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Artificial Kidney Research
The replacement of a failed renal function by dialysis is probably the most successful story of artificial solid organ replacement. Despite the fact that some dialysis patients have survived more than 30 years with dialysis therapy, many problems are yet unresolved. Dialysis patients have a highly accelerated mortality rate. Part of this accelerated mortality as compared with the normal population is certainly explained by the fact that a very sick patient population with high baseline mortality (the majority with kidney failure from longstanding diabetes) is selected for dialysis therapy. Nevertheless, it is also important to realize that current state-of-the-art dialysis therapy, while highly effective during the actual treatment procedures of about 4 hours thrice weekly, results in an average clearance corresponding to only about 10 to 15% of a normal renal function over the whole week.
Conventional methods to increase the amount of dialysis delivered during the treatment procedure either by increasing the quality of filters or by adding convective transport have failed to decrease overall mortality in controlled studies. The use of nightly intermittent or daily dialyses to significantly increase the total amount of dialysis delivered is tempting, but due to the low number of patients treated with this methods, no outcome data are expected anytime soon. Hemodialysis is an expensive procedure. The current reimbursement rate is 497 Swiss francs per dialysis. Given the current state of health care finances it is unlikely that an increased number of dialysis per week will be reimbursed, especially with no outcome data available. Research into methods resulting in an increased frequency of dialysis treatments will therefore also have to focus on simplification and reduction of costs per treatment.
The main goal of the research is to obtain micro/nanofluidic devices which in more precise way address kidney functions than the current dialysis systems.
