How can we advance in renal replacement therapy techniques?
End-Stage Renal Disease (ESRD) is one of the major causes of morbidity and mortality worldwide. Although the incidence of ESRD is relatively stable, the prevalence of maintenance dialysis is increasing, and it is expected to reach a staggering 5439 million patients worldwide by 2030. Despite the gre...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-07-01
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| Series: | Nefrología (English Edition) |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2013251419301233 |
| _version_ | 1811287476837285888 |
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| author | Ana Castro Mauro Neri Akash Nayak Karopadi Anna Lorenzin Nicola Marchionna Claudio Ronco |
| author_facet | Ana Castro Mauro Neri Akash Nayak Karopadi Anna Lorenzin Nicola Marchionna Claudio Ronco |
| author_sort | Ana Castro |
| collection | DOAJ |
| description | End-Stage Renal Disease (ESRD) is one of the major causes of morbidity and mortality worldwide. Although the incidence of ESRD is relatively stable, the prevalence of maintenance dialysis is increasing, and it is expected to reach a staggering 5439 million patients worldwide by 2030. Despite the great technological evolution that has taken place in recent years, most patients are still treated with in-centre haemodialysis and their prognosis remains far from desirable.Since 1980, there has been an increasing interest in the development of a portable device for renal replacement therapy (RRT), which ultimately led to the creation of the Wearable Artificial Kidney (WAK) and the Wearable Ultrafiltration (WUF) system. Portable RRT devices may be acceptable alternatives that deal with several unmet clinical needs of ESRD patients. So far, 3 important human studies with WAK and WUF have been carried out and, although these devices require considerable technological improvement, their safety and efficacy in solute clearance and fluid removal is undeniable.In this article, we review the evolution of the WAK and the WUF and the main clinical trials performed, highlighting some of their technical features. Some of the main possible clinical advantages that could be achieved with these devices, as well as some economic aspects, are also pointed out.In the future, all renal replacement therapy techniques should evolve to perfectly match the clinical and personal needs of each patient, allowing for an improved health-related quality of life. Resumen: La enfermedad renal crónica terminal (ERCT) es una de las principales causas de morbimortalidad mundial. Aunque la incidencia de esta enfermedad es relativamente estable, la prevalencia en diálisis está aumentando, y se espera que llegue a la cifra de 5.439 millones de pacientes en todo el mundo en el año 2030. A pesar de la gran evolución tecnológica ocurrida en los últimos años, la mayoría de los pacientes continúan siendo tratados con hemodiálisis, y su pronóstico queda lejos de lo deseable.Desde 1980, existe un interés creciente en el desarrollo de dispositivos portátiles para la terapia de sustitución de la función renal (TSFR), y que llevaron a la creación del Wearable Artificial Kidney (WAK) y del Wearable Ultrafiltration (WUF) system. Estos pueden ser alternativas aceptables que permiten alcanzar las necesidades de los pacientes con ERCT, que hasta ahora no se han alcanzado. A pesar de que estos dispositivos necesitan mejoras tecnológicas, su seguridad y eficacia en el aclaramiento de solutos y la eliminación de fluidos es innegable.Revisamos la evolución del WAK y del WUF, y los principales ensayos clínicos desarrollados, destacando algunas de sus particularidades tecnológicas. Adicionalmente, señalamos algunas de las posibles ventajas clínicas que podrían ser alcanzadas con estos dispositivos, así como algunos aspectos económicos.En el futuro, todas las TSFR deben evolucionar para satisfacer todas las necesidades clínicas y personales de cada paciente, permitiendo una mejor calidad de vida relacionada con la salud. Keywords: Vascular access, Wearable Artificial Kidney, Wearable Ultrafiltration device, Renal replacement therapy, End-Stage Renal Disease, Health-related quality of life, Palabras clave: Acceso vascular, Riñón Artificial Portátil, Dispositivo de ultrafiltración portátil, Terapia de sustitución renal, Enfermedad renal crónica terminal, Calidad de vida relacionada con la salud |
| first_indexed | 2024-04-13T03:19:10Z |
| format | Article |
| id | doaj.art-fc50493b89e24e97874866d58f4584e1 |
| institution | Directory Open Access Journal |
| issn | 2013-2514 |
| language | English |
| last_indexed | 2024-04-13T03:19:10Z |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología (English Edition) |
| spelling | doaj.art-fc50493b89e24e97874866d58f4584e12022-12-22T03:04:49ZengElsevierNefrología (English Edition)2013-25142019-07-01394372378How can we advance in renal replacement therapy techniques?Ana Castro0Mauro Neri1Akash Nayak Karopadi2Anna Lorenzin3Nicola Marchionna4Claudio Ronco5Department of Nephrology, Dialysis and Transplantation, Oporto Hospital Centre, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal; International Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy; Corresponding author.International Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, ItalyInternational Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy; Dr. Nayak Dialysis Centres Private, Limited, 12-2-718, Nanal Nagar, X Roads, Toli Chowki, Hyderabad, Telangana 500008, IndiaInternational Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, ItalyInternational Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy; Department of Nephrology, Dialysis and Transplantation, Ospedale San Bortolo, San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, ItalyInternational Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy; Department of Nephrology, Dialysis and Transplantation, Ospedale San Bortolo, San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, ItalyEnd-Stage Renal Disease (ESRD) is one of the major causes of morbidity and mortality worldwide. Although the incidence of ESRD is relatively stable, the prevalence of maintenance dialysis is increasing, and it is expected to reach a staggering 5439 million patients worldwide by 2030. Despite the great technological evolution that has taken place in recent years, most patients are still treated with in-centre haemodialysis and their prognosis remains far from desirable.Since 1980, there has been an increasing interest in the development of a portable device for renal replacement therapy (RRT), which ultimately led to the creation of the Wearable Artificial Kidney (WAK) and the Wearable Ultrafiltration (WUF) system. Portable RRT devices may be acceptable alternatives that deal with several unmet clinical needs of ESRD patients. So far, 3 important human studies with WAK and WUF have been carried out and, although these devices require considerable technological improvement, their safety and efficacy in solute clearance and fluid removal is undeniable.In this article, we review the evolution of the WAK and the WUF and the main clinical trials performed, highlighting some of their technical features. Some of the main possible clinical advantages that could be achieved with these devices, as well as some economic aspects, are also pointed out.In the future, all renal replacement therapy techniques should evolve to perfectly match the clinical and personal needs of each patient, allowing for an improved health-related quality of life. Resumen: La enfermedad renal crónica terminal (ERCT) es una de las principales causas de morbimortalidad mundial. Aunque la incidencia de esta enfermedad es relativamente estable, la prevalencia en diálisis está aumentando, y se espera que llegue a la cifra de 5.439 millones de pacientes en todo el mundo en el año 2030. A pesar de la gran evolución tecnológica ocurrida en los últimos años, la mayoría de los pacientes continúan siendo tratados con hemodiálisis, y su pronóstico queda lejos de lo deseable.Desde 1980, existe un interés creciente en el desarrollo de dispositivos portátiles para la terapia de sustitución de la función renal (TSFR), y que llevaron a la creación del Wearable Artificial Kidney (WAK) y del Wearable Ultrafiltration (WUF) system. Estos pueden ser alternativas aceptables que permiten alcanzar las necesidades de los pacientes con ERCT, que hasta ahora no se han alcanzado. A pesar de que estos dispositivos necesitan mejoras tecnológicas, su seguridad y eficacia en el aclaramiento de solutos y la eliminación de fluidos es innegable.Revisamos la evolución del WAK y del WUF, y los principales ensayos clínicos desarrollados, destacando algunas de sus particularidades tecnológicas. Adicionalmente, señalamos algunas de las posibles ventajas clínicas que podrían ser alcanzadas con estos dispositivos, así como algunos aspectos económicos.En el futuro, todas las TSFR deben evolucionar para satisfacer todas las necesidades clínicas y personales de cada paciente, permitiendo una mejor calidad de vida relacionada con la salud. Keywords: Vascular access, Wearable Artificial Kidney, Wearable Ultrafiltration device, Renal replacement therapy, End-Stage Renal Disease, Health-related quality of life, Palabras clave: Acceso vascular, Riñón Artificial Portátil, Dispositivo de ultrafiltración portátil, Terapia de sustitución renal, Enfermedad renal crónica terminal, Calidad de vida relacionada con la saludhttp://www.sciencedirect.com/science/article/pii/S2013251419301233 |
| spellingShingle | Ana Castro Mauro Neri Akash Nayak Karopadi Anna Lorenzin Nicola Marchionna Claudio Ronco How can we advance in renal replacement therapy techniques? Nefrología (English Edition) |
| title | How can we advance in renal replacement therapy techniques? |
| title_full | How can we advance in renal replacement therapy techniques? |
| title_fullStr | How can we advance in renal replacement therapy techniques? |
| title_full_unstemmed | How can we advance in renal replacement therapy techniques? |
| title_short | How can we advance in renal replacement therapy techniques? |
| title_sort | how can we advance in renal replacement therapy techniques |
| url | http://www.sciencedirect.com/science/article/pii/S2013251419301233 |
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