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Can an artificial kidney finally free patients from dialysis?

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Re: Can an artificial kidney finally free patients from dialysis?

#31

Post by robbiep »

blorenz wrote: post #10
candiddevmike wrote: post #5

Earlier quoted context omitted.

Would teaching the immune system to "forget" cover this situation (along with other autoimmune diseases) too?

As someone totally unqualified to make an assessment about this, I feel selectively forgetting is much harder than generalized forgetting. This would make the person vulnerable to multitudes of vectors.

You’re basically right, we have no idea how to do this - we can help the immune system remember new things (ie we’ve started teaching it how to attack cancers that it has been ignoring) but when the body wants to go at something, the only way we’ve been able to get it to sort it’s shit out is to wipe out all the agents of the adaptive immune system and implant a new one (give someone a bone marrow transplant).

This has resulted in cures for patients with MS, but is really risky and doesn’t scale.

Re: Can an artificial kidney finally free patients from dialysis?

#33

Post by civilitty »

mdhen wrote: post #19
cardy31 wrote: post #8

Earlier quoted context omitted.

There is a lot of research going into making kidneys without the markers that cause rejection. They hope to make pig kidneys compatible with human transplantation this way.

They have one in a brain dead patient right now, been over a month with no issues.

Did the patient donate his body to science or something? What’s the legality and ethics of operating on a neurologically dead person?

Re: Can an artificial kidney finally free patients from dialysis?

#34

Post by gjm11 »

ma55ypi3 wrote: post #16

Will this be abused whereby peoples are coerced into trading their kidney for an artificial one for a price?

What does that scenario look like in practice?

Suppose I'm the evil coercing person. I have an artificial kidney and $X, you have (still in your body) a real kidney, and you're short of money so you prefer (artificial kidney + $X) to (real kidney). We make the trade.

Why would I do that? Presumably so that I can (evilly) treat someone with kidney disease by giving them a real kidney, which they prefer to an artificial one. In fact, to make it worth my while they must also be paying me at least $X more for the real kidney than they would have for the artificial one.

So the incentives work out provided my patient prefers (real kidney) to (artificial kidney + $X), and my victim prefers (artificial kidney + $X) to (real kidney), and what I'm doing is (evilly, coercively) enabling them both to get what they prefer.

It's hard to see how I can be doing anyone very much harm here. Presumably the idea is that the victim is worse off, having been persuaded to give up their precious real kidney for an inferior artificial kidney in exchange for mere money, but also-presumably they are poor enough not to have the luxury to use phrases like "mere money" and $X is a life-changing amount for them. Which probably means their situation at the outset is very bad, but that isn't my fault.

I expect there are possible situations where the existence of artificial kidneys enables some things to happen that look good to all participants but end up being bad ideas in the long run. But it seems super-implausible to me that these could outweigh the benefits of being able to make functioning artificial kidneys.

Re: Can an artificial kidney finally free patients from dialysis?

#37

Post by tialaramex »

civilitty wrote: post #33
mdhen wrote: post #19

Earlier quoted context omitted.

They have one in a brain dead patient right now, been over a month with no issues.

Did the patient donate his body to science or something? What’s the legality and ethics of operating on a neurologically dead person?

"This important research, which study leaders say could save many lives in the future, was made possible by the family of a 57-year-old male who elected to donate his body after a brain death declaration and a circumstance in which his organs or tissues were not suitable for transplant."

Re: Can an artificial kidney finally free patients from dialysis?

#38

Post by brokenmeds »

Using throw-away as this sounds dismal, BUT: who makes money from this and who loses money? That will tell you whether this can happen or not.

Dialysis is big business. Technicians. Consumables. Doctors. Repeated Vi$it$. Real estate (often owned by the Nephrologist $.)

More saliently, Nephrologist also control the standard of care. Do they stand to gain more from artificial kidney surgery/maintenance, or do they stand more to lose from dialysis going away?

Re: Can an artificial kidney finally free patients from dialysis?

#39

Post by AnnikaL »

Tagbert wrote: post #18
tptacek wrote: post #14

Earlier quoted context omitted.

https://archive.ph/ba9Cw Presumably it's just an overbroad filter responding to some random attack in the past. Either way: best not to pick it apart on this thread, which isn't about web filtering, but rather artificial kidneys.

Oddly, I'm getting a server not found for archive.ph.

Cloudflare DNS does not work for archive.ph and its other domains.

Re: Can an artificial kidney finally free patients from dialysis?

#40

Post by DennisP »

phibz wrote: post #4

As someone on dialysis, this would be amazing to see. I wonder if the same immunoresponse issues would happen with this like with a transplant. The holy grail of transplant medicine for years has been acquired immunity, where you convince the immunesystem not to attack the transplant. Still hoping we see progress there, but this looks like a viable alternative to a donor transplant.

The article says it "does not trigger the recipient’s immune system to go on the attack." I've read elsewhere that the biological stuff inside is sealed off from the immune system.
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