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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?

#83
post #41

Earlier quoted context omitted.

On the other hand, the government spends a huge amount on dialysis. Medicare pays for it regardless of your age. Removing the need for dialysis simplifies life for politicians by putting off the day they need to raise taxes or cut Medicare services. Dialysis is also a lot crappier than this would be. My mom was on dialysis and quality of life is not great. Neither is the expected lifespan. Free markets have their fla…

>> Free markets have their flaws but their big advantage is competition. Medicine is not a "free market", it is tightly controlled. The standards of care are determined by doctors. Doctors also happen to control the supply of care and hence the price of care. Doctors also happen to rake in money doing all this. You cannot just release a medical device or medicine like you release code into github.

I said "if the government approves this device." And if it does, there are about 1300 transplant nephrologists in the US who make their money from doing transplants, not from dialysis.

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

#84
post #78

Earlier quoted context omitted.

It’s pretty hard to seal off the kidney from the immune system since the immune system is in the blood and kidneys filter blood

And yet, they seem to have accomplished this, in pigs at least.

No they have not. Read the article carefully. They have had some success with implanting renal epithelial cells, but they have not demonstrated filtration function. It’s promising but not quite there and things may go prove to be more difficult than you think.

“ Eventually, scientists plan to fill the bioreactor with different kidney cells that perform vital functions like balancing the body’s fluids and releasing hormones to regulate blood pressure – then pair it with a device that filters waste from the blood.”

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

#85

I might got to hell for this: Can an artificial kidney finally free patients from kidney stones?

I don't think there's anything bad about wondering that at all. While people generally don't die from kidney stones nowadays (although sometimes they still do), they are widely acknowledged as producing some of the most severe pain that humans can experience (sometimes they're not bad, or even painless, but when they are painful, boy howdy does it hurt).

Just speculating, I'd guess that while artificial kidneys might possibly develop stones, they wouldn't be painful, as the artificial kidney probably wouldn't be connected to the patient's nervous system.

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

#86

This probably isn't a viable solution for my father who has been on dialysis for 2 years and is in ESRD. I am a candidate for a kidney transplant for him (I went through the whole process), but he has other issues that have been preventing him from having another surgery. I'm pretty scared to do the procedure, too. But really glad to see progress being made here. Hopefully, also, the world works toward improving diet…

I've looked at this from a fathers perspective and have made the decision that no matter how much my kids may be a good match I would never want to be a donor recipient from them. That short-circuits a lot of ethical dilemmas around such a decision and making that decision well before it would ever come into play makes it a lot easier. My eldest one day said he'd gladly give up a kidney for me and it caused me to thi…

Indeed tricky problems; I suspect the same thought process that leads you to doing it for them in a heartbeat is likely theirs for you. The difference of a few dozen years in expected longevity due to your head start isn't that massive.

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

#87
post #84
post #78

Earlier quoted context omitted.

And yet, they seem to have accomplished this, in pigs at least.

No they have not. Read the article carefully. They have had some success with implanting renal epithelial cells, but they have not demonstrated filtration function. It’s promising but not quite there and things may go prove to be more difficult than you think. “ Eventually, scientists plan to fill the bioreactor with different kidney cells that perform vital functions like balancing the body’s fluids and releasing ho…

But they did successfully isolate the epithelial cells from the immune system, as claimed above. And those cells survived for a week and managed to "mimic several important kidney functions." I don't see how they could have survived if they weren't exposed to blood.

The filter won't be biological, so that part shouldn't trigger an immune response either.

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

#88
My friend’s startup is working to make the dialysis itself more portable and accessible by dramatically relaxing the water and other operational requirements. They are now running a human trial in Canada.

A device that can be in the body feels like the ultimate holy grail in this area. Medical advances like this take a lot of effort and time.

https://qidni.life/

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

#89
post #87
post #84

Earlier quoted context omitted.

No they have not. Read the article carefully. They have had some success with implanting renal epithelial cells, but they have not demonstrated filtration function. It’s promising but not quite there and things may go prove to be more difficult than you think. “ Eventually, scientists plan to fill the bioreactor with different kidney cells that perform vital functions like balancing the body’s fluids and releasing ho…

But they did successfully isolate the epithelial cells from the immune system, as claimed above. And those cells survived for a week and managed to "mimic several important kidney functions." I don't see how they could have survived if they weren't exposed to blood. The filter won't be biological, so that part shouldn't trigger an immune response either.

Well they were “exposed” through a silicon membrane - but the point that were not exposed to whole blood. So the two questions on feasibility is how massive does this have to be to get effective filtration without resorting to pumping, and the thrombosis question. They discuss the methods - they last for 7 days but will they last for 7 years? 7 weeks? There’s just a ton of stuff between this experiment and a fully functional kidney.

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

#90

Earlier quoted context omitted.

https://nyulangone.org/news/pig-kidney-xenotransplantation-p...

That article is two weeks old. Is there a place where they publish regular updates?

Not sure, much more here:

https://scholar.google.com/scholar?hl=en&as_sdt=0,33&q=%22pi...

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