PKD Fundraising Atlanta: Day of the Juice, Bionic Kidney Trials in 2018, Growing Veins for Dialysis

PKD Fundraising

From Paste Magazine, By Jim Vorel
Talking All Things Hoppy With the Organizers of Atlanta’s New “Day of the Juice” Festival

Paste: Who are your charities?

Lowenberg: There’s two charities, the Polycystic Kidney Disease Foundation and the Georgia Transplant Foundation. Eric Levin, one of our founders, has had a kidney transplant, so those charities are pretty close to home for Modern Hops as a whole.

Finding a niche for a first-time beer festival is no easy feat. Organizers need to hit upon a concept that captures some element of the current zeitgeist, while also dealing with a lack of brand recognition for a festival whose name or production company are unfamiliar to attendees. For the same reasons, it’s difficult to get the most hyped and desirable breweries to attend a new festival, just as it’s hard to book popular bands at a first-year music fest. On some level, if you’re trying to start a new festival from scratch (especially in a city with no shortage of fests), the deck is stacked against you.

Enter, Modern Hops and Atlanta’s upcoming (March 31) Day of the Juice charity festival. Rather than simply replicating the format of one of Atlanta’s more established beer festivals (which are numerous), this indie craft beer distributor is doubling down on a more esoteric concept—a showcase of juicy (and mostly hop-forward) beers from a collection of well-curated, buzzworthy, but relatively smaller stature breweries. Yes, it’s a festival of hoppy, hazy and juicy … but without a Tree House or Trillium in sight. Rather, the focus is on younger breweries striving to be the nextTree House or Trillium.

Considering this fest is happening in Paste’s backyard, I was able to sit down for a short chat with one of the organizers, Michael Lowenberg, Modern Hops’ “flavor chaser extraordinaire.” Fun fact: After hearing him say those words, I inquired if that’s the title that appears on his business cards. As it turns out: Yep. It certainly is. Lowenberg is one of four partners in the indie distributor, along with co-founders Eric Levin and Barrett Hoard, and partner Philip Barnes, all of whom are working to make Georgia’s first brewery-hosted festival a reality. Modern Hops also collaborated with the founder of festival sponsor Craft Connect, Elias Spartis, to create the brand direction and artwork.

Artificial Kidney Research

From Snopes, By Alex Kasprak

Will Bionic Kidneys Replace Dialysis by 2020?

Kidneys are responsible for removing harmful chemicals and impurities from our blood — the filter in the hot tub that is our body’s circulatory system. When kidneys fail, a condition known clinically as end stage kidney failure, a patient currently has two options: a kidney transplant, or dialysis.

Kidney transplants are challenging to obtain, due primarily to a massive shortage of living kidney donations. For every person who received a kidney transplant in 2016, five patients did not, and 4000 people died on the waiting list that year.

For those waiting for a transplant, dialysis is the only solution, but it is an imperfect one. Dialysis is a process in which blood is mechanically filtered to remove excess water, solutes and toxins from the blood, mimicking the job of a kidney. Compared to the real deal, it is far from a perfect replacement, as reported in a 2017 Wired feature:

Dialysis does a decent job cleansing blood of waste products, but it also filters out good stuff: salts, sugars, amino acids. Blame the polymer manufacturing process, which can’t replicate the 7-nanometer precision of nephrons — the kidney’s natural filters.

Making dialysis membranes involves a process called extrusion, which yields a distribution of pore sizes — most are about 7nm but you also get some portion that are much smaller, some that are much larger, and everything in between. This is a problem because that means some of the bad stuff (like urea and excess salts) can sneak through and some of the good stuff (necessary blood sugars and amino acids) gets trapped.

Because of these realities, there has been a great deal of Internet buzz over a project out of the University of California, San Francisco named The Kidney Project. Lead by UCSF bioengineering professor Shuvo Roy and professor of medicine at Vanderbilt University William Fissell, it has the ultimate goal of creating an artificial kidney approved by the Food and Drug Administration that could be installed with a minimally invasive surgery and function for an indefinite amount of time.

The challenge, essentially, is to create a molecular-scale filter that the body can easily push blood through without the need for additional power, that does not cause the blood to clot, and that allows for the passage of “good stuff” while still blocking out the “bad stuff.”

The solution the UCSF team has come up with involves two components: A nano-engineered silica filter to remove dissolved toxins, sugars, and salts, and a bioreactor containing live kidney cells that allow the body to resorb the sugar, salt, and water removed by the filter. A 2018 press release from the NIH’s National Institute of Biomedical Imaging and Bioengineering describes the current conceptual design:

The experimental device is designed to accommodate up to a liter of blood per minute, filtering it through an array of silicon membranes. The filtered fluid contains toxins, water, electrolytes, and sugars. The fluid then undergoes a second stage of processing in a bioreactor of lab-grown cells of the type normally lining the tubules of the kidney. These cells reabsorb most of the sugars, salts, and water back into the bloodstream. The remainder becomes urine that is directed to the bladder and out of the body.

Advances in silicon nanotechnology spurred by electronics manufacturing gave the researchers the ability to manufacture silicon pores that consistently have the precise size and shape necessary to reduce stress on the blood cells and, as a result, clotting, Roy told Wired in 2017. On the cellular side, bioreactors that utilize living kidney cells have been tested successfully in animal studies since 1999.

The project, which aims to combine both of these elements into a single device, received a boost in 2015 when the researchers received a $6 million grant from the NIH, and the FDA included it an initiative aimed at fast-tracking the development, evaluation, and review of certain medical devices. The next steps will involve humans:

Clotting is the biggest concern, so they’ll surgically implant the device in each participant’s abdomen for a month to make sure that doesn’t happen. If that goes well they will do a follow-up study to make sure it actually filters blood in humans the way it’s supposed to. Only then can they combine the filter with the bioreactor portion of the device […] to test the full capacity of the artificial kidney.

While some reports suggest that clinical trials began in 2017, Roy told us via e-mail that their hope was that clinical trials could begin later in 2018. He is optimistic about the prospect of bringing the device to market before the close of the decade, however. “We are hopeful that the first clinical trial will begin this year. If all goes well and funds are available, we could be on the market as early as 2020,” he said.

From Engadget, by Daniel Cooper

Future dialysis patients could grow their own artificial veins

I rarely think about kidney failure, and when I do, it's almost always in the context of a charity appeal from my local hospital. Dialysis machines are the primary way that people with kidney disorders survive until a donor organ can be found. Going to a hospital multiple times a week to have your blood cleaned never seemed like it was a fun way to spend one's time, either. But after talking to Aditlys CEO Silvére Lucquin, I learned these trips to the hospital are not the worst part of the process.

Lucquin's company has been working on a polymer-based implant that can be wired into a person's blood vessels. The implant is, essentially, a hollow scaffold built from a new plastic polymer that encourages tissue growth. Once inserted into a person's veins, their own bodies begin growing a new blood vessel around the artificial one. The implant then dissolves after a couple of months. Leaving behind an entirely new link that can be connected up to a dialysis machine.

The implant itself is harnessing a variety of doctrines, including electrospinning and supramolecular chemistry. These techniques have been married under the new process of endogenous tissue restoration which has been pioneered by a company called Xeltis. That company, however, has used the process to restore damaged heart valves, leaving Aditlys to experiment with its vascular implant.

Our kidneys, you see, are filters that clear out the excess fluid and junk that lingers in our bloodstream, turning it into urine. If a person's kidneys shut down, then the bad stuff in their blood builds up, which can often be fatal. Until a transplant can take place, patients have to visit hospitals every few days to have their blood cleaned. That's where the dialysis machine comes in, which pulls blood out of a vessel, filters it and pushes it back into their bodies.

In emergencies, that can be carried out using a catheter that's been inserted into a blood vessel, but that's not possible on a regular basis. Long-term dialysis users instead need to have a plastic tube implanted into their arm, either an arteriovenous graft or an arteriovenous fistula -- essentially an artificial junction. Regular veins simply can't cope with having thick needles shoved in on a biweekly basis and all that blood taken out. Not to mention that fistulas help improve the blood flow, making dialysis easier.

But "when you leave plastic implants in the body," explained Lucquin, "they tend to occlude [block] quite easily." His research claims that these blockages take place around 50 percent of the time, often within the first year. That's not the only problem because, according to a paper out of Bayer College of Medicine, these implants are a hotbed of germs. Researchers George Nassar and Juan-Carlos Ayus say that the pipes have "repeatedly shown to be a risk factor for bacteremic and nonbacteremic infections."

Worse still, even in a best-case scenario, fistulas fail in almost 40 percent of implantations for a variety of reasons. Even if it doesn't, they normally have to be replaced once every two years or so, and that means regular trips back to the vascular surgeon. Those patients, explained Lucquin, "after a decade of dialysis and all that decay, means that it's really complicated to find a clean place to put a new graft or fistula."

Now, the hope is that with Aditlys' new device, many of these issues will go away and most patients will need only one implant. Or, at the very worst, a couple, but that's not something that Lucquin could comment on publicly. After all, things are at such an early stage that it's not clear if the theory and the practice really match up. But the CEO did point out that even if the vessels do fail, those failures won't nearly be as frequent as they are right now.

Of course, it's going to be several years worth of clinical testing before the company can market the implant to patients. And it'll take a while before vascular surgeons decide to attempt to use the tool in place of what currently works. But if successful, some of the many additional pains that people with kidney failure have to deal with may be a thing of the past.