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


Journal

Nature reviews. Nephrology
ISSN: 1759-507X
Titre abrégé: Nat Rev Nephrol
Pays: England
ID NLM: 101500081

Informations de publication

Date de publication:
08 2023
Historique:
accepted: 28 04 2023
medline: 21 7 2023
pubmed: 6 6 2023
entrez: 5 6 2023
Statut: ppublish

Résumé

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.

Identifiants

pubmed: 37277461
doi: 10.1038/s41581-023-00726-9
pii: 10.1038/s41581-023-00726-9
pmc: PMC10240485
doi:

Substances chimiques

Dialysis Solutions 0

Types de publication

Journal Article Review Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

481-490

Informations de copyright

© 2023. Springer Nature Limited.

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Auteurs

David Loureiro 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.

Joost de Vries (J)

Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.

Jeroen 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.

Nazia 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.

Odyl 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.

Silvia M Mihăilă (SM)

Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.

Fokko 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.

Rosalinde Masereeuw (R)

Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.

Karin Gerritsen (K)

Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.

Dimitrios 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.

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