Search Results (7)

Despite limited organ availability and post-transplant complications, kidney transplantation remains the optimal treatment for End-Stage Kidney Disease (ESKD). However, innovative dialysis technologies such as portable, wearable, and implantable bioartificial kidney systems are being developed with the aim of addressing these issues and improving patient care. An ideal implantable device could combine bioreactors and blood ultrafiltration to replicate key native cell functions for solute reabsorption, secretion, and endocrinologic activities. Today, the feasibility of an implantable bioreactor for renal cell therapy opens the challenge of developing a fully implantable bioartificial kidney based on silicon nanopore membranes to ensure immunological isolation, cell viability, and the possibility of maintaining a blood substrate for metabolic activities. Current technology is not sufficient to obtain an efficient artificial bioreactor to reach physiological blood purification, which requires a more complex system to produce an ultrafiltrate from the blood that can be processed by cells and eliminated as urine. The number of cells in the bioreactor, endocrine activity, immunological cell isolation, solute and fluid secretion/reabsorption, cell viability, blood and ultrafiltration flow control, and thrombogenicity are fundamental issues that require a new technology that today appears to be a challenge for the design of an implantable artificial kidney. This review aims to analyze the state of the art in this particular field of kidney replacement therapy to highlight the current limitations and possible future technology developments to create implanted and wearable organs capable of treating ESKD with artificial organs that can replicate all native kidneys functions. Full article

Affective computing through physiological signals monitoring is currently a hot topic in the scientific literature, but also in the industry. Many wearable devices are being developed for health or wellness tracking during daily life or sports activity. Likewise, other applications are being proposed for the early detection of risk situations involving sexual or violent aggressions, with the identification of panic or fear emotions. The use of other sources of information, such as video or audio signals will make multimodal affective computing a more powerful tool for emotion classification, improving the detection capability. There are other biological elements that have not been explored yet and that could provide additional information to better disentangle negative emotions, such as fear or panic. Catecholamines are hormones produced by the adrenal glands, two small glands located above the kidneys. These hormones are released in the body in response to physical or emotional stress. The main catecholamines, namely adrenaline, noradrenaline and dopamine have been analysed, as well as four physiological variables: skin temperature, electrodermal activity, blood volume pulse (to calculate heart rate activity. i.e., beats per minute) and respiration rate. This work presents a comparison of the results provided by the analysis of physiological signals in reference to catecholamine, from an experimental task with 21 female volunteers receiving audiovisual stimuli through an immersive environment in virtual reality. Artificial intelligence algorithms for fear classification with physiological variables and plasma catecholamine concentration levels have been proposed and tested. The best results have been obtained with the features extracted from the physiological variables. Adding catecholamine’s maximum variation during the five minutes after the video clip visualization, as well as adding the five measurements (1-min interval) of these levels, are not providing better performance in the classifiers. Full article

Dialysis is life-saving for an exponentially growing number of kidney failure patients. Yet, the current concept also has several drawbacks, such as high societal cost, incomplete kidney function replacement, dismal outcomes, low quality of life and a considerable ecologic footprint. In spite of many changes over the last fifty years, the original concept remained largely unmodified and the drawbacks did not disappear. In this article, we present a number of alternative solutions that are currently considered or tested which might have a potential impact on uremic toxin concentration, quality of life or environmental footprint that goes beyond what is currently achieved with traditional dialysis. These comprise applications of regenerative medicine; bioartificial kidney; conceptual changes in extracorporeal removal; energy-neutral, water-limiting dialysis; material recycling; keto-analogues; xenobiotics; and preservation of residual kidney function. As metabolism generating uremic toxins also generates beneficial compounds, some of these options may also maintain or restore this balance in contrast to dialysis that likely removes without distinction. All proposed options are also exemplary of how out-of-the-box thinking is needed to disrupt the status quo in treatment of kidney diseases that has now persisted for too long. Full article

We developed Mixed Matrix Membrane Adsorbers (MMMAs) formed by cellulose acetate and various sorbent particles (activated carbon, zeolites ZSM-5 and clinoptilolite) for the removal of urea, creatinine and uric acid from aqueous solutions, to be used in the regeneration of spent dialysate water from Hemodialysis (HD). This process would allow reducing the disproportionate amount of water consumed and permits the development of closed-loop HD devices, such as wearable artificial kidneys. The strategy of MMMAs is to combine the high permeability of porous membranes with the toxin-capturing ability of embedded particles. The water permeability of the MMMAs ranges between 600 and 1500 L/(h m² bar). The adsorption of urea, the limiting toxin, can be improved of about nine times with respect to the pure cellulose acetate membrane. Flow experiments demonstrate the feasibility of the process in a real HD therapy session. Full article

The artificial kidney, one of the greatest medical inventions in the 20th century, has saved innumerable lives with end stage renal disease. Designs of artificial kidney evolved dramatically in decades of development. A hollow-fibered membrane with well controlled blood and dialysate flow became the major design of the modern artificial kidney. Although they have been well established to prolong patients’ lives, the modern blood purification system is still imperfect. Patient’s quality of life, complications, and lack of metabolic functions are shortcomings of current blood purification treatment. The direction of future artificial kidneys is toward miniaturization, better biocompatibility, and providing metabolic functions. Studies and trials of silicon nanopore membranes, tissue engineering for renal cell bioreactors, and dialysate regeneration are all under development to overcome the shortcomings of current artificial kidneys. With all these advancements, wearable or implantable artificial kidneys will be achievable. Full article

Adsorption of urea from dialysate is essential for wearable artificial kidneys (WRK). Molecularly imprinted microspheres with nanoporous and multilayered structures are prepared based on liquid–liquid phase separation (LLPS), which can selectively adsorb urea. In addition, we combine the microspheres with a designed polydimethylsiloxane (PDMS) chip to propose an efficient urea adsorption platform. In this work, we propose a formulation of LLPS including Tripropylene glycol diacrylate (TPGDA), ethanol, and acrylic acid (30% v/v), to prepare urea molecularly imprinted microspheres in a simple and highly controllable method. These microspheres have urea molecular imprinting sites on the surface and inside, allowing selective adsorption of urea and preservation of other essential constituents. Previous static studies on urea adsorption have not considered the combination between urea adsorbent and WRK. Therefore, we design the platform embedded with urea molecular imprinted microspheres, which can disturb the fluid motion and improve the efficiency of urea adsorption. These advantages enable the urea absorption platform to be highly promising for dialysate regeneration in WRK. Full article

Hemodialysis involves large, periodic treatment doses using large-area membranes. If the permeability of dialysis membranes could be increased, it would reduce the necessary dialyzer size and could enable a wearable device that administers a continuous, low dose treatment of chronic kidney disease. This paper explores the application of ultrathin silicon membranes to this purpose, by way of analytical and finite element models of diffusive and convective transport of plasma solutes during hemodialysis, which we show to be predictive of experimental results. A proof-of-concept miniature nanomembrane dialyzer design is then proposed and analytically predicted to clear uremic toxins at near-ideal levels, as measured by several markers of dialysis adequacy. This work suggests the feasibility of miniature nanomembrane-based dialyzers that achieve therapeutic levels of uremic toxin clearance for patients with kidney failure. Full article