Big steps towards a wearable kidney
What if haemodialysis was portable, contained inside something no bigger than a backpack? Transforming treatments such as haemodialysis is one of our key strategic ambitions and a Kidney Research UK-funded team at the University of Edinburgh are making great headway in the search for a ‘wearable kidney’.
Haemodialysis machines have worked to the same principle for decades, with the size of machines and a clean water supply requiring patients to be anchored to them at hospital or at home for several hours at a time. Peritoneal dialysis is a good option for many patients, but still leads to some lifestyle restrictions. With our support, Professor Grazia De Angelis and her team want to develop newer, improved options for kidney patients and believe that they have reached the final step in creating a workable, wearable kidney.
In current haemodialysis machines, for each treatment many litres of ultrapure water are used to clean the blood aiming to replace lost kidney function. Designing a portable water regeneration technology inside the system is essential to miniaturise the dialysis machine. Previous attempts at this have relied on chemicals to remove the toxins whereas the Edinburgh team’s innovative technology will use ‘smart’ filters to clean the water so it can be recycled.
Selecting the right combination of filter materials to be used in the purification, process could be the final piece of the jigsaw. But there are thousands of options.
The shrink challenge
Using ultrapure water in haemodialysis reduces the risk of cardiovascular complications, but requires a large volume of water. Creating a recycling system could drastically reduce the amount of water required and remove the need for an external water supply – and haemodialysis could become more easily mobile.
Faster answers through AI
The team will use computer-based technologies including machine learning (a method of artificial intelligence) to analyse which materials might be most suitable to put in the ‘smart’ filter membrane before testing them in the laboratory to identify which are the most efficient and clinically safe to use.
“Machine learning accelerates work which would traditionally take years into just a matter of months.” Grazia said: “By feeding the computer programme as much information as possible about the characteristics of the materials and the toxins that it will need to filter, we can get a quite accurate understanding of whether the chosen substance would perform well in a clinical setting. Then, testing in a lab will not only confirm the findings from the AI programme but allows us to introduce fluids from real patients, ensuring that we can be certain that the material will be effective when introduced in a clinical trial setting with real patients.”
"This is potentially revolutionary. If this came to fruition it could offer patients a semblance of normality and allow them to more readily engage socially which would have such a positive impact on their mental health too. The thought of being able to go to school whilst having treatment… wow."
Melina is mum to Charlie (pictured), 12, who has recently started haemodialysis.
Helping patients feel better
While having a machine that could be more easily used away from hospital or home is highly desirable, Grazia’s research also has the potential to reduce the gruelling side effects of haemodialysis such as fatigue and sickness.
“Dialysis is designed to replicate the blood-filtering function of the kidneys, but a key difference is that a healthy kidney is working all the time while haemodialysis patients only receive treatment three times a week.” Grazia continued: “By the time of their next scheduled treatment not only is their body full of toxins but their blood pressure is very high. Four hours isn’t long enough to be on dialysis in terms of cleaning the blood, but it’s impossible for patients to have haemodialysis 24 hours a day. Having a device that is portable would allow more frequent dialysis over longer periods of time; this could drastically reduce the side effects of the treatment. It could also enable patients to have a degree of control over their own treatment administering it at a time that suits them.”
The team in Edinburgh hope to have completed shortlisting the best materials in the next two years. From there, laboratory research will confirm the most effective material and the team will be ready to test it in a portable device.
This project is funded through a Stoneygate-Kidney Research UK project grant of £180,000.
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