SUSTAINABLE ANTICOAGULATION-FREE HEMODIALYSIS USING A HEMODIALYSIS FILTER ROTATOR – THE SECOND PROTOTYPE ROTATOR IS READY FOR PRIMETIME!

Introduction:

We first described, in 2021, the ‘Locke-Onuigbo maneuver’, a new original and groundbreaking hemodialysis filter rotational approach to achieving anticoagulation-free hemodialysis using the NxStage hemodialysis machine, in the Mayo Clinic Proceedings Innovations Quality Outcomes journal. We subsequently designed and developed the first prototype hemodialysis filter rotator (HDFR) in early 2022, and subsequently, we successfully completed the design and development of an advanced second-generation HDFR prototype in 2023. Furthermore, a Clinical Journal of the American Society of Nephrology article in 2023 reported a RCT that compared regional citrate anticoagulation with no-anticoagulation in 89 adult liver failure patients requiring CRRT. Severe hypocalcemia (13% vs. 77%, p < 0.001) was demonstrated with citrate anticoagulation, and higher filter failure occurred with no-anticoagulation. Clearly, there remains a global and critical unmet need for a sustainable approach to anticoagulation-free hemodialysis.

Methods:

The aim of this project is to translate the ‘Locke-Onuigbo maneuver’ and to successfully design and develop a functional HDFR that would work with the NxStage hemodialysis machine to achieve a sustainable and robust anticoagulation-free hemodialysis for the ICU, the in-center outpatient hemodialysis unit, and for patients on home hemodialysis.

Results:

In the Spring of 2023, we successfully completed the design and development of an advanced second-generation HDFR prototype that is now ready for testing, first in animals, and then finally in human subjects. We completed several “dry live runs” of this second-generation HDFR prototype with saline prime on the NxStage machine while testing out all the different features and functionalities of the HDFR during the design and development process.

Conclusions:

There is a long overdue imperative to develop a robust, safe, and sustainable modality for anticoagulation-free hemodialysis. Citrate anticoagulation and no-anticoagulation while available, have several drawbacks and limitations to their utilization. Our second-generation HDFR with its enhanced new features of increased resilience, longer running times, enhanced angle and speed consistency, improved ergonomics, solid state sensors for temperature and angle fidelity verifications, and an accompanying user-friendly versatile smartphone App with Bluetooth Connectivity to facilitate ease and convenience of monitoring and control of the HDFR, is the solution for this long overdue imperative for anticoagulation-free hemodialysis. Developers, Investors and Sponsors Are Welcome!The content of this abstract was submitted to the American Society of Nephrology 2024 Kidney Week and this resubmission is allowed.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.