End-stage kidney disease is on the rise in Malaysia. It is estimated that nationally, the number of patients will rise to 10,208 in 2020. Globally, there are 2.6 million patients with end-stage kidney disease requiring dialysis in 2010 and this number will almost double by 2030.
End-stage kidney disease happens when both kidneys in an individual fail completely. This causes toxins such as urea, which are usually removed by the kidneys into urine, to build up in the body. Other functions of the kidney, such as keeping salt and water in the body to be regulated also go haywire. When this happens, these patients must rely on dialysis to keep all these factors in check or it can be extremely uncomfortable and even fatal.
Globally, there are 2.6 million patients with end-stage kidney disease requiring dialysis in 2010 and this number will almost double by 2030
Improving patient lives
Dialysis is very time consuming, expensive and inconvenient for patients. Furthermore, there is shortage of kidney donors, hence many patients are stuck in a limbo with dialysis or face death without dialysis.
Therefore, scientists from University of California, San Francisco (UCSF) are currently working on an implantable bionic kidney that will take over most, if not all, of the functions of a kidney, freeing the patient from the shackles of dialysis.
The bionic kidney consists of two parts:
- Efficient membranes created with silicon nano-technology which filter toxins from blood without the need of an additional pump or external electrical power supply
- A bioreactor containing bio-engineered kidney cells that will perform other functions of a kidney such as regulating salt and water in the body.
This bionic kidney will then be implanted into the body via a surgical procedure similar to that of a kidney transplant, under general anaesthesia. The device will be connected to the body’s blood circulation system and will filter the toxins out as waste to be passed out of the body through the bladder, just like what a kidney does.
This is amazing as patient no longer needs to be dependent on a dialysis machine and will be able to eat and drink more normally.
When will it be ready?
The research team anticipates to start clinical trials for this device in early 2018. During which, they would establish that the components of the device are safe for humans and human blood exposure. This is one of the many steps for them to gain the approval from FDA to follow up with more trials to confirm the efficiency, capabilities and safety of the bionic kidney.
They expect to arrive at the final stage of the clinical trials (the stage just before releasing it to public) by 2020.
Side-effects and risks
Preliminary tests show that the bionic kidney does not cause rejection, hence patients do not have to take immune suppressing medicine unlike patients receiving a kidney transplant. Furthermore, it also does not cause blood clots to occur unlike certain heart implants, therefore blood thinners are also not necessary.
The risk of putting this implant into the body is similar to that of having a kidney transplant surgery. There is risk of infection, surgical failure, trauma and scars.
This research is certainly exciting and very much anticipated as it can potentially change the lives of many patients suffering from end-stage kidney disease
Efficiency and cost
This will be confirmed as the preclinical studies are conducted, but for now, the researchers estimate that the Glomerular Filtration Rate(GFR)* with the device implanted will be about 20 to 30 ml/min.
As for cost, it is estimated to be similar to that of a regular kidney transplant.
This research is certainly exciting and very much anticipated as it can potentially change the lives of many patients suffering from end-stage kidney disease. If you have more questions or doubts, feel free to browse their official website for more information.
*GFR is the rate in which our kidneys filter blood, hence, it is a way to measure the efficiency of a kidney. The GFR of a normal kidney is more than 90ml/min while a patient with end-stage kidney disease is less than 15ml/min.
Pharm.ucsf.edu. (2018). Home | The Kidney Project | UCSF. [online] Available at: https://pharm.ucsf.edu/kidney [Accessed 28 Mar. 2018].