From MedGadget reprint from Vanderbilt University, watch video
Artificial Kidney Made of Nanofilters and Living Cells to Replace Dialysis
At Vanderbilt University scientists are building an artificial kidney that they envision will one day will be a standard of care over dialysis. The device consists of a silicon nanotechnology filter chip and embedded living kidney cells that would work together to mimic the functionality of a healthy kidney. The end result is expected to be about the size of a natural kidney, small enough to be implantable and powered by the body’s own blood flow.
The filter component has tiny pores that can be individually shaped to perform a specific task. These filters would sit in a series, each one performing a different filtration step. Between the filter slices there would be living kidney cells that perform tasks that the man made components are not very good at, including re-absorption of nutrients and getting rid of accumulated waste.
“There are only about 20,000 patients a year who receive a kidney transplant,” Fissell said.
He’s dedicated his life’s work to this project and he said it’s taken decades of research.
“In the 1980s is when I first met a dialysis patient when I was a paramedic in Boston,” Fissell said. “And the incredible courage and humanity of the patients that I cared for every day then, 30 years ago, and that I care for every day today drives this work forward."
Fissell said they use a microchip technology to dissect fluids inside the artificial kidney.
"These are probably things like the insides of your video camera, or the gyroscope in your iPhone. We've taken that technology and used it to make a miniature membrane that's small enough that it can fit inside a patient's body and efficient enough that it doesn't require big bulky pumps to circulate fluid around,” he added.
He said the challenge will be connecting the membrane to the patient’s blood vessels.
“We use the same engineering tools that, for example, people use to design jet liners,” Fissell said. “The computational fluid dynamics that allows you to predict exactly how much force of fluid will experience as it's moved from your aorta another artery through this artificial device."
PKD Fundraising
From Broadway World
Wesley Taylor, Jessica Phillips & More Set for BROADWAY SINGS FOR PKD at Laurie Beechman
The fifth annual Broadway Sings for PKD, a concert benefiting the Polycystic Kidney Disease Foundation, will be offered Thursday, February 25 at 7:00 pm at The Laurie BeechmanTheatre.
The concert will feature new musical theatre songs by emerging writers, including Scotty Arnold, Ben Bonnema, Christina Capatides, Seth Christenfeld, Amy Engelhardt, Benny Gammerman, Sean Havrilla, Doug Katsaros, Rachel Kunstadt, Jane Lee, Natalie Lovejoy, Brandon Michael Lowden, Rachel Peters, Paulo K. Tirol, and Amanda Yesnowitz
Performers will include Abby Burke, Hannah Corneau, Emma Davis, Angel Desai (Company), Sam Heldt, Jillian Louis (It Shoulda Been You), Jessica Phillips (Next to Normal, "Law & Order SVU"), Ariella Serur, and Wesley Taylor (The Addams Family, Rock of Ages). Ben Cameron hosts.
Broadway Sings for PKD is produced by Rachel Kunstadt with musical direction by Benjie Dia.
Proceeds from the evening will go to the Polycystic Kidney Disease Foundation, which "promotes programs of research, advocacy, education, support and awareness in order to discover treatments and a cure for Polycystic Kidney Disease and improve the lives of all it affects."
Tickets are $15, and there is a $20 food or drink minimum. Tickets are available at www.westbankcafe.com.
For more information on the Polycystic Kidney Disease Foundation, please visit www.pkdcure.org.
Living with PKD
From Stuff, Canterbury, New Zealand, by BRENDON EGAN
Christchurch's Eugene Sanders, second left, turned to cricket umpiring after a kidney disease and won national umpiring award. He is pictured talking with International umpires, from left, Richard Illingworth, Ranmore Martinesz and Richard Kettleborough.
A kidney disease forced Eugene Sanders to give up playing cricket seven years ago.
Rather than being lost to the sport, the Christchurch man turned his attention to umpiring.
Sanders' commitment and dedication has paid off, winning a national award, run in conjunction by New Zealand Cricket (NZC) and optical company, Specsavers.
In 2009, Sanders was playing in a suburban club game for Heathcote and realised something was wrong when he got home and experienced abdominal pain and discovered blood in his urine.
He visited the doctor and was diagnosed with polycystic kidney disease, which came as a major shock.
Sanders was told if he kept playing cricket he would be putting his life at risk.
"I'd been a bowler all my life. The motion going over your side, probably wouldn't be a good idea with the cysts," he said.
"You're prone to a lot of infections with the cysts bursting."
Sanders, 43, freely admits he is a more talented umpire than he was cricketer.
Switching to umpiring was an easy call.
"I thought why not get into the hot seat, the best seat in the house, and I decided to do that."
He was nominated for the national award, which recognises the unsung heroes of community cricket, by his brother, Charne Christensen, who wrote a supporting letter.
Sanders prevailed over five regional winners.
"It's very humbling. It's the last thing I expected. You don't expect these awards, especially when you just do it for the love of the game.
"It came as a very welcome surprise." [Read more]
NEJM Journal Watch
Decline in glomerular filtration rate in children with ARPKD was comparable with declines in other pediatric chronic kidney diseases.
Autosomal recessive polycystic kidney disease (ARPKD) can cause death in the neonatal period; however, the majority of children with this condition now survive infancy. This improvement in survival necessitates a better understanding of the natural history of ARPKD to guide care of survivors.
In a prospective study, researchers compared glomerular filtration rate (GFR), blood pressure, left ventricular hypertrophy, and proteinuria in 22 children with ARPKD surviving infancy and two cohorts of children with other renal diseases, including 44 children with aplasia/hypoplasia/dysplasia and 44 with obstructive uropathy. All children were diagnosed during the neonatal period. Results were as follows:
Children with ARPKD had an annual decline in GFR of –1.4 mL/min/1.73m2 (representing a 6% decrement), which was similar to declines in the other groups.
In all groups, annual decline in renal function was greater with baseline GFR level <45 ml/min/1.73m2 versus ≥45.
Children with ARPKD aged ≥10 years had more than double the rate of annual GFR decline compared with those aged <10 years.
Hypertension and left ventricular hypertrophy rates were similar between all groups; however, antihypertensive therapy use was higher among patients with ARPKD.
Children with ARPKD had less proteinuria compared with the two comparison groups.
Kelly Case said she chose to donate a kidney to her husband, Jesse, not long after hearing that the two were a match. PHOTO PROVIDED
It took a long time to get to this point, Jesse and Kelly Case said recently, but the two of them were a match.
On one level, the two Wellsville residents have known that for a long time — they have been married since 1992. What they found out much more recently is that Kelly Case was a match for her husband when Jesse, who has suffered from polycystic kidney disease (PKD) needed a new kidney (for more information on PKD, see the accompanying box).
“It’s called PKD. I have the adult version,” said Jesse Case, 56, who works at Dresser-Rand in Wellsville. “Basically, cysts grow on your kidneys until they can’t function anymore. It’s something you’re born with, but the diagnosis of it was 16 years ago. I went into kidney failure slightly over a year ago, in December 2014. I’ve been on dialysis since then.”
The short version of this story is the couple found out last year that Kelly was a donor match, which led to the surgery that was performed five days ago at Strong Memorial Hospital in Rochester. The surgeries on Kelly and Jesse went well, Kelly’s sister, Tammy Christman, said Friday. Kelly came home Friday and Jesse was coming home Saturday, she said.
The longer version involved testing and visits to doctors in Hornell and Rochester and discussion between the husband and wife, the Cases said in the days before they made the trip to Rochester for Tuesday’s operations.
“The Dialysis Center in Hornell is who I do everything through. They made the referral up to Strong for us to get on the donor list,” Jesse Case said. “It can take several years to find a donor.”
Kelly recalled asking last May, when Jesse went for an evaluation, whether she could be tested to see if she was a match.
“We did know enough to know it goes by blood type and that’s how I got involved. They said living organ donation is the best outcome. I knew we were the same blood type (Type O) and they tested us and we were a match,” she said.
The Cases both went through a two-day testing period at some point.
“They did a lot of tests and you meet with the entire team and they fully explain the process to you, step by step — ‘This is what’s going to happen. This is what is expected. This is how things will work,’” he said.
The way doctors worked with her as a potential donor was very private, Kelly remembered.
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