| Summary: | The chronic renal disease (CRD) is a
public health problem worldwide. The
check of high costs of Colombia for
2013 reported the existence of 22.926
patients in dialysis therapy, 5.941 with
kidney transplantation and 1.015.124
patients with CRD in stages I – IV, with
possibility of progressing and to require
renal replacement therapy (RRT), for
an incidence approximate of ingress to
dialysis of 65 people per million of habitants (1). In the United States in
2011, 430.723 patients were in dialysis and 185.626 were transplanted
(2).
In 1954 Murray carried out the first successful kidney transplantation
in humans and in 1945 Willen Kolff carried out the first session of
hemodialysis with success. The hemodialysis was progressing since the
use in acute patients until its application in chronic patients. In 1972 in
EEUU, the chronic hemodialysis was approved for the treatment of all
patients with advanced CRD (3).
Since then, the dialysis in its two modalities (hemodialysis and peritoneal
dialysis) just as the kidney transplantation, are the base of the management
of patients with advance CRD. Although dialysis improves the quality of
life of patients, the complication rate continues being high and it only
offers replacement of the renal excretory function.
The kidney transplantation is the ideal therapy, but it is not exempt of
infectious complications, neoplasms risk and adverse effects associated
to the immunosuppressive drugs that must accompanied it. In EEUU,
100.000 patients are waiting for a kidney transplantation with accumulative
probability of receiving it in 9.6% in the first year, 21.6 and 36.0% in the
third and fifth year respectively, which demonstrates the high unsatisfied
demand. The average waiting time for the kidney transplantation in
between three and six years (4).
Searching to improve the dialysis therapies to achieve the renal
metabolic and endocrine functions, the regenerative medicine and the
bioengineering pretend to obtain new models of RRT. Aebischer (1987)
developed a model of acute renal damage in dogs, the bioartificial kidney
(BAK), which combines the conventional hemofiltration with a device that
provides renal epithelial cells. It demonstrated the capacity to carry out
excretory function, electrolytes regulation and vitamin D production. In
1999 Humes transformed the device using cells of the renal proximal
tubule allowing the sodium, glucose and organic anions transportation.
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