Quest for a Wearable Kidney: Will Nanotechnology Make a Difference?

Nearly 400,000 patients in the U.S. have end stage kidney disease requiring dialysis or transplantation. Currently, the number on dialysis or with an allograft number is approximately 1,300,000 worldwide, a number much smaller than the prevalence of end stage renal disease because of the amount of resources required for maintenance dialysis and the scarcity of organs. Even for those on dialysis there is reason to believe that more frequent dialysis would be beneficial. Wearable dialysis machines have been discussed for at least 40 years and yet little progress has been made. Some of the design challenges include:
removal of fluid that has been taken in by the patient, clearing the blood of urea, creatinine, potassium, acids and metabolic waste products among other things maintaining serum electrolytes and pH in a normal range having no significant adverse effect on blood pressure.

Under normal circumstances, an individual's kidneys can filter 150-180 liters a day of blood and reabsorb approximately 98-99% of that filtrate while excreting the appropriate waste products and finely regulation volume status and electrolyte status of the individual. The normal kidney is also an endocrine organ providing, for example, the erythropoietin, that then acts on the bone marrow to increase red blood cell production. Thus there are many challenges for an artificial kidney which must replace many of these functions.

Joseph Bonventre, MD, PhD, Robert Ebert Professor of Medicine and Health Sciences and Technology, Harvard Medical School; Director, Renal Division, Brigham and Women's Hospital; CIMIT Site Miner, BWH, [email protected]

Continuously Functioning Artificial Nephron: The Promise of Nanotechnology
Theodore I. Steinman, MD, Clinical Professor of Medicine, Harvard Medical School; Beth Israel Deaconess Medical Center, [email protected]

Nanotechnology is being translated into nanomedicine. Our current dialysis delivery system is cumbersome, time consuming and associated with a high morbidity and mortality. With nanotechnology we are at the verge of developing a human nephron filter that mimics the function of the human glomerulus and tubule. Compared to current technology, the newest nano-membranes will be two to three times greater in efficiency than current dialyzers, be much more compact, and light weight so as to be adaptable for wearing. No dialysis solutions will be needed with the newest devices. The goal for the future is to make this device implantable.

Joseph Bonventre; Theodore Steinman; Greg Erman, MBA, Serial Entrepreneur and former President & CEO, Renalworks Medical Corporation, [email protected]; and Jeffrey Borenstein, PhD, Director, Biomedical Engineering Center; Distinguished Member of the Technical Staff, Charles Stark Draper Laboratory; Program Leader for Biomaterials and Tissue Engineering and Draper Laboratory Site Miner, CIMIT, [email protected]

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Comments

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Nanotechnology is very diverse, ranging from novel extensions of conventional device physics, to completely new approaches based upon molecular self-assembly, to developing new materials with dimensions on the nanoscale, even to speculation on whether we can directly control matter on the atomic scale.

Hi,
Great information.Nanomedicine is the medical application of nanotechnology.The approaches to nanomedicine range from the medical use of nanomaterials, to nanoelectronic biosensors, and even possible future applications of molecular nanotechnology...