarkiewicz A, Jarosiewicz A, Tomin V, Kamiński P, Kurhaluk N. Ecophysiological characteristics of wintering mute swan population in anthropogenically modified environments. THE EUROPEAN ZOOLOGICAL JOURNAL 2022. [DOI: 10.1080/24750263.2022.2077995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- H. Tkachenko
- Department of Biology, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - T. Hetmański
- Department of Earth Sciences, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - A. Włodarkiewicz
- Department of Physics, Institute of Exact and Technical Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - A. Jarosiewicz
- Department of Earth Sciences, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - V. Tomin
- Department of Physics, Institute of Exact and Technical Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - P. Kamiński
- Department of Medical Biology and Biochemistry, Department of Ecology and Environmental Protection, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Department of BiotechnologyFaculty of Biological Sciences, University of Zielona Góra, Institute of Biological Sciences, Zielona Góra, Poland
| | - N. Kurhaluk
- Department of Biology, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Słupsk, Poland
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3
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Sivanathan PC, Ooi KS, Mohammad Haniff MAS, Ahmadipour M, Dee CF, Mokhtar NM, Hamzah AA, Chang EY. Lifting the Veil: Characteristics, Clinical Significance, and Application of β-2-Microglobulin as Biomarkers and Its Detection with Biosensors. ACS Biomater Sci Eng 2022; 8:3142-3161. [PMID: 35848712 DOI: 10.1021/acsbiomaterials.2c00036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Because β-2-microglobulin (β2M) is a surface protein that is present on most nucleated cells, it plays a key role in the human immune system and the kidney glomeruli to regulate homeostasis. The primary clinical significance of β2M is in dialysis-related amyloidosis, a complication of end-stage renal disease caused by a gradual accumulation of β2M in the blood. Therefore, the function of β2M in kidney-related diseases has been extensively studied to evaluate its glomerular and tubular functions. Because increased β2M shedding due to rapid cell turnover may indicate other underlying medical conditions, the possibility to use β2M as a versatile biomarker rose in prominence across multiple disciplines for various applications. Therefore, this work has reviewed the recent use of β2M to detect various diseases and its progress as a biomarker. While the use of state-of-the-art β2M detection requires sophisticated tools, high maintenance, and labor cost, this work also has reported the use of biosensor to quantify β2M over the past decade. It is hoped that a portable and highly efficient β2M biosensor device will soon be incorporated in point-of-care testing to provide safe, rapid, and reliable test results.
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Affiliation(s)
- P C Sivanathan
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Kai Shen Ooi
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia.,Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia
| | | | - Mohsen Ahmadipour
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Chang Fu Dee
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Norfilza Mohd Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Kuala Lumpur, Malaysia
| | - Azrul Azlan Hamzah
- Institute of Microengineering and Nanoelectronics, Universiti Kebangsaan Malaysia, 43600 Bangi, Malaysia
| | - Edward Y Chang
- Department of Material Science and Engineering, International College of Semiconductor Technology, National Yang Ming Chiao Tung University, 30010 Hsinchu, Taiwan
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4
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Mohajerani F, Clark WR, Ronco C, Narsimhan V. Mass Transport in High-Flux Hemodialysis: Application of Engineering Principles to Clinical Prescription. Clin J Am Soc Nephrol 2022; 17:749-756. [PMID: 35277434 PMCID: PMC9269577 DOI: 10.2215/cjn.09410721] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An understanding of the processes underlying mass transfer is paramount for the attainment of adequate solute removal in the dialytic treatment of patients with kidney failure. In this review, engineering principles are applied to characterize the physical mechanisms behind the two major modes of mass transfer during hemodialysis, namely diffusion and convection. The manner in which flow rate, dialyzer geometry, and membrane microstructure affect these processes is discussed, with concepts such as boundary layers, effective membrane diffusivity, and sieving coefficients highlighted as critical considerations. The objective is to improve clinicians' understanding of these concepts as important factors influencing the prescription and delivery of hemodialysis therapy.
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Affiliation(s)
- Farzad Mohajerani
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana
| | - William R Clark
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana
| | - Claudio Ronco
- International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.,Nephrology Department, San Bortolo Hospital, Vicenza, Italy.,Department of Medicine, University of Padova, Padua, Italy
| | - Vivek Narsimhan
- Davidson School of Chemical Engineering, Purdue University, West Lafayette, Indiana
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Abd Samad MI, Kayani AA, Zoolfakar AS, Hamzah AA, Majlis BY, Buyong MR. Lab-on-a-chip Dielectrophoretic Manipulation of Beta-2 Microglobulin for Toxin Removal in An Artificial Kidney. MICRO AND NANOSYSTEMS 2019; 11:40-46. [DOI: 10.2174/1876402911666181218145459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 09/02/2023]
Abstract
Background:
This paper presents a fundamental study of protein manipulation under the
influence of dielectrophoretic (DEP) force for a lab-on-a-chip platform.
Objective:
Protein manipulation is dependent on the polarisation factor of protein when exposed to an
electric field. Therefore the objective of this work is a microfluidic device and measurement system
are used to characterise the human beta-2 microglobulin (β2M) protein via lateral attractive forces and
vertical repulsive forces by means of DEP responses.
Method:
The manipulation of the β2M protein was conducted using a microfluidic platform with a tapered
DEP microelectrode and the protein concentration was quantified based on a biochemical interaction
using an Enzyme-Linked Immunosolvent Assay (ELISA). The protein distribution has been analysed
based on the β2M concentration for each microfluidic outlet.
Results:
At 300 kHz, the protein experienced a negative DEP (nDEP) with of 83.3% protein distribution
on the middle microchannel. In contrast, the protein experienced a positive DEP (pDEP) at 1.2
MHz with of 78.7% of protein on the left and right sides of the microchannel.
Conclusion:
This is concept proved that the tapered DEP microelectrode is capable of manipulating
a β2M via particle polarisation, hence making it suitable to be utilised for purifying proteins in biomedical
application.
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Affiliation(s)
- Muhammad Izzuddin Abd Samad
- Institute of Microengineering and Nanoelectronics (IMEN), Universiti Kebangsaan Malaysia, Bangi, 43600, Malaysia
| | - Aminuddin Ahmad Kayani
- Center for Advanced Materials and Green Technology, Multimedia University, 75450 Melaka, Malaysia
| | - Ahmad Sabirin Zoolfakar
- NANOElecTronic Centre, NET, Universiti Teknologi Mara, UiTM, Shah Alam 45450, Selangor, Malaysia
| | - Azrul Azlan Hamzah
- Institute of Microengineering and Nanoelectronics (IMEN), Universiti Kebangsaan Malaysia, Bangi, 43600, Malaysia
| | - Burhanuddin Yeop Majlis
- Institute of Microengineering and Nanoelectronics (IMEN), Universiti Kebangsaan Malaysia, Bangi, 43600, Malaysia
| | - Muhamad Ramdzan Buyong
- Institute of Microengineering and Nanoelectronics (IMEN), Universiti Kebangsaan Malaysia, Bangi, 43600, Malaysia
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6
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Chu G, Choi P, McDonald VM. Sleep disturbance and sleep-disordered breathing in hemodialysis patients. Semin Dial 2017; 31:48-58. [DOI: 10.1111/sdi.12617] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ginger Chu
- Nephrology Department; Medical & Interventional Services; John Hunter Hospital; Hunter New England Local Health District NSW Australia
- School of Nursing and Midwifery; University of Newcastle; Newcastle NSW Australia
| | - Peter Choi
- Nephrology Department; Medical & Interventional Services; John Hunter Hospital; Hunter New England Local Health District NSW Australia
| | - Vanessa M. McDonald
- School of Nursing and Midwifery; University of Newcastle; Newcastle NSW Australia
- Priority Research Centre for Healthy Lung; School of Nursing and Midwifery; University of Newcastle; Newcastle NSW Australia
- Department of Respiratory and Sleep Medicine; John Hunter Hospital; Hunter New England Local Health District NSW Australia
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7
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Hemodialysis is associated with higher serum FGF23 level when compared with peritoneal dialysis. Int Urol Nephrol 2017; 49:1653-1659. [PMID: 28455658 DOI: 10.1007/s11255-017-1605-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/21/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Considering the growing relevance of fibroblast growth factor-23 (FGF23) and increased cardiovascular mortality in dialysis population, an analysis was performed to assess the influence of dialysis modality (peritoneal dialysis and hemodialysis) on level of FGF23. METHODS A cross-sectional study was performed in 80 continuous ambulatory peritoneal dialysis (CAPD) and 65 hemodialysis (HD) patients without residual renal function. Levels of calcium, phosphate, parathyroid hormone and FGF23 were measured, and their correlations were analyzed. Data on demographics, dialysis modality and FGF23 level were also analyzed. RESULTS A significant correlation was found between FGF23 and serum calcium, serum phosphate and dialysis vintage in dialysis patients. Level of FGF23 was significantly higher in hemodialysis patients than that in peritoneal dialysis population. Multivariable regression revealed that, compared to CAPD, hemodialysis was found to be a predictor for higher FGF23 level, which was independent of serum calcium and phosphate level (P < 0.05). CONCLUSIONS These findings demonstrate that FGF23 levels are significantly higher in hemodialysis patients than that in peritoneal dialysis patients. We demonstrate an important association between dialysis modality (HD vs CAPD) and higher FGF23, independent of classical determinants (serum calcium and phosphate level).
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Nepomniashchikh V, Lomivorotov V, Deryagin M, Lomivorotov V, Kniazkova L. Cytochrome P450-endogenous substrates metabolism is reduced in patients with a multiple organ dysfunction after coronary artery bypass grafting. Interv Med Appl Sci 2012. [DOI: 10.1556/imas.4.2012.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Aim: To evaluate endogenous toxic substrates and liver monooxygenase function in cardiosurgical patients with multiple organ dysfunction syndrome (MODS). Methods: 45 patients with MODS and 34 patients with an uneventful postoperative period were studied. The endogenous substrates were quantified with blood middle molecules (MM). Liver monooxygenase function was evaluated with antipyrine (AP) pharmacokinetics. Results: On the first postoperative day, MODS patients were characterized by high concentration of toxic substrates (MM: +43.8%) and a significant decrease in liver monooxygenase function (AP clearance: −44%), while controls patients had a mild increase in endogenous substrates and a slight depression in monooxygenase function. On the 3rd–4th postoperative day, in the main group, endogenous substrates increased (MM: +53.1%), while in the control group toxic substrates decreased (MM: +6.9%). In both groups, an increase in liver monooxygenase function was noticed. Major differences were observed on the 10th–12th postoperative day. In the main group, toxic substrates remained elevated (MM: +37.5%) and monooxygenase function was depressed (AP clearance: −45.4%), while in the control group endogenous substrates and monooxygenase function were equal to the baseline. The correlation analysis showed a negative relationship between AP pharmacokinetics and endogenous substrates. Conclusion: Slowdown in liver microsomal oxidation is one of the main reasons for the accumulation of endogenous toxic substrates in MODS cardiac patients.
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Affiliation(s)
- Valery Nepomniashchikh
- 1 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, Novosibirsk, 630055, Russia
- 2 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, 15 Rechkunovskya Str., Novosibirsk, 630055, Russia
| | - Vladimir Lomivorotov
- 1 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, Novosibirsk, 630055, Russia
| | - Michael Deryagin
- 1 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, Novosibirsk, 630055, Russia
| | - Vladimir Lomivorotov
- 1 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, Novosibirsk, 630055, Russia
| | - Lubov Kniazkova
- 1 Department of Anaesthesiology, Academician E. Meshalkin Research Institute of Circulation Pathology, Novosibirsk, 630055, Russia
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Abstract
Over one million patients worldwide have end-stage renal disease and require dialysis or kidney transplantation. Despite the availability of these forms of renal replacement therapy for nearly four decades, mortality and morbidity are high and patients often have a poor quality of life. We have developed a human nephron filter (HNF) utilizing bottom-up nanotechnology that would eventually make feasible a continuously functioning, wearable or implantable artificial kidney. The device consists of two membranes operating in series within one device cartridge. The first membrane mimics the function of the glomerulus, using convective transport to generate a plasma ultra filtrate, which contains all solutes approaching the molecular weight of albumin. The second membrane mimics the function of the renal tubules, selectively reclaiming designated solutes to maintain body homeostasis. No dialysis solution is used in this device. The HNF has been computer modeled, and operating 12 hour per day, 7 days per week the HNF provides the equivalent of 30 ml/min glomerular filtration rate (compared to half that amount for conventional thrice-weekly hemodialysis). The HNF system, by eliminating dialysate and utilizing a novel membrane system created through applied nanotechnology, represents a breakthrough in renal replacement therapy based on the functioning of native kidneys. The enhanced solute removal and wearable design should substantially improve patient outcomes and quality of life.
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Affiliation(s)
- Allen R Nissenson
- Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
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10
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Dirkes S, Hodge K. Continuous Renal Replacement Therapy in the Adult Intensive Care Unit: History and Current Trends. Crit Care Nurse 2007. [DOI: 10.4037/ccn2007.27.2.61] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Susan Dirkes
- Susan Dirkes is a clinical educator at NxStage Medical, Lawrence, Mass
| | - Kimberly Hodge
- Kimberly Hodge is the Advanced Cardiac Life Support and Pediatric Advanced Life Support senior educator for the Emergency Response Training Institute at Clarian Health, Indianapolis, Ind
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Nissenson AR, Ronco C, Pergamit G, Edelstein M, Watts R. The Human Nephron Filter: Toward a Continuously Functioning, Implantable Artificial Nephron System. Blood Purif 2005; 23:269-74. [PMID: 15908745 DOI: 10.1159/000085882] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nearly 900,000 patients worldwide have end-stage renal disease and require dialysis or kidney transplantation, and this number is expected to more than double by 2010, placing considerable stress on healthcare systems throughout the world. Despite the availability of these forms of renal replacement therapy for nearly four decades, mortality and morbidity is high and patients often have a poor quality of life. METHODS We have developed a human nephron filter (HNF) utilizing nanotechnology that would eventually make feasible a continuously functioning, implantable artificial kidney. The device consists of two membranes operating in series within one device cartridge. The first membrane mimics the function of the glomerulus, while the second membrane mimics the function of the renal tubules. FINDINGS The device has been computer-modeled and operating 12 h/day, 7 days/week, the HNF provides the equivalent of 30 ml/min glomerular filtration rate (compared to half that amount for conventional thrice weekly hemodialysis). CONCLUSIONS The HNF system, by eliminating dialysate and utilizing a novel membrane system created through applied nanotechnology may represent a breakthrough in renal replacement therapy based on the functioning of native kidneys. The enhanced solute removal and wearable design should substantially improve patient outcomes and quality of life.
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Affiliation(s)
- Allen R Nissenson
- Department of Medicine, Division of Nephrology, David Geffen School of Medicine, Los Angeles, CA 90095, USA
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12
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Nissenson AR, Ronco C, Pergamit G, Edelstein M, Watts R. Continuously functioning artificial nephron system: The promise of nanotechnology. Hemodial Int 2005; 9:210-7. [PMID: 16191071 DOI: 10.1111/j.1492-7535.2005.01135.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nearly 900,000 patients worldwide have end-stage renal disease and require dialysis or kidney transplantation. Despite the availability of these forms of renal replacement therapy for nearly four decades, mortality and morbidity are high and patients often have a poor quality of life. We have developed a human nephron filter (HNF) utilizing nanotechnology that would eventually make feasible a continuously functioning, wearable or implantable artificial kidney. The device consists of two membranes operating in series within one device cartridge. The first membrane mimics the function of the glomerulus, using convective transport to generate a plasma ultrafiltrate containing all solutes approaching the molecular weight of albumin. The second membrane mimics the function of the renal tubules, selectively reclaiming designated solutes to maintain body homeostasis. No dialysis solution is used in this device. The HNF has been computer-modeled, and operating 12 hr per day, 7 days per week the HNF provides the equivalent of 30 mL/min glomerular filtration rate (compared to half that amount for conventional thrice-weekly hemodialysis). Animal studies should begin in the next 1 to 2 years, and clinical trials would then follow 1 to 2 years subsequent. The HNF system, by eliminating dialysate and utilizing a novel membrane system created through applied nanotechnology, represents a breakthrough in renal replacement therapy based on the functioning of native kidneys. The enhanced solute removal and wearable design should substantially improve patient outcomes and quality of life.
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Affiliation(s)
- Allen R Nissenson
- Department of Medicine, Division of Nephrology, David Geffen School of Medicine, Los Angeles, California 90095, USA.
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13
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Huang Z, Li B, Zhang W, Gao D, Kraus MA, Clark WR. Convective renal replacement therapies for acute renal failure and end-stage renal disease. Hemodial Int 2004; 8:386-93. [DOI: 10.1111/j.1492-7535.2004.80415.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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