IMPLANTABLE ARTIFICIAL KIDNEY FOR HYBRID RENAL REPLACEMENT THERAPY

 

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https://storage.unitedwebnetwork.com/files/1099/880f5ebc2be1b2542c26291aeea0a55a.pdf
IMPLANTABLE ARTIFICIAL KIDNEY FOR HYBRID RENAL REPLACEMENT THERAPY

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Norihisa
Miki
Norihisa Miki miki@mech.keio.ac.jp Keio University Mechanical Engineering Yokohama Japan *
Takashi Ota takashi94@keio.jp Keio University Mechanical Engineering Yokohama Japan -
Masaki Takasu takasu.masaki.i4@f.gifu-u.ac.jp Gifu University Institute for Advanced Research Gifu Japan -
Yoshihiko Kanno kannoyh@tokyo-med.ac.jp Tokyo Medical University Nephrology Tokyo Japan -
 
 
 
 
 
 
 
 
 
 
 

Current dialysis patients face a demanding routine of thrice-weekly, four-hour sessions, accompanied by blood pressure fluctuations and strict fluid restrictions. While artificial kidneys have been studied to fully replicate renal function, reproducing both the filtration of 200 L of fluid per day and tubular reabsorption remains extremely challenging.

We propose a hybrid renal replacement therapy combining an implantable hemofiltration device with conventional dialysis. The implanted device continuously removes an appropriate amount of fluid, maintaining stable body fluid volume and allowing patients to drink an equivalent amount of water (designed at 1.5 L/day). As a result, dialysis frequency can be reduced according to residual kidney function, improving both quality of life and clinical outcomes.

Our hemofiltration device operates under natural blood pressure without an external pump. A 10-day in vivo goat experiment successfully demonstrated the feasibility of this concept.

The hemofiltration device consists of a layered filter structure composed of a polyethersulfone (PES) dialysis membrane, with alternating microchannels for blood flow and filtrate flow. The device is connected to the carotid artery and vein of a goat via artificial vascular grafts and implanted in the cervical region. During the experiment, systemic anticoagulation was maintained with heparin to keep the activated clotting time (ACT) at approximately 250 seconds. The collected filtrate confirmed that the device was functioning properly.

After the device was connected to the carotid artery and vein of the goat, filtrate was successfully obtained. The goat recovered from anesthesia and began eating a few hours later. During the first two days, the activated clotting time (ACT) exceeded 300 seconds, and the goat’s condition deteriorated. After the heparin dosage was reduced, the goat gradually recovered and showed good activity. The animal remained active throughout the 10-day experimental period, and filtrate was continuously obtained.


We designed and fabricated a hemofiltration device for hybrid renal replacement therapy. A 10-day experiment using a goat was successfully conducted, demonstrating the feasibility of the device. Longer-term in vivo experiments are planned to further evaluate its performance.

Kewords