Innovations in Home Dialysis

Many of us take for granted that all our organs function perfectly without thinking of them on a daily basis. For patients suffering from renal failure or subnormal renal function this is not the case and is a persistent cause of worry. This cohort of patients will undergo renal dialysis on a regular basis.

Adele Graham-King

Renal dialysis is the artificial process of removing waste products from the blood and unwanted water from the body -- a process that is undertaken by the kidneys under normal physiological conditions. In pathological states the kidneys fail to complete this task, toxins rapidly build up in the blood, and water imbalance occurs, which can be fatal.

Dialysis may be used in patients who have a temporary loss of kidney failure (acute) or for patients who are in long-term (chronic) renal failure. The causes of acute failure can include cardiac issues, serious diarrhea (decreased circulatory volume), drug induced reactions, and more. Chronic renal failure can be a result of long-term progressive conditions such as diabetes, persistent hypertension, build-up of toxins (e.g., lead), or over-use of drugs (e.g., NSAIDs).

Renal dialysis usually takes place in a hospital for one simple reason: It's a complex procedure. The patient has to use a created access (fistula) in order provide a semi-permanent access route. This is created via a surgical procedure and facilitates rapid blood flow to enable dialysis. But, it's the actual dialysis device that is complicated to set up. Dialysis machines are cumbersome pieces of equipment -- they require filter cleaning, change of disposable tubing, changing and loading dialysate, etc. And ultimately it requires frequent, lengthy visits to hospital.

There are currently various home-based haemodialysis (HHD) machines on the market, including B.Braun Avitum, Fresenius Dialysis Machines, and NxStage (distributed by Kimal in the UK). However, all these machines require lengthy training, relatively complicated set-up, and change of dialysate. They also remain quite cumbersome and large.

In a recent business meeting an associate mentioned to me a new home-based dialysis machine that is currently being developed in the UK by Quanta Fluid Solutions in association with The University of Sheffield and Devices4Dignity. This collaboration has resulted in the design and development of the SelfCare+ machine, which is appropriate for use in the home, with simple set-up, a disposable single-use dialysate cartridge, automatic priming, and, as a result, reduced training for the patient. It has been designed to be intuitive and simple, with the patient and clinician's journey in mind.

Not quite yet to market, it was launched at the 5th Annual Conference on Home Dialysis in Manchester last year -- but could this be the breakthrough in dialysis treatments that both clinicians and patients have been waiting for?

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Adele Graham-King, Blogger

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