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wearable kidney

Thomas A Mavrakanas, David M Charytan
PURPOSE OF REVIEW: This review article focuses on the most significant cardiovascular complications in dialysis patients [sudden cardiac death (SCD), acute coronary syndromes, heart failure, and atrial fibrillation]. RECENT FINDINGS: Current and ongoing research aims to quantify the rate and pattern of significant arrhythmia in dialysis patients and to determine the predominant mechanism of SCD. Preliminary findings from these studies suggest a high rate of atrial fibrillation and that bradycardia and asystole may be more frequent than ventricular arrhythmia as a cause of sudden death...
November 2016: Current Opinion in Nephrology and Hypertension
Bo Mi Moon, Myung-Jin Choi, Md Tipu Sultan, Jae Won Yang, Hyung Woo Ju, Jung Min Lee, Hyun Jung Park, Ye Ri Park, Soo Hyeon Kim, Dong Wook Kim, Min Chae Lee, Ju Yeon Jeong, Ok Joo Lee, Gun Yong Sung, Chan Hum Park
During the last decade, there has been a great advance in the kidney dialysis system by wearable artificial kidney (WAK) system for end-stage renal disease patients. Uremic solute removal and water regeneration system are the most prerequisite for WAK to work properly. In this study, we designed a filtering membrane system by using immobilized urease silk fibroin filter and evaluated its comparative effectiveness with a PVDF filtering system in peritoneal dialysate regeneration system by urea removal efficacy...
July 15, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Victor Gura, Matthew B Rivara, Scott Bieber, Raj Munshi, Nancy Colobong Smith, Lori Linke, John Kundzins, Masoud Beizai, Carlos Ezon, Larry Kessler, Jonathan Himmelfarb
BACKGROUND: Stationary hemodialysis machines hinder mobility and limit activities of daily life during dialysis treatments. New hemodialysis technologies are needed to improve patient autonomy and enhance quality of life. METHODS: We conducted a FDA-approved human trial of a wearable artificial kidney, a miniaturized, wearable hemodialysis machine, based on dialysate-regenerating sorbent technology. We aimed to determine the efficacy of the wearable artificial kidney in achieving solute, electrolyte, and volume homeostasis in up to 10 subjects over 24 hours...
June 2, 2016: JCI Insight
Hnin Yin Yin Nyein, Wei Gao, Ziba Shahpar, Sam Emaminejad, Samyuktha Challa, Kevin Chen, Hossain M Fahad, Li-Chia Tai, Hiroki Ota, Ronald W Davis, Ali Javey
Homeostasis of ionized calcium in biofluids is critical for human biological functions and organ systems. Measurement of ionized calcium for clinical applications is not easily accessible due to its strict procedures and dependence on pH. pH balance in body fluids greatly affects metabolic reactions and biological transport systems. Here, we demonstrate a wearable electrochemical device for continuous monitoring of ionized calcium and pH of body fluids using a disposable and flexible array of Ca(2+) and pH sensors that interfaces with a flexible printed circuit board...
July 26, 2016: ACS Nano
Wee-Keat Cheah, Kunio Ishikawa, Radzali Othman, Fei-Yee Yeoh
Hemodialysis, one of the earliest artificial kidney systems, removes uremic toxins via diffusion through a semipermeable porous membrane into the dialysate fluid. Miniaturization of the present hemodialysis system into a portable and wearable device to maintain continuous removal of uremic toxins would require that the amount of dialysate used within a closed-system is greatly reduced. Diffused uremic toxins within a closed-system dialysate need to be removed to maintain the optimum concentration gradient for continuous uremic toxin removal by the dialyzer...
February 23, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Kristen K Rumer, Anirudh Saraswathula, Marc L Melcher
PURPOSE OF REVIEW: Frailty is the concept of accumulating physiologic declines that make people less able to deal with stressors, including surgery. Prehabilitation is intervention to enhance functional capacity before surgery. Frailty and prehabilitation among transplant populations and the role of wearable fitness tracking devices (WFTs) in delivering fitness-based interventions will be discussed. RECENT FINDINGS: Frailty is associated with increased complications, longer length of hospital stay and increased mortality after surgery...
April 2016: Current Opinion in Organ Transplantation
Dong Ki Kim, Jung Chan Lee, Hajeong Lee, Kwon Wook Joo, Kook-Hwan Oh, Yon Su Kim, Hyung-Jin Yoon, Hee Chan Kim
Wearable artificial kidney (WAK) has been considered an alternative to standard hemodialysis (HD) for many years. Although various novel WAK systems have been recently developed for use in clinical applications, the target performance or standard dose of dialysis has not yet been determined. To calculate the appropriate clearance for a HD-based WAK system for the treatment of patients with end-stage renal disease with various dialysis conditions, a classic variable-volume two-compartment kinetic model was used to simulate an anuric patient with variable target time-averaged creatinine concentration (TAC), daily water intake volume, daily dialysis pause time, and patient body weight...
April 2016: Hemodialysis International
Jeroen P Kooman, Jaap A Joles, Karin G F Gerritsen
A wearable and, ultimately, an implantable artificial kidney is a long-held aim in the treatment of patients with end-stage renal disease, provided that it would combine continuous blood purification, preventing the fluctuations in the internal environment associated with hemodialysis, while maintaining a high efficiency for removal of uremic toxins. Sorbent and enzyme technology, allowing for the regeneration of dialysis fluid, have played a vital role in the development of present prototypes, although the development of a low-weight regeneration module as well as safety and control issues still need to be solved...
July 2015: Expert Review of Medical Devices
Paolo Armignacco, Francesco Garzotto, Corrado Bellini, Mauro Neri, Anna Lorenzin, Marco Sartori, Claudio Ronco
The wearable artificial kidney (WAK) is a device that is supposed to operate like a real kidney, which permits prolonged, frequent, and continuous dialysis treatments for patients with end-stage renal disease (ESRD). Its functioning is mainly related to its pumping system, as well as to its dialysate-generating and alarm/shutoff ones. A pump is defined as a device that moves fluids by mechanical action. In such a context, blood pumps pull blood from the access side of the dialysis catheter and return the blood at the same rate of flow...
2015: Blood Purification
Paolo Armignacco, Francesco Garzotto, Mauro Neri, Anna Lorenzin, Claudio Ronco
The wearable artificial kidney (WAK) is a device that allows prolonged and frequent dialysis treatments for patients with end stage renal disease. It potentially provides a practical and feasible solution to satisfy the need for an optimal delivered dialysis. Until now, the WAK has already been presented in several models, proposing different therapeutic modalities and engineering approaches. The ideal solution of a WAK may come from a combination of all the prototypes developed and/or those currently in development...
2015: Blood Purification
Paolo Armignacco, Anna Lorenzin, Mauro Neri, Federico Nalesso, Francesco Garzotto, Claudio Ronco
The prevalences of end-stage renal disease (ESRD) and renal replacement therapy (RRT) continue to increase across the world imposing staggering costs on providers. Therefore, strategies to optimize the treatment and improve survival are of fundamental importance. Despite the benefits of daily dialysis, its implementation is difficult and wearable hemodialysis might represent an alternative by which frequent treatments can be delivered to ESRD patients with much less interference in their routines promoting better quality of life...
March 2015: Seminars in Dialysis
Andrew Davenport
Dialysis is a life-sustaining treatment for patients with end-stage kidney disease. In a different context, for many patients this treatment is the focal point around which their life revolves, not only due to the time spent travelling to and from treatment sessions and the time dedicated to the dialysis treatment itself, but also due to the accompanying dietary and fluid restrictions and medication burden. Wearable and portable dialysis devices could potentially improve patient quality of life by allowing patients to continue with their daily activities of life while undergoing dialysis, as well as by loosening-or removing entirely-dietary and fluid restrictions and reducing pill burden...
December 2015: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Steven J Russell, Firas H El-Khatib, Manasi Sinha, Kendra L Magyar, Katherine McKeon, Laura G Goergen, Courtney Balliro, Mallory A Hillard, David M Nathan, Edward R Damiano
BACKGROUND: The safety and effectiveness of automated glycemic management have not been tested in multiday studies under unrestricted outpatient conditions. METHODS: In two random-order, crossover studies with similar but distinct designs, we compared glycemic control with a wearable, bihormonal, automated, "bionic" pancreas (bionic-pancreas period) with glycemic control with an insulin pump (control period) for 5 days in 20 adults and 32 adolescents with type 1 diabetes mellitus...
July 24, 2014: New England Journal of Medicine
Maarten Wester, Karin G F Gerritsen, Walther H Boer, Jaap A Joles, Jeroen P Kooman
Portable or wearable dialysis devices could increase treatment flexibility and dialysis patients' independence. Current renal replacement therapies such as intermittent haemodialysis extend life but are a burden, are time-consuming and immobilize patients. An additional disadvantage is the discontinuous nature of the treatment. Peritoneal dialysis is a good alternative, but is associated with relatively limited toxin clearance and a need for high glucose concentrations in the dialysate. Portable dialysis devices could be used as a replacement or to support existing dialysis techniques...
2013: Nederlands Tijdschrift Voor Geneeskunde
Chingping Wan, Charles A Herzog, Wojciech Zareba, Steven J Szymkiewicz
BACKGROUND: The survival outcome following a sudden cardiac arrest (SCA) in hemodialysis (HD) patients is poor regardless of whether an event takes place in or out of a dialysis center. The characteristics of SCA and post-SCA survival with HD patients using a wearable cardioverter defibrillator (WCD) are unknown. METHODS: All HD patients who were prescribed a WCD between 2004 and 2011 and experienced at least one SCA event were included in this study. Demographics, clinical background, characteristics of SCA events were identified from the manufacturer's database...
May 2014: Annals of Noninvasive Electrocardiology
Dean G Johnson, Tejas S Khire, Yekaterina L Lyubarskaya, Karl J P Smith, Jon-Paul S Desormeaux, Jeremy G Taylor, Thomas R Gaborski, Alexander A Shestopalov, Christopher C Striemer, James L McGrath
The development of wearable or implantable technologies that replace center-based hemodialysis (HD) hold promise to improve outcomes and quality of life for patients with ESRD. A prerequisite for these technologies is the development of highly efficient membranes that can achieve high toxin clearance in small-device formats. Here we examine the application of the porous nanocrystalline silicon (pnc-Si) to HD. pnc-Si is a molecularly thin nanoporous membrane material that is orders of magnitude more permeable than conventional HD membranes...
November 2013: Advances in Chronic Kidney Disease
Christos Bellos, Athanassios Papadopoulos, Roberto Rosso, Dimitrios I Fotiadis
The CHRONIOUS system defines a powerful and easy to use framework which has been designed to provide services to clinicians and their patients suffering from chronic diseases. The system is composed of a wearable shirt that integrate several body sensors, a portable smart device and a central sub-system that is responsible for the long term storage of the collected patient's data. A multi-parametric expert system is developed for the analysis of the collected data using intelligent algorithms and complex techniques...
2013: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Behnam Molavi, Babak Shadgan, Andrew J Macnab, Guy A Dumont
Lack of bladder fullness sensation is an issue that arises in different neurogenic conditions and in addition to influencing patients' quality of life, can result in serious kidney damage. We describe a wireless wearable sensor for detecting bladder fullness using near infrared spectroscopy (NIRS). The sensor has been tested in vitro and in vivo to verify its feasibility and is shown to be capable of detecting changes in bladder content noninvasively.
June 2014: IEEE Transactions on Biomedical Circuits and Systems
Jeong Chul Kim, Claudio Ronco
To improve hemodialysis (HD) patients' clinical tolerance and quality of life, a new paradigm of technological evolution of the artificial kidney needs to be addressed at this point. Compared to the second law of thermodynamics, if HD is a barrier against entropy increase, personal daily dialysis (PDD), taking account of multidimensional treatment parameters specific to the patient, can be a new treatment option. Here, we review currently used HD equipment and competing technologies of the wearable artificial kidney (WAK) for future application to PDD...
2013: Blood Purification
H David Humes, Deborah Buffington, Angela J Westover, Shuvo Roy, William H Fissell
The rapid understanding of the cellular and molecular bases of organ function and disease processes will be translated in the next decade into new therapeutic approaches to a wide range of clinical disorders, including acute and chronic renal failure. Central to these new therapies are the developing technologies of cell therapy and tissue engineering, which are based on the ability to expand stem or progenitor cells in tissue culture to perform differentiated tasks and to introduce these cells into the patient either via extracorporeal circuits or as implantable constructs...
March 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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