Project aim and strategy (Part I)
Although life-saving, dialysis cannot fully replace the kidney function of patients with end-stage kidney disease. The development of portable/wearable artificial kidney (PAK/WAK) and bioartificial kidney (BAK) devices could represent important steps towards better treatment. In this first 2-year project, we focused on evaluating the functionality of a laboratory-scale BAK under clinically relevant conditions.
For the clinical application of BAK, we have addressed the following:
- The functional performance of the ‘living membranes’ when perfused with uremic plasma in the presence of dialysate.
- The potential interaction between commonly prescribed drugs in end-stage kidney disease and endogenous protein-bound uremic toxins (PBUTs) that might affect the clearance capacity of BAK.
Project partners
- Dr. Silvia Mihaila (Nephrology and Hypertension – UMCU)
- Dr. Karin Gerritsen (Nephrology and Hypertension – UMCU)
- Prof. dr. Dimitrios Stamatialis (Bioartifical organs, Biomaterials Science and Technology – UT)
- Prof. dr. Roos Masereeuw (Experimental pharmacology – UU)
- Prof. dr. Marianne Verhaar (Nephrology and Hypertension – UMCU)
Highlights
- Bioengineering organs for blood detoxification, C Legallais, D Kim, SM Mihaila, ..., KGF Gerritsen, MC Verhaar, ..., R Masereeuw, D Stamatialis, Advanced Healthcare Materials, 2018, DOI 10.1002/adhm.201800430
- From portable dialysis to a bioengineered kidney, MK van Gelder*, SM Mihaila*, ..., MC Verhaar, D Stamatialis, R Masereeuw, KGF Gerritsen (*equal contribution), Expert Review of Med. Devices, 2018, DOI: 10.1080/17434440.2018.1462697
Project aim and strategy (Part II)
This project aims to develop new membrane concepts for achieving high removal of uremic toxins combined with low water consumption. Specific focus will be on regeneration of dialysis fluid so that it can be re-used, including efficient urea removal and ion regulation.
The number of patients with end-stage kidney disease progressively increases and the need for renal replacements therapies expands. For these patients the best solution by far is kidney transplantation. However, the average time on the transplant waiting list for a cadaveric kidney is 4 years and not every patient is eligible for transplantation. Therefore, most end-stage kidney disease patients undergo dialysis to replace kidney function. Currently, this therapy requires patients to visit the dialysis centre 3-4 times a week, which is a great social and psychological burden for them. Importantly, the current therapy, despite being life-saving, has several major drawbacks:
- Removal of uremic solutes is poor,
- It is non-continuous (3-4x/week), causing large fluctuations in water balance and uremic waste, whereas waste products are constantly produced in the human body
- It is costly and requires time-consuming visits to the hospital
- It has a high environmental impact, since it produces an excess of wastewater (120 L per session) and requires large dialysis machine with high energy footprint
Project partners
- Dr. Dazia Noor (Bioartifical organs, Biomaterials Science and Technology – UT)
- Dr. Karin Gerritsen (Nephrology and Hypertension – UMCU)
- Prof. dr. Dimitrios Stamatialis (Bioartifical organs, Biomaterials Science and Technology – UT)
- Prof. dr. Roos Masereeuw (Experimental pharmacology – UU)
- Prof. dr. Marianne Verhaar (Nephrology and Hypertension – UMCU)
Highlights
- Dimitrios Stamatialis elected governor in the board of the European society for artificial organs (ESAO), for Appointment 2021-2023.
- Dimitrios Stamatialis was elected to the board of the International Federation of Artificial Organs (IFAO), the world organization which includes the American - ASAIO, ESAO and the Japanese society for artificial organs (JSAO). Appointment 2021-2022.
- NWO take off fase 1 grant: Technological and commercial feasibility study of new membranes for improved blood purification therapy. Applicant: D. Stamatialis (UT) – 2021
- Ter Beek OEM, van Gelder MK, Lokhorst C, Hazenbrink DHM, Lentferink BH, Gerritsen KGF, Stamatialis D. In vitro study of dual layer mixed matrix hollow fiber membranes for outside-in filtration of human blood plasma.Acta Biomater. 2021 Mar 15;123:244-253. doi: 10.1016/j.actbio.2020.12.063.