Wearable and implantable artificial kidney devices for end‐stage kidney disease treatment: Current status and review

Abstract

Background: Chronic kidney disease (CKD) is a major cause of early death worldwide. By 2030, 14.5 million people will have end-stage kidney disease (ESKD, or CKD stage 5), yet only 5.4 million will receive kidney replacement therapy (KRT) due to economic, social, and political factors. Even for those who are offered KRT by various means of dialysis, the life expectancy remains far too low.Observation: Researchers from different fields of artificial organs collaborate to overcome the challenges of creating products such as Wearable and/or Implantable Artificial Kidneys capable of providing long-term effective physiologic kidney functions such as removal of uremic toxins, electrolyte homeostasis, and fluid regulation. A focus should be to develop easily accessible, safe, and inexpensive KRT options that enable a good quality of life and will also be available for patients in less-developed regions of the world.Conclusions: Hence, it is required to discuss some of the limits and burdens of transplantation and different techniques of dialysis, including those performed at home. Furthermore, hurdles must be considered and overcome to develop wearable and implantable artificial kidney devices that can help to improve the quality of life and life expectancy of patients with CKD.

Venous chambers in clinical use for hemodialysis have limited capacity to eliminate microbubbles from entering the return bloodline: An in vitro study

“…Even if such a chamber would fit their device, it would need some administrative work, while in some devices, modifications on the design of the dialysis monitors would also be needed. In future dialysis developments, these are issues that are being addressed 23 …”

Die Zukunft der Nierenersatztherapie

“…Ebenso machen die anderen KidneyX-Projekte gute Fortschritte, aber sie werden auch noch viele Jahre bis zur CE-Zulassung und bis in die klinische Routine brauchen. Natürlich laufen zusätzlich verschiedene andere Innovationsprojekte außerhalb von KidneyX [7].…”

“…Im Moment laufen verschiedene Projekte, in denen sowohl biologische, technische als auch hybride Möglichkeiten untersucht werden. Empfehlenswert ist dazu ein aktueller, frei verfügbarer Übersichtartikel von Groth et al, der die wichtigsten im Moment laufenden Projekte beschreibt 7 .…”

Flexible and Stretchable Light-Emitting Diodes and Photodetectors for Human-Centric Optoelectronics

“…As such, there is a significant interest in developing advanced optoelectronic devices that may enable future human-centric applications (Figure ). These devices may be integrated into a contact lens to diagnose various diseases such as glaucoma and diabetes − or provide augmented/virtual reality vision. − Flexible and stretchable PDs with high resolution can realize various curvy-shaped retinas in natural eyes, which can be implemented in artificial vision for mobile robotics or visual prostheses to provide/restore vision. − Fully mimicked, bioinspired artificial imagers can provide user-friendly preprocessed images, minimizing the computational cost for refining the raw data. − Wearable and implantable devices can be used to detect activities in the brain, heart, and muscles, blood pressure, and other vital signs. − The collected data can be transmitted to the cloud for real-time analysis to assist in predictive diagnostics or provide proper treatment, including but not limited to drug delivery and therapy based on thermal, electrical, and ultrasound stimulation. − These soft sensors and actuators can also be applied to various prosthetics or human-machine interfaces (HMIs) to restore senses or major functionalities of the human body. − In conjunction with the artificial intelligence (AI) technology, the human-centric devices with flexible and stretchable form factors are expected to bring a change of paradigm in medicine from treatment to diagnosis, prevention, and restoration, transitioning to personalized precision medicine. Through the utilization of medical big data, AI can impact various areas of healthcare, including prediction, diagnosis, treatment, and rehabilitation.…”