Review Study about Portable and Wearable Artificial Kidney Systems
DOI:
https://doi.org/10.29194/NJES.27030295Keywords:
Home Hemodialysis, Cener-Based Hemodialysis, Portable Dialysis Machine, Wearable Artificial KidneyAbstract
Kidney renal failure is a life-threatening disease in which one or both kidneys are not functioning normally. The only available treatment other than a kidney transplant is to start on dialysis sessions, whether it is peritoneal or Hemo-dialysis[1].
For some patients, the dialysis procedure is an exhausting and sometimes expensive trip to the specialized dialysis centers since it must be done about three times a week, depending on the physician's decision depending on the glomerular filtration rate of the kidneys[2-4].
Different researchers have made many attempts over the years to replace conventional dialysis machines with more accessible at-home dialysis systems to provide patients with comfortable treatment sessions at the time they want without the need to change their lifestyle to fit the dialysis center's schedule.
A review of the critical methods utilized in the creation and application of a portable dialysis machine that resembles the traditional dialysis center devices was conducted using a number of prior studies (research conducted between 2009 and 2024); the goal of all studies was to create a device that consists of filtering system, detection system to ensure there is no blood leakage and all parameters are within the acceptable limits, alarm system, and dialysate regeneration system, and each method will be described precisely in this review.
As a result, the discussed studies found that using peristaltic pump pumps with a phase difference by half cycle between blood and dialysate will cause a higher urea clearance rate; multiple studies focused on the modification of the dialyzing filter to find that using Polyethene glycol surface-modified silicon nanopore membranes, dual-layer hollow fiber membranes, the use of BRECS cell therapy, carbon activated blocks, all contributed highly in enhancing the dialyzing process providing the patients with highly efficient blood purification session.
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References
J. Himmelfarb, R. Vanholder, R. Mehrotra, and M. Tonelli, "The current and future landscape of dialysis," Nature Reviews Nephrology, vol. 16, no. 10, pp. 573-585, 2020.
F. Locatelli, U. Buoncristiani, B. Canaud, H. Köhler, T. Petitclerc, and P. Zucchelli, "Dialysis dose and frequency," Nephrology Dialysis Transplantation, vol. 20, no. 2, pp. 285-296, 2005.
L. A. Stevens and A. S. Levey, "Measured GFR as a confirmatory test for estimated GFR," Journal of the American society of nephrology, vol. 20, no. 11, pp. 2305-2313, 2009.
J. T. Daugirdas et al., "KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update," American Journal of Kidney Diseases, vol. 66, no. 5, pp. 884-930, 2015.
Fresenius Medical Care (FMC). "Annual Report 2018." https://www.freseniusmedicalcare.com/fileadmin/data/com/pdf/Media_Center/Publications/Annual_Reports/FME_Annual-Report_2018.pdf (accessed.
N. K. foundation. " number of dialysis patients worldwide." NKF. https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease (accessed 23 October 2023.
U. o. C. S. Francisco. " number of dialysis patients worldwide." https://pharm.ucsf.edu/kidney/need/statistics (accessed 23 October.
M. Coemans et al., "Analyses of the short-and long-term graft survival after kidney transplantation in Europe between 1986 and 2015," Kidney international, vol. 94, no. 5, pp. 964-973, 2018.
Y. Y. Majeed, H. Faris, B. Kadhim, and S. Ala, "Haemodialysis services in Iraq in 2012: situation analysis, epidemiology and infrastructure," Iraqi New Medical Journal, vol. 4, no. 8, pp. 91-99, 2018.
J.-E. Kim, L. Kessler, Z. McCauley, I. Niiyama, and L. N. Boyle, "Human factors considerations in designing a personalized mobile dialysis device: An interview study," Applied ergonomics, vol. 85, p. 103003, 2020.
M. B. Rivara and J. Himmelfarb, "From Home to Wearable Hemodialysis: Barriers, Progress, and Opportunities," Clinical Journal of the American Society of Nephrology, p. 10.2215, 2024.
M. Chan, D. Estève, J.-Y. Fourniols, C. Escriba, and E. Campo, "Smart wearable systems: Current status and future challenges," Artificial intelligence in medicine, vol. 56, no. 3, pp. 137-156, 2012.
F. Termorshuizen et al., "Relative contribution of residual renal function and different measures of adequacy to survival in hemodialysis patients: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2," Journal of the American Society of Nephrology, vol. 15, no. 4, pp. 1061-1070, 2004.
R. Rope, E. Ryan, E. D. Weinhandl, and G. E. Abra, "Home-Based Dialysis: A Primer for the Internist," Annual Review of Medicine, vol. 75, pp. 205-217, 2024.
R. C. Walker et al., "Patient and caregiver perspectives on home hemodialysis: a systematic review," American Journal of Kidney Diseases, vol. 65, no. 3, pp. 451-463, 2015.
J. Perl et al., "Home dialysis: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference," Kidney international, vol. 103, no. 5, pp. 842-858, 2023.
M. Wilkie and T. Barnes, "Shared hemodialysis care: increasing patient involvement in center-based dialysis," Clinical Journal of the American Society of Nephrology, vol. 14, no. 9, pp. 1402-1404, 2019.
C. Moore, R. Majeed‐Ariss, A. Jayanti, S. Mitra, S. Skevington, and A. Wearden, "How an ordeal becomes the norm: A qualitative exploration of experiences of self‐cannulation in male home haemodialysis patients," British journal of health psychology, vol. 23, no. 3, pp. 544-560, 2018.
M. Pipkin et al., "Recruitment and training for home hemodialysis: experience and lessons from the Nocturnal Dialysis Trial," Clinical Journal of the American Society of Nephrology, vol. 5, no. 9, pp. 1614-1620, 2010.
S. Saponara, M. Donati, L. Fanucci, and A. Celli, "An Embedded sensing and communication platform, and a healthcare model for remote monitoring of chronic diseases," Electronics, vol. 5, no. 3, p. 47, 2016.
N. El-Rashidy, S. El-Sappagh, S. R. Islam, H. M. El-Bakry, and S. Abdelrazek, "Mobile health in remote patient monitoring for chronic diseases: Principles, trends, and challenges," Diagnostics, vol. 11, no. 4, p. 607, 2021.
V. Gura, A. S. Macy, M. Beizai, C. Ezon, and T. A. Golper, "Technical breakthroughs in the wearable artificial kidney (WAK)," Clinical Journal of the American Society of Nephrology: CJASN, vol. 4, no. 9, p. 1441, 2009.
D. A. Buffington, C. J. Pino, L. Chen, A. J. Westover, G. Hageman, and H. D. Humes, "Bioartificial renal epithelial cell system (BRECS): a compact, cryopreservable extracorporeal renal replacement device," Cell medicine, vol. 4, no. 1, pp. 33-44, 2012.
W. H. Fissell, S. Roy, and A. Davenport, "Achieving more frequent and longer dialysis for the majority: wearable dialysis and implantable artificial kidney devices," Kidney international, vol. 84, no. 2, pp. 256-264, 2013.
M. S. Tijink et al., "Mixed matrix hollow fiber membranes for removal of protein-bound toxins from human plasma," Biomaterials, vol. 34, no. 32, pp. 7819-7828, 2013.
A. Davenport, "Portable and wearable dialysis devices for the treatment of patients with end-stage kidney failure: Wishful thinking or just over the horizon?," Pediatric nephrology, vol. 30, pp. 2053-2060, 2015.
H. Salhab, R. Jabari, and A. Abu-Khriebah, "Design and Implementation of a Wearable Artificial Kidney Prototype for Home Dialysis," 2015.
N. V. Chevtchik et al., "Upscaling of a living membrane for bioartificial kidney device," European journal of pharmacology, vol. 790, pp. 28-35, 2016.
V. Gura et al., "A wearable artificial kidney for patients with end-stage renal disease," JCI insight, vol. 1, no. 8, 2016.
N. Rajhans, V. Sardar, and A. Sajgure, "Design of Wearable Dialysis Unit," 2017.
C. J. Lee and P. J. Rossi, "Portable and Wearable Dialysis Devices for the Treatment of Patients with End-Stage Renal Disease," Hemodialysis Access: Fundamentals and Advanced Management, pp. 349-353, 2017.
K. A. Johnston et al., "Development of a wearable bioartificial kidney using the Bioartificial Renal Epithelial Cell System (BRECS)," Journal of tissue engineering and regenerative medicine, vol. 11, no. 11, pp. 3048-3055, 2017.
M. Wester et al., "A regenerable potassium and phosphate sorbent system to enhance dialysis efficacy and device portability: a study in awake goats," Nephrology Dialysis Transplantation, vol. 32, no. 6, pp. 951-959, 2017.
C. J. Pino, A. J. Westover, D. A. Buffington, and H. D. Humes, "Bioengineered renal cell therapy device for clinical translation," ASAIO journal (American Society for Artificial Internal Organs: 1992), vol. 63, no. 3, p. 305, 2017.
Y.-C. Du, B.-Y. Lim, W.-S. Ciou, and M.-J. Wu, "Novel wearable device for blood leakage detection during hemodialysis using an array sensing patch," Sensors, vol. 16, no. 6, p. 849, 2016.
N. A. Bazaev, V. M. Grinvald, N. M. Zhilo, B. M. Putrya, and E. V. Streltsov, "In vitro and in vivo trials of wearable artificial kidney," in 2018 IEEE Conference of Russian Young Researchers in Electrical and Electronic Engineering (EIConRus), 2018: IEEE, pp. 1877-1881.
M. Salani, S. Roy, and W. H. Fissell IV, "Innovations in wearable and implantable artificial kidneys," American Journal of Kidney Diseases, vol. 72, no. 5, pp. 745-751, 2018.
M. K. van Gelder et al., "From portable dialysis to a bioengineered kidney," Expert review of medical devices, vol. 15, no. 5, pp. 323-336, 2018.
K. Gerritsen, "WEAKID-Clinical validation of miniature wearable dialysis machine-H2020," Impact, vol. 2018, no. 3, pp. 55-57, 2018.
A. C. Castro, M. Neri, A. Nayak Karopadi, A. Lorenzin, N. Marchionna, and C. Ronco, "Wearable artificial kidney and wearable ultrafiltration device vascular access—future directions," Clinical kidney journal, vol. 12, no. 2, pp. 300-307, 2019.
S. Sankaran, M. P. Rajasekaran, and P. Vishnuvarthanan Govindaraj, "Design of Mobile Hemodialysis Apparatus for Acute Renal Failure Patient's Self-Help and Treatment Adherence," International Journal of Recent Technology and Engineering, vol. 8, no. 2 Special Issue 4, pp. 65-76, 2019.
P. Boscariol et al., "Description and in-vitro test results of a new Wearable/Portable device for extracorporeal blood ultrafiltration," Machines, vol. 7, no. 2, p. 37, 2019.
L. Di Liberato, A. Arduini, G. Di Fulvio, L. Piscitani, O. Favre, and M. Bonomini, "SP482 A NEW PORTABLE DEVICE FOR HOME HAEMODIALYSIS," Nephrology Dialysis Transplantation, vol. 34, no. Supplement_1, p. gfz103. SP482, 2019.
M. K. van Gelder et al., "Urea removal strategies for dialysate regeneration in a wearable artificial kidney," Biomaterials, vol. 234, p. 119735, 2020.
A. T. Layton and H. E. Layton, "A computational model of epithelial solute and water transport along a human nephron," PLoS computational biology, vol. 15, no. 2, p. e1006108, 2019.
C. N. Hestekin et al., "Simulating nephron ion transport function using activated wafer electrodeionization," Communications Materials, vol. 1, no. 1, p. 20, 2020.
F. Moustapha et al., "Manual Individualization of the Dialysate flow according to blood flow: Effects on the Hemodialysis dose delivered and on Dialysate consumption," 2020.
I. S. IQS, "Iraqi standard of drinking water No. 417," Second modification, 2009.
Y. Raad Humudat and S. K. Al-Naseri, "Evaluation of dialysis water quality at hospitals in Baghdad, Iraq," Journal of Health and Pollution, vol. 10, no. 28, p. 201211, 2020.
C. UNIVERSITY. "Water For Hemodialysis and Related Therapies." https://dialysiswatersolution.com/regulations-and-guidelines/ansiaami/ansiaami-13959-water-for-hemodialysis-and-related-therapies/ (accessed 2015).
C. M. Jha, "Cost-effectiveness of home hemodialysis with bedside portable dialysis machine" DIMI" in the United Arab Emirates," Cureus, vol. 13, no. 10, 2021.
A. Anna Jónsdóttir, S. Firestone, L. Kessler, and J.-E. Kim, "Human Factors Considerations in Designing a Portable Dialysis Device: Understanding Patients’ and Care Partners’ Needs for Increased Mobility," in Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2021, vol. 65, no. 1: SAGE Publications Sage CA: Los Angeles, CA, pp. 520-524.
H. Htay et al., "Preliminary safety study of the automated wearable artificial kidney (AWAK) in peritoneal dialysis patients," Peritoneal Dialysis International, vol. 42, no. 4, pp. 394-402, 2022.
Y.-S. Tang, Y.-C. Tsai, T.-W. Chen, and S.-Y. Li, "Artificial kidney engineering: the development of dialysis membranes for blood purification," Membranes, vol. 12, no. 2, p. 177, 2022.
T. Groth et al., "Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review," Artificial Organs, vol. 47, no. 4, pp. 649-666, 2023.
S. Lee, T. L. Sirich, I. J. Blanco, N. S. Plummer, and T. W. Meyer, "Removal of uremic solutes from dialysate by activated carbon," Clinical Journal of the American Society of Nephrology, vol. 17, no. 8, pp. 1168-1175, 2022.
R. Lucena, "Water use and water saving strategies in dialysis, room for improvement," Port J Nephrol Hypertens, 2023.
P. Armignacco, F. Garzotto, M. Neri, A. Lorenzin, and C. Ronco, "Wak engineering evolution," Blood purification, vol. 39, no. 1-3, pp. 110-114, 2015.
M. Murea et al., "Risk of catheter-related bloodstream infection in elderly patients on hemodialysis," Clinical Journal of the American Society of Nephrology, vol. 9, no. 4, pp. 764-770, 2014.
J. Ahlmen et al., "Preliminary results from the use of new vascular access (Hemaport) for hemodialysis," Hemodialysis International, vol. 7, no. 1, pp. 73-104, 2003.
W. H. Fissell, A. Dubnisheva, A. N. Eldridge, A. J. Fleischman, A. L. Zydney, and S. Roy, "High-performance silicon nanopore hemofiltration membranes," Journal of membrane science, vol. 326, no. 1, pp. 58-63, 2009.
D. M. Kanani, W. H. Fissell, S. Roy, A. Dubnisheva, A. Fleischman, and A. L. Zydney, "Permeability–selectivity analysis for ultrafiltration: Effect of pore geometry," Journal of membrane science, vol. 349, no. 1-2, pp. 405-410, 2010.
M. S. Tijink et al., "A novel approach for blood purification: Mixed-matrix membranes combining diffusion and adsorption in one step," Acta biomaterialia, vol. 8, no. 6, pp. 2279-2287, 2012.
H. D. Humes et al., "Cell therapy with a tissue-engineered kidney reduces the multiple-organ consequences of septic shock," Critical care medicine, vol. 31, no. 10, pp. 2421-2428, 2003.
A. J. Westover, D. A. Buffington, K. A. Johnston, P. L. Smith, C. J. Pino, and H. D. Humes, "A bio‐artificial renal epithelial cell system conveys survival advantage in a porcine model of septic shock," Journal of tissue engineering and regenerative medicine, vol. 11, no. 3, pp. 649-657, 2017.
F. Tarrass, O. Benjelloun, and M. Benjelloun, "Towards zero liquid discharge in hemodialysis. Possible issues," nefrologia, vol. 41, no. 6, pp. 620-624, 2021.
E. Chang, J. A. Lim, C. L. Low, and A. Kassim, "Reuse of dialysis reverse osmosis reject water for aquaponics and horticulture," Journal of nephrology, vol. 34, pp. 97-104, 2021.
S. Mbakop, L. N. Nthunya, and M. S. Onyango, "Recent advances in the synthesis of nanocellulose functionalized–hybrid membranes and application in water quality improvement," Processes, vol. 9, no. 4, p. 611, 2021.
Q. Gao, J. Xu, and X.-H. Bu, "Recent advances about metal–organic frameworks in the removal of pollutants from wastewater," Coordination Chemistry Reviews, vol. 378, pp. 17-31, 2019.
G. M. Payne and J. Curtis, "CNE. Water Treatment for Hemodialysis: What You Must Know to Keep Patients Safe," Nephrology Nursing Journal, vol. 45, no. 2, 2018.
H. H. Malluche, "Aluminium and bone disease in chronic renal failure," Nephrology Dialysis Transplantation, vol. 17, no. suppl_2, pp. 21-24, 2002.
R. M. de Oliveira, C. A. de los Santos, I. Antonello, and D. d Avila, "Warning: an anemia outbreak due to chloramine exposure in a clean hemodialysis unit—an issue to be revisited," Renal failure, vol. 31, no. 1, pp. 81-83, 2009.
I. H. Khan and G. R. Catto, "Long-term complications of dialysis: infection," Kidney International Supplement, no. 41, 1993.
D. L. Ramada et al., "Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges," Nature Reviews Nephrology, vol. 19, no. 8, pp. 481-490, 2023.
B. Belinda and Z. L. Dewi, "Exploring Self-Regulation of Patients with Chronic Kidney Disease Undergoing Hemodialysis," Jurnal Psikologi, vol. 48, no. 2, pp. 118-132, 2021.
Y. Tri Wulansari and C. UW, "Description of Depression Symptoms in Hemodialysis Patients at Jemursari Hospital, Surabaya," 2020.
A. X. Garg et al., "Patients receiving frequent hemodialysis have better health-related quality of life compared to patients receiving conventional hemodialysis," Kidney international, vol. 91, no. 3, pp. 746-754, 2017.
S. M. Lang, A. Bergner, M. Töpfer, and H. Schiffl, "Preservation of residual renal function in dialysis patients: effects of dialysis-technique–related factors," Peritoneal Dialysis International, vol. 21, no. 1, pp. 1-7, 2001.
C. Ronco and D. Cruz, "Hemodiafiltration history, technology, and clinical results," Advances in Chronic Kidney Disease, vol. 14, no. 3, pp. 231-243, 2007.
F. Maduell, "Hemodiafiltration versus conventional hemodialysis: should “conventional” be redefined?," in Seminars in dialysis, 2018, vol. 31, no. 6: Wiley Online Library, pp. 625-632.
J. C. Kim et al., "A wearable artificial kidney: technical requirements and potential solutions," Expert review of medical devices, vol. 8, no. 5, pp. 567-579, 2011.
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