Calculation of the clearance requirements for the development of a hemodialysis‐based wearable artificial kidney

Abstract Wearable artificial kidney (WAK) has been considered an alternative to standard hemodialysis (HD) for many years. Although various novel WAK systems have been recently developed for use in clinical applications, the target performance or standard dose of dialysis has not yet been determined. To calculate the appropriate clearance for a HD‐based WAK system for the treatment of patients with end‐stage renal disease with various dialysis conditions, a classic variable–volume two‐compartment kinetic model was used to simulate an anuric patient with variable target time‐averaged creatinine concentration (TAC), daily water intake volume, daily dialysis pause time, and patient body weight. A 70‐kg anuric patient with a HD‐based WAK system operating for 24 h required dialysis clearances of creatinine of at least 100, 50, and 25 mL/min to achieve TACs of 1.0, 2.0, and 4.0 mg/dL, respectively. The daily water intake volume did not affect the clearance required for dialysis under various conditions. As the pause time per day for the dialysis increased, higher dialysis clearances were required to maintain the target TAC. The present study provided theoretical dialysis doses for an HD‐based WAK system to achieve various target TACs through relevant mathematical kinetic modeling. The theoretical results may contribute to the determination of the technical specifications required for the development of a WAK system.
Source: Hemodialysis International - Category: Hematology Authors: Tags: Original Article Source Type: research

Related Links:

The objectives of the conservative treatment for chronic kidney disease are to slow down the progression of kidney dysfunction, treat complications (anemia, bone diseases, cardiovascular diseases), vaccination for hepatitis B, and preparation for kidney replacement therapy.
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
Abstract In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA), a policy intended to transition Medicare away from pure fee-for-service care to value-based care. MACRA does this by evaluating the cost and quality of providers, resulting in financial bonuses and penalties in Medicare reimbursement. MACRA offers two tracks for participation, the Merit-based Incentive Payment System and the Advanced Alternative Payment Models. Although the payment rules are different for each of the tracks, common to both is an emphasis on holding providers accountable for high-quality, cost-efficient care...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research
A novel endovascular device is a new alternative to surgery for the creation of an arteriovenous fistula for hemodialysis access in those with kidney disease, and has a high level of patient satisfaction.Medscape Medical News
Source: Medscape Transplantation Headlines - Category: Transplant Surgery Tags: Nephrology News Source Type: news
Publication date: Available online 11 December 2019Source: International Journal of Nursing SciencesAuthor(s): Lei Cui, Weixia Chen, Xingxing Yu, Changping JuAbstractPurposePatients undergoing maintenance hemodialysis (MHD) have a higher prevalence of cognitive impairment and inferior cognitive performance than the general population, and those with cognitive impairment are at higher risk of death than those without cognitive impairment. Having diabetes has been associated with an increased risk of cognitive decline in end-stage kidney disease patients treated with peritoneal dialysis or kidney transplant. However, these f...
Source: International Journal of Nursing Sciences - Category: Nursing Source Type: research
ConclusionsOur study found that the decision-making process in ESRD is multifactorial and involves not only medical factors, but also assessment of social factors, quality of life, and patient/family preference. Bettering our understanding of this decision-making process will positively impact patients and families through more informed decision-making.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
AbstractCardiovascular disease (CVD) is a life-limiting comorbidity in patients with chronic kidney disease (CKD). In childhood, imaging studies have demonstrated early phenotypic characteristics including increases in left ventricular mass, carotid artery intima-media thickness, and pulse wave velocity, which occur even in young children with early stages of CKD. Vascular calcifications are the signature of an advanced phenotype and are mainly found in adolescents and young adults treated with dialysis. Association studies have provided valuable information regarding the significance of a multitude of risk factors in prom...
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
AbstractBackgroundEnteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age.MethodsRetrospective study of pre-transplant, pre-pubertal children (
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
CONCLUSION: There is a high CKD burden in the ME countries. There needs to be emphasis on prevention of ESRD and provision of adequate care for the total ESRD patient population. National renal registries are needed to monitor the status of ESRD patients. Health expenditures should be increased to cover all aspects of RRT in ME Countries. PMID: 31793874 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
Abstract End-stage kidney disease (ESKD) represents a major challenge for Latin America (LA). The Latin American Dialysis and Renal Transplantation Registry (LADRTR) has published several reports, and its continuity has implied a sustained effort of the nephrology community to improve care of ESKD in the region; this paper summarizes results of the year 2014. Methods have been reported previously; participant countries complete annual surveys collecting data on incident and prevalent patients undergoing renal replacement therapy (RRT) in all modalities. 20 countries participated in the surveys (more than 90% of th...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
Introduction: Most of patients in Egypt with end stage renal disease (ESRD) are on hemodialysis because of the low rate of kidney transplantation due to legal, religious, and financial issues.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
More News: Dialysis | Hematology | Hemodialysis | Kidney Transplant | Study | Urology & Nephrology