The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge
Despite limited organ availability and post-transplant complications, kidney transplantation remains the optimal treatment for End-Stage Kidney Disease (ESKD). However, innovative dialysis technologies such as portable, wearable, and implantable bioartificial kidney systems are being developed with...
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| Format: | Article |
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MDPI AG
2024-01-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/14/2/491 |
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| author | Federico Nalesso Francesco Garzotto Leda Cattarin Elisabetta Bettin Martina Cacciapuoti Cristina Silvestre Lucia F. Stefanelli Lucrezia Furian Lorenzo A. Calò |
| author_facet | Federico Nalesso Francesco Garzotto Leda Cattarin Elisabetta Bettin Martina Cacciapuoti Cristina Silvestre Lucia F. Stefanelli Lucrezia Furian Lorenzo A. Calò |
| author_sort | Federico Nalesso |
| collection | DOAJ |
| description | Despite limited organ availability and post-transplant complications, kidney transplantation remains the optimal treatment for End-Stage Kidney Disease (ESKD). However, innovative dialysis technologies such as portable, wearable, and implantable bioartificial kidney systems are being developed with the aim of addressing these issues and improving patient care. An ideal implantable device could combine bioreactors and blood ultrafiltration to replicate key native cell functions for solute reabsorption, secretion, and endocrinologic activities. Today, the feasibility of an implantable bioreactor for renal cell therapy opens the challenge of developing a fully implantable bioartificial kidney based on silicon nanopore membranes to ensure immunological isolation, cell viability, and the possibility of maintaining a blood substrate for metabolic activities. Current technology is not sufficient to obtain an efficient artificial bioreactor to reach physiological blood purification, which requires a more complex system to produce an ultrafiltrate from the blood that can be processed by cells and eliminated as urine. The number of cells in the bioreactor, endocrine activity, immunological cell isolation, solute and fluid secretion/reabsorption, cell viability, blood and ultrafiltration flow control, and thrombogenicity are fundamental issues that require a new technology that today appears to be a challenge for the design of an implantable artificial kidney. This review aims to analyze the state of the art in this particular field of kidney replacement therapy to highlight the current limitations and possible future technology developments to create implanted and wearable organs capable of treating ESKD with artificial organs that can replicate all native kidneys functions. |
| first_indexed | 2024-03-08T09:59:35Z |
| format | Article |
| id | doaj.art-225ad3139757489f9505ebd4187383bd |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-08T09:59:35Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-225ad3139757489f9505ebd4187383bd2024-01-29T13:42:01ZengMDPI AGApplied Sciences2076-34172024-01-0114249110.3390/app14020491The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney ChallengeFederico Nalesso0Francesco Garzotto1Leda Cattarin2Elisabetta Bettin3Martina Cacciapuoti4Cristina Silvestre5Lucia F. Stefanelli6Lucrezia Furian7Lorenzo A. Calò8Department of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Cardiac Thoracic Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, 35128 Padova, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Surgical Oncological and Gastroenterological Sciences, Kidney and Pancreas Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Surgical Oncological and Gastroenterological Sciences, Kidney and Pancreas Transplant Unit, University of Padua, 35128 Padua, ItalyDepartment of Medicine, Nephrology-Dialysis-Kidney Transplant Unit, University of Padua, 35128 Padua, ItalyDespite limited organ availability and post-transplant complications, kidney transplantation remains the optimal treatment for End-Stage Kidney Disease (ESKD). However, innovative dialysis technologies such as portable, wearable, and implantable bioartificial kidney systems are being developed with the aim of addressing these issues and improving patient care. An ideal implantable device could combine bioreactors and blood ultrafiltration to replicate key native cell functions for solute reabsorption, secretion, and endocrinologic activities. Today, the feasibility of an implantable bioreactor for renal cell therapy opens the challenge of developing a fully implantable bioartificial kidney based on silicon nanopore membranes to ensure immunological isolation, cell viability, and the possibility of maintaining a blood substrate for metabolic activities. Current technology is not sufficient to obtain an efficient artificial bioreactor to reach physiological blood purification, which requires a more complex system to produce an ultrafiltrate from the blood that can be processed by cells and eliminated as urine. The number of cells in the bioreactor, endocrine activity, immunological cell isolation, solute and fluid secretion/reabsorption, cell viability, blood and ultrafiltration flow control, and thrombogenicity are fundamental issues that require a new technology that today appears to be a challenge for the design of an implantable artificial kidney. This review aims to analyze the state of the art in this particular field of kidney replacement therapy to highlight the current limitations and possible future technology developments to create implanted and wearable organs capable of treating ESKD with artificial organs that can replicate all native kidneys functions.https://www.mdpi.com/2076-3417/14/2/491end-stage renal diseasechronic kidney diseasekidney transplantimplantable bioartificial kidneybioreactor |
| spellingShingle | Federico Nalesso Francesco Garzotto Leda Cattarin Elisabetta Bettin Martina Cacciapuoti Cristina Silvestre Lucia F. Stefanelli Lucrezia Furian Lorenzo A. Calò The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge Applied Sciences end-stage renal disease chronic kidney disease kidney transplant implantable bioartificial kidney bioreactor |
| title | The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge |
| title_full | The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge |
| title_fullStr | The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge |
| title_full_unstemmed | The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge |
| title_short | The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge |
| title_sort | future for end stage kidney disease treatment implantable bioartificial kidney challenge |
| topic | end-stage renal disease chronic kidney disease kidney transplant implantable bioartificial kidney bioreactor |
| url | https://www.mdpi.com/2076-3417/14/2/491 |
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