Ambulatory Hemodialysis-Technology Landscape and Potential for Patient-Centered Treatment.
CKD is a worldwide health problem and the number of patients requiring kidney replacement therapy is rising. In the United States, most patients with ESKD rely on in-center hemodialysis, which is burdensome and does not provide the same long-term benefits as kidney transplantation. Intensive hemodialysis treatments have demonstrated improved clinical outcomes, but its wider adoption is limited by equipment complexity and patient apprehension. Ambulatory devices for hemodialysis offer the potential for self-care treatment outside the clinical setting as well as frequent and prolonged sessions. This article explains the motivation for ambulatory hemodialysis and provides an overview of the necessary features of key technologies that will be the basis for new wearable and implantable devices. Early work by pioneers of hemodialysis is described followed by recent experience using a wearable unit on patients. Finally, ongoing efforts to develop an implantable device for kidney replacement and its potential for implantable hemodialysis are presented.
['Hojs|Nina|N|', 'Fissell|William H|WH|', 'Roy|Shuvo|S|']
D000553:Ambulatory Care D004867:Equipment Design D006437:Hemodialysis, Home D006801:Humans D007668:Kidney D007688:Kidneys, Artificial D018802:Patient-Centered Care D051436:Renal Insufficiency, Chronic D012648:Self Care D016896:Treatment Outcome
kidney transplantation motivation implantable hemodialysis Kidney Failure, Chronic Renal Insufficiency, Chronic Renal Replacement Therapy end stage kidney disease global health implantable artificial kidney renal dialysis renal replacement therapy self care wearable artificial kidney