August was a big month for the BigD community. Early in the month, Dr. Christopher Chan, medical director of Home Hemodialysis at Toronto General Hospital’s University Health Network announced the results of a study of 1,239 patients over 12 years that showed that kidney patients who received home hemodialysis treatments lived as long as those who got kidney transplants from donors.
As has been found before, the study confirms that the more often the dialysis, the better the cardio-vascular health (weight is stable, which reduces impact on the heart) and quality of life.
Building on this desirability of regular or even continuous dialysis came a breakthrough on August 20: the Wearable Artificial Kidney. The press release, titled “HELLO ‘WEARABLE KIDNEY,’ GOODBYE DIALYSIS MACHINE” states:
“Our vision of a technological breakthrough has materialized in the form of a Wearable Artificial Kidney, which provides continuous dialysis 24 hours a day, seven days a week,” says Victor Gura, MD (David Geffen School of Medicine at UCLA).
The device—essentially a miniaturized dialysis machine, worn as a belt—weighs about 10 pounds (4.5kg) and is powered by two nine-volt batteries. Because patients don’t need to be hooked up to a full-size dialysis machine, they are free to walk, work, or sleep while undergoing continuous, gentle dialysis that more closely approximates normal kidney function.
See the belt and how it is worn:
Such a device could lead to a “paradigm change” in the treatment of dialysis patients. Despite enduring long hours on dialysis every week—with major limitations in activities, diet, and other areas of life—dialysis patients face high rates of hospitalization and death. The U.S. dialysis population currently exceeds 400,000, with costs of over $30 billion per year. “We believe that the Wearable Artificial Kidney will not only reduce the mortality and misery of dialysis patients, but will also result in significant reduction in the cost of providing viable health care,” says Gura.
The Wearable Artificial Kidney is successful in preliminary tests, including two studies in dialysis patients. The new study provides important information on the technical details that made these promising results possible.
“However, the long-term effect of this technology on the well-being of dialysis patients must be demonstrated in much-needed clinical trials,” adds Gura. “Although successful, this is but one additional step on a long road still ahead of us to bring about a much-needed change in the lives of this population.”
The WAK uses several innovations, including a pulse pumps that operate quite differently from the current roller pump technology. Where possible they have used standard off-the-shelf components.
Here’s the schematic from the paper.
Still, the results are very encouraging. It looks a little clunky now, but so did the first TV, computer and mobile phone.
Obviously there are still many questions: What kind of access would enable continuous, 24/7 use? What would it cost (the current estimate is “less than the current machines” and the monthly consumables ‘below the current sums spent”. How would this disruptive technology impact the current approach?
From a personal level: Is it the Can I get involved in a trial? When can I have one?
For more information on “Technical Breakthroughs in the Wearable Artificial Kidney (WAK),” the article is available online at the Clinical Journal of the American Society of Nephrology for a mere US$22. The Press Release is here.