Wearable artificial kidney could be ‘game-changer’

In a chapter of my book Dialing in on DI-AL-Y-SIS (released in November of 2017), I made mention in a chapter titled Perhaps There Is Hope Ahead that research involving Dr. Jonathan Himmelfarb is working on developing a wearable artificial kidney.

Dr. Himmelfarb is the director of the Kidney Research Institute & Joseph W. Eschbach Endowed Chair in Kidney Research at the University of Washington School of Medicine in Seattle. An update on the progress of his team’s research suggests that the wearable artificial kidney project could reach clinical trials by 2022.

The following account sheds the light on the status of the research effort that hopefully will someday become a game-changer for many patients who are on dialysis today, and many others who will someday wind up as end stage renal disease patients.

By Omar Ford, Managing Editor

Medical Device Business

(Posted online February 8, 2018)

Most innovations medicine occur by asking one simple question. Is there a better way? Physicians at the Kidney Research Institute of the University of Washington have asked that question about hemodialysis treatments – lengthy procedures that filter a patient’s blood when the kidneys no longer function properly.

The institute is developing a wearable artificial kidney that could completely change the paradigm for some of these patients with impaired kidney function.

Earlier this week at MD & M West, Dr. Jonathan Himmelfarb, director of the Kidney Research Institute, spoke about the development of the artificial kidney and gave a timetable on when such a technology could be up for review by the FDA.

“There has been an increase in the number of people with kidney failure who were treated particularly with dialysis and particularly with hemodialysis,” Himmelfarb said. “Now there are about 600,000 people in the United States today in which the vast majority – close to 500,000 – are treated at dialysis centers.”

Typically, these patients go to dialysis three times a week with a four-hour treatment. These treatments have significant impact on lifestyle, but even more than that the mortality and morbidity of these patients is very high.

“The average person, even today, who starts dialysis will survive for about three to four years,” Himmelfarb said. “The mortality is about 20 percent per year. With what we provide for dialysis function today, we don’t really restore kidney health.”

In 2012, the FDA issued out a challenge to innovators to develop a technology to address kidney failure patients.

The Kidney Research Institute submitted an application to the FDA, and was one of three chosen out of 32 applicants to move forward with the development of an artificial kidney. The Institute conducted an initial trial in Seattle.

The wearable artificial kidney is a 10-pound, battery-powered device worn on a belt that provides around-the-clock, continuous dialysis.

“A lot of the components will work like dialysis does today,” Himmelfarb explained. “You take blood out of the body and you circulate it across a membrane that allows certain toxins to move to the other side of the membrane. You drop them on the other side and the blood goes back into the patient. That’s the basic concept of hemodialysis, and that will be the same [for the device].”

An early trial of a prototype of the device showed that five out of seven patients completed the full 24 hours of treatment. Two others had to stop participation in the trial because of technical issues with the device. The treated patients were able to walk in the hospital’s halls while the device continuously cleaned their blood.

Himmelfarb said the Institute’s goal is to take a more refined version of the wearable artificial kidney to take through clinical trials in 2022. He said a commercial vehicle to market such a device hasn’t been established yet.

“First, we have to generate all of the intellectual property and then we’ll eventually develop a commercialization strategy,” he said. “But right now, we’re focused on the science of trying to make this work.”

Why we must not let newspapers disappear

While whiling away time on dialysis, I at times as a retired journalist run across some humorous items on the Internet. This recent finding makes you wonder how some readers never get past the headline. Click on link.Why We Must Not Let Newspapers Disappear

Greeley said ‘Go West’ — I decided to ‘Go North’

It is often thought that “the grass is always greener on the other side of the (pick one: fence, hill, road, wall, or whatever).” It’s a thought so much stated that the time-worn bromide is among “the 50 most important proverbs” as listed online by phrasemix.com.

After completing one year of in-center dialysis at the end of this past January, I found myself contemplating whether a fresh medical evaluation might be in the best interest of assessing my mortality. In other words, what are the possibilities looking ahead? And what is available ongoing that I as an end stage renal disease patient can control?

Being a retired journalist, it is appropriate that a phrase often credited to the American author and newspaper editor Horace Greeley crossed my mind: “Go West, young man, and grow up with the country.” Of course, I am no longer anywhere near being a young man, and I have no intention of subscribing to that popular concept of the mid-1800s known as the Manifest Destiny, a widely held belief in the United States that its settlers were destined to expand across North America.

What has become prevalent nowadays, though, is what many patients face in dealing with a current chronic disease, and perhaps with an impending surgical procedure. Often, after they get the original prognosis, they seek a second opinion. Or maybe a third. And often what falls on patients’ ears at each stop are the same old lines of embarkment. This is the treatment you need; this is the protocol for what needs to be done. And in many cases, it needs to be done right away.

For those who have reached the final stage of kidney disease, the options for treatment in the Western civilization are pretty much set in stone – go on dialysis for the rest of your life, … or receive a kidney transplant. Neither are all that inviting, although those are the methods available in this country for prolonging your existence.

Also, among my several thoughts were those gleaned from Indiana author Mark Montieth, a familiar sports writer and television/radio personality. I have known of Montieth for some years but only met him face-to-face once. A few years back, Mark had the gumption to defy traditional Western civilization treatment in coping with squamous cell carcinoma, a cancer which began with a tumor on his tonsils and spread to his lymph nodes. According to his story – which is documented on his markmontieth.com website – the cancer was the result of a virus, HPV 16.

Montieth’s parents and older brother have owned a natural food store, Georgetown Market, on Indy’s northwest side since 1973. What Mark had heard from one doctor after another was needed in treating his disease didn’t set quite right with his upbringing.

In one portion of his online account, Montieth writes: “I know of and believe in the world of natural ‘medicine,’ and have always believed instinctively the body usually can heal itself with the proper nutrients. I also believe traditional medicine is mostly a corporate, profit-motivated enterprise, filled with some great minds and good-hearted people but also no shortage of brainwashed money-grubbers who care more about their bank accounts than their patients. It requires massive overhead to keep all those high-tech cancer centers operating, and the only way for them to do it is with the income from chemo and radiation treatments. A ‘cure’ might shut them all down and put thousands of people out of work.”

What Montieth ultimately did was sidestep traditional medicine, deciding to follow as natural a path as possible. That included some local holistic treatment sessions and consultations from outside the United States (and outside Indiana). In the long run, this stubborn and determined warrior beat his cancer, and offers a compelling account of his journey.

I certainly don’t have the background in natural healing that Montieth has. However, I did encounter – through research while writing a recent book titled Dialing in on DI-AL-Y-SIS – an interesting Australian fellow by the name of Duncan Capicchiano. For more than a dozen years, this certified naturopath has promoted a program known as The Kidney Disease Solution. The program, according to his website beatkidneydisease.com, is a complete and holistic approach to regaining kidney function and for living a normal healthy life.

I literally bought into his program and have been using many of the specifically created to fit the 80/20 ratio of alkalizing/acidifying ingredients by volume required during the restorative phase of The Kidney Disease Solution treatment. I am convinced the material in his 130-page cookbook and kitchen companion guide was instrumental in helping me attain consistent monthly lab results and satisfactory daily weight readings.    

After weighing in on a mixture of the English proverb, the Horace Greeley suggestion, and the Mark Montieth testimonial on beating cancer, my thoughts finally crystallized into a decision on what to do about obtaining a fresh evaluation on my mortality. While not necessarily expecting greener pastures, nor hankering to “Go West,” I did decide to transition to a different treatment facility on the south side of Indianapolis.That entailed being accepted by a newly certified Fresenius Dialysis Care operation and “Going North” about a mile to near the corner of Southport Road and South Madison Avenue. My first session was on Valentine’s Day (February 14), and my new starting time aligns with the roosters at 6 o’clock in the morning on Mondays, Wednesdays, and Fridays.

I do acknowledge being somewhat comfortable in recognizing that the past half dozen months or so have been rather consistent when assessing lab work. And I have been “feeling fine,” too. However, my sales background tells me that status quo is not good enough. A successful sales organization relishes a gain in production; otherwise, there is the perspective of falling behind.

So far, on perhaps the greener side at the Fresenius center are the individual patient TV sets that include some sports channels. And hopefully looming ahead is a fresh evaluation of my current and likely future on or off dialysis.  As legendary baseball pitcher Satchel Paige once said: “Don’t look back. Something may be gaining on you.”