Dr. Munavvar Izhar discusses that the total Medicare spending on both chronic kidney disease (CKD) and End-Stage Renal Disease (ESRD) patients is about 150 – 200 billion dollars a year in the USA. The yearly cost of hemodialysis for one patient is about $50,000-80,000/ year. The average survival of an ESRD patient on dialysis is about 5-8 years. According to Munavvar Izhar, Dialysis treatment entails inconvenience to patients in terms of time away from work, home and family. It also involves significant costs, visits to doctors and specialists, hospitalizations, etc. all leading to poor quality of life. Renal Transplant obviates that. However, the limited availability of organs precludes that from happening optimally.
Munavvar Izhar says that the Dialysis treatment which does not involve being tied at the dialysis center or at home for dialysis is a dream come true for any ESRD patient. A synthetic kidney, mimicking an original kidney implanted inside the patient is the optimal solution for a renal failure patient. This provides flexibility, mobility, and a better quality of life for the patient and is much cheaper too! according to Dr. Munavvar Izhar.
Dr. Munavvar Izhar has reviewed the recent advances in the dialysis treatment of renal failure patients. Munavvar Izhar says that the treatment of Wearable Artificial Kidney (WAK) is a portable dialysis device designed to enable patients to experience the benefits of daily dialysis while performing their normal, day-to-day routines. The device is connected to the patient via one catheter that is surgically inserted in a 20-minute procedure under a local anesthetic. The WAK assembly is still a sizable bag to carry along on the body all day long. Hence, the need for a small Bio-artificial Kidney. Researchers at UCSF, Cleveland Clinic, CWRU, Univ. of Michigan, and Univ of Pennsylvania have spearheaded a bioartificial kidney project.
Munavvar Izhar informs that a series of clinical trials are being conducted for the combined “Hemo-filter” and “Bio-reactor device”, i.e. the “Bio-artificial kidney”. After these trials are completed successfully, the Bio-artificial kidney will be available to the public. We expect it to arrive at the final stage of clinical trials by late 2021.
Dr. Munavvar Izhar says that the Bio-artificial kidney combines a membrane hemofilter and a bioreactor of human renal tubular epithelial cells to mimic many of the metabolic, endocrine, and immunological functions of a healthy kidney.
Nanotechnology has miniaturized the dialyzer part. Munavvar Izhar also emphasizes that both the Hemofilter and Bioreactor combined together are the size of a small coffee cup roughly the size of a normal human kidney which is surgically implanted inside the patient similar to the procedure of renal transplant.
Munavvar Izhar mentions that after a single surgery to establish a permanent blood connection, the bioartificial kidney processes blood continuously for 24 hours a day, which mitigates the inconveniences and morbidities associated with intermittent hemodialysis. There will be no need for fluid and salt restriction, no needle sticks, no time on chair or dialysis center, no cramps, thirst, inter-dialytic weight gain, or fatigue as often happens on hemodialysis. The 24-hour continuous hemodialysis with the Bio-Artificial kidney brings the metabolic milieu to normal drastically reducing the pill burden. According to Dr. Munavvar Izhar, all these advantages will improve the quality of life and dramatically reduce the rates of depression in patients with ESRD. As the rate of in-center dialysis treatment will be remarkably decreased it will save billions of dollars for Medicare and the government in health care expenditure.
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- Fissell WH, Roy S., Davenport A., Achieving More Frequent and Longer Dialysis for the Majority: Wearable Dialysis and Implantable Artificial Kidney Devices. Kidney Int. 2013 Aug; 84(2): 256-64