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BIOARTIFICIAL KIDNEY TO END PATIENTS ON DIALYSIS WAITING FOR TRANSPLANT?

Author: Amrin Fathima, I year of Btech in civil engineering from Christ University, Banglore


In India, almost 10% of its population suffers from chronic kidney disease. It is a disease where one's kidney slowly loses function and fails. Our kidneys are one of the important organs in our body. Its major function is to remove waste products and excess fluid in our bodies. These waste products are removed through the urine. The kidneys are bean-shaped organs about the size of our fists. They are located under our ribcage, toward our back. Most people have two working kidneys, but people can live well as long as at least one is working properly. When someone's kidneys stop functioning we call it kidney failure. The only treatments currently available for this are dialysis and kidney transplant.


Dialysis is the process of cleaning the patient's blood outside their body through a machine. The dialysis machine cleans your body’s blood when your kidneys stop working well. Dialysis is a life-sustaining short-term solution that is time-consuming, expensive treatment and doesn't replace all the functions of a healthy kidney. A kidney transplant means taking a healthy kidney from a donor's body and transplanting it to the patient's body. A person only needs one kidney to live. In India, 1,50,000 people are waiting for a kidney transplant. Only 3,000 of them can receive a transplant. That is, only 1 out of 30 people who need a kidney receives one. 90% of people on the waiting list die without getting an organ. Researchers have been working on developing artificial kidneys for a very long time. Scientists at UCSF have been working on creating artificial kidneys by working with scientists and engineers worldwide. They are working on a small device that replicates many functions of the kidneys. Super-efficient membranes created using silicon nanotechnology will filter toxins from the blood without requiring pumps or electrical power while the bioreactor containing specially engineered kidney tubule cells will perform other renal activities, maintaining appropriate water volume in blood, electrolyte balance, and metabolic functions. These two advanced technologies will make up a small bio-compatible device that attaches to the circulatory system and remove toxins to the bladder as waste.


This bioartificial kidney will help to restore the quality of life of the patients suffering from kidney failure. They will no longer have to go through long and expensive procedures of dialysis till they get a donor. They'll be able to eat and drink more freely and live their life more freely. Patients using artificial kidneys will have to take a drug. Unlike human transplanted kidneys, which have an average lifespan of 10-12 years, the artificial kidney can last forever. New cells may have to be implanted every 2 years. “It’s a mechanical device combined with cells,” said Dr. Shuvo Roy, the leader of the artificial kidney project. Let us take a look at how they made this achievement possible. The silicon membrane was mounted in polycarbonate hosting to construct a hemofilter. similarly, bioreactors were assembled to imunoprotect the renal tubule cells. The hemofilter and bioreactor components were then connected to create bioartificial kidney prototypes. In the proof of concept experiment the hemofilter operated under blood pressure alone without systemic anticoagulation. Not even the human transplanted kidney will be able to do this. They were even able to keep the renal cells in the bioreactor alive and healthy without immunosuppression throughout the test. Once implanted the whole system is only able to operate under blood pressure. Bioartificial kidneys work just like human kidneys the only difference is that they won't need immunosuppression after transplant. Bioartificial kidneys consist of two modules that work together and are powered by the human body the hemofilter removes toxins from the blood. The bioreactor helps in performing other functions of the kidney like regulating blood pressure. It is made of lab-cultivated live kidney cells. They have completed animal testing. They are planning to start human trials by 2022. Wow, doesn't all of these sound amazing? We aren't far away from getting bioartificial kidneys in our markets. Dr. Shuvo Roy stated that " What we are doing right now is working on obtaining the FDA approval for testing the completed bioartificial kidney on humans. We expect to arrive at this final stage of clinical trials by late 2021." to this, he also added that the final product will be available by 2025. The Kidney Project leader Dr. Shuvo Roy disclosed recently that a bioartificial kidney will cost just $9000(approx.). Which will be way less expensive than dialysis. It is said it costs at least $400,000 per year for dialysis treatment and $150,000 for a kidney transplant in the US. Dr. Roy hopes an artificial kidney could be manufactured for $30,000 or less added to this there will be the cost of surgery. This cost is very less compared to dialysis cost or kidney transplant cost.


REFERENCES

https://pharm.ucsf.edu/kidney

https://my.vanderbilt.edu/kidney/the-human-kidney/

https://www.fastcompany.com/1679693/an-artificial-kidney-to-take-patients-off-the-transplant-waiting-list

https://mobilemag.com/2012/04/23/artificial-kidney-made-with-real-cells-video/

https://www.youtube.com/watch?v=2GH5ytkFeYk

https://www.kidney.org/kidneydisease/howkidneyswrk#:~:text=Most people know that a major function of involves highly complex steps of excretion and re-absorption