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Two separate studies recently examined new advances in understanding how Health Outcomes and Quality of Life for Hemodialysis (HD) and Peritoneal Dialysis (PD) patients may be  greatly improved.
A cutting-edge machine, which could transform the lives of kidney disease sufferers by making it easier for them to do their own dialysis treatment at home, is set to undergo clinical testing over the next few months.
The new haemodialysis machine is intended to replace the need for patients with kidney disease to make trips to the hospital three times a week to undergo dialysis.
Although leading renal units have managed to implement some successful home haemodialysis programs using standard equipment, these machines are complex, large and heavy. The D4D Co-operative, which is led by Professor Wendy Tindale, Clinical Director for Devices for Dignity, who holds a chair at the University of Sheffield and is Consultant Clinical Scientist and Scientific Director at Sheffield Teaching Hospitals, aims to drive forward innovative new products to help people with debilitating conditions deal with their daily challenges.
The Quanta machine uses a sophisticated cartridge to mix the water and salt solutions required to generate the fluid required for dialysis. Having the machine at home allows patients to adapt their treatment schedule, enabling them to dialyse at times which fit into their daily lives. In addition, according to latest medical research, more frequent and longer dialysis will have a beneficial impact on patient survival and long-term overall wellbeing.
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The wearable artificial kidney has passed the first FDA-approved proof-of-concept trial, Victor Gura, MD, FASN and other researchers announced at the American Society of Nephrology’s Kidney Week 2015. Seven hemodialysis patients wore the device for 24 hours and remained hemodynamically stable with no adverse events. Six out of seven patients ambulated while receiving WAK treatment, according to the abstract presented at Kidney Week. According to Gura, the current WAK prototype will become smaller, lighter and easier to wear.
Nephrology News & Issues covers the latest developments in nephrology and provides a forum for the exchange of ideas among the professional disciplines responsible for delivering care to the ESRD patient.
Though different in approach, both sets of findings are enlightening and can assist an extended and improved life.
This follows breakthrough work facilitated by the Devices for Dignity Healthcare Technology Co-operative (D4D), involving experts at the University of Sheffield. The machine removes waste from the blood when the kidneys can no longer function as normal. This has left patients with limited options on where to install the system, a problem the National Institute for Health Research (NIHR) funded D4D Co-operative wanted to address. The project brought together experts from the hydraulics industry and the NHS, which led to the formation of a new company, Quanta Fluid Solutions, and the development of the revolutionary new machine. Although it produces the fluid in small amounts, it is able to match the flow rates of a standard machine so that patients receive exactly the same high quality treatment they would receive in a hospital haemodialysis unit.
They can also chose to have short sessions each day, reducing the build up of excess fluid and toxins between treatments, or to have slow, gentle dialysis overnight. Current hospital dialysis capacity is unlikely to be able to expand to cope with the increased treatment delivery required, so the new haemodialysis machine aims to provide a cost effective solution for increased dialysis frequency for a significant proportion of kidney patients. If all goes well, staff and patients at the Sheffield Kidney Institute, the University of Sheffield?s Nephrology Unit, and at Leeds Teaching Hospitals will be starting the clinical evaluation early next year.

The opportunities this will give for renal patients to have more independence, flexibility and improved quality of life are significant.
Why The Decline?Did you know that according to Medicare data, mortality rates were as high as 23% in 1999? In a second subject, treatment was discontinued due to discoloration of dialysate observed after 10 hours. As the cartridge is disposable, the need for disinfecting the fluid pathways of the machine after each dialysis is eliminated.
It is anticipated that the launch of the system in the UK market will be late 2011 and it will be made available to dialysis patients via their local renal units in the NHS Trusts that have progressive home programs. The present prototype of the WAK is a 10-pound device, powered by nine-volt batteries and worn around the waist.
The trial was stopped after the 7th subject due to device-related malfunctions that included excessive CO2 bubbles in the dialysate, variable blood and dialysate flows, and tubing leaks during the priming phase. Redesign and re-manufacturing of the WAK prototype will be required prior to additional human studies. Other aspects of the dialysis procedure such as individualizing dialysate composition may also minimize cardiovascular risk. In effect, systemic (whole body) inflammation controls the survival whilst peritoneal inflammation controls membrane survival. While those on PD should monitor inflammation and bring it to the attention of their Nephrologist who should then determine if it is inflammation in the body or in the peritoneal cavity which will require different treatment methods.

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