Steps towards a wearable artificial kidney: The development and validation of innovative strategies to improve dialysis

Abstract

Worldwide 3.5 million patients receive dialysis treatment of which 89% is treated with hemodialysis (HD) and 11% with peritoneal dialysis (PD). Although life sustaining, existing dialysis techniques have major shortcomings. Both HD and PD merely partially compensate for renal glomerular filtration and do not replace renal tubular function, resulting in inadequate removal of uremic waste solutes and excess water. As a result, quality of life of dialysis patients is poor due to a high morbidity and high treatment burden. This thesis addresses the (preclinical) development of innovative dialysis techniques that aim to improve dialysis, including miniature artificial kidney devices for HD and PD, novel dual-layer hollow fiber mixed matrix membranes (MMMs) for outside-in-filtration (OIF) and hemodiafiltration (HDF).