Updates about Bioartificial Kidneys

1. Nephrology Updates
Bioartificial Kidney
Dr. Chaudhary Muhammad Junaid Nazar
MBBS,MPH,FRSPH,MD INTERNAL MEDICINE,MSC NEPHROLOGY, FCPS-1
NEPHROLOGY
Senior Medical Officer,
Neohrology Department ,
Shifa International Hospital, Islamabad,Pakistan

2. Unmet Medical Needs
• Acute Renal Failure
1.Mortality rate exceeds 50%
• End Stage Renal Disease
1.20% Annual Mortality Rate
2.Self Withdrawal from dialysis
• Renal Transplantation Improves Survival

3. What Next?

4. History of the Artificial Kidney
• University of California-San
Francisco researchers unveiled
a prototype model of the first
implantable artificial kidney on
September 2, 2010.
• Led by Shuvo Roy, PhD, in the
UCSF Department of
Bioengineering and
Therapeutic Sciences.
• First Phase (already
completed) – focused on
developing the technologies
required to reduce the device
to a size to be tested by
animals.
• Second Phase (current) –
doing the work needed to
scale up the device for
humans.
• Received $3 million in funding
as of October 1, 2012.
• Plan to go through human
clinical trials by 2017.

5. Current State
• Two Stage System:
• First compartment holds
thousands of nano-scale filters
remove toxins from the blood
(dialysis).
• A second compartment would
hold live kidney cells that
perform the other biological
actions of a real kidney.
• The entire device would be
implanted in the abdomen and
powered by the body’s blood
pressure, without a need for
external pumps or tubes.

7. Component of BAK
• Membrane Hemofilter
• Used silcon nanotechnology to produce highly
efficient and compact membrane relies on
blood pressure to perform filtration without
needing a pump or power supply
• Must be capable of producing meaningful
ultrafiltration volume at driving pressure similar
to capillary perfusion pressure while remaining
free of fouling for months
• Protein Loss must be minimal
• Bioreactor
• Field of tissue engineering to grow and maintain
renal tubule cells.
• Must be capable
1. High Volume Salt and Water reabsorption from
ultra filtrate
2. Maintain biological activity such as
autoregulation of blood pressure and
production of vitamin D

8. What it Plans to Solve
• Plans to replace dialysis (blood
is pumped through an external
circuit for filtration; typically
three sessions per week, 3-5
hours per session.)
• U.S. Medicare system spends
upwards of $29 billion per
year (6 percent of its total
budget) to treat kidney failure.
• $24 billion each year to pay for
dialysis.
• Allows the patient to live a
more normal lifestyle; takes
less of a toll on them than
normal from today’s dialysis.
• Maintain water and salt
balances, produce Vitamin D,
and regulate blood pressure.

9. Fundamental Barrier to Miniature

10. Key Target Specification

11. Completed Wafer

12. 2nd
Generation Membrane

14. Anti-Biofouling Coatings
• Evaluations of 3 coatings for protein
resistance
1.Polyethylene glycol(PEG) is widely used
2.Poly(N-vinyldextran aldonamide-co-N-
vinylhexanamide
3.Polysulobetaine Methacrylate

15. Benchtop Testing-10 day

16. Clinical Trails on Dog

17. Plasma Analysis

18. Scale Up Mini hemofilter

19. Cell Growth
• Human renal tubule cells(HRTCs)
1. reliable isolation and expansion protocols
2.1gm od biopsy tissue for 17 doubling
Successful cryopreservation and functional
longevity
4 plus month in liquid nitrogen
6 plus month cell viability in perfusion circuit

21. Perfusion Flow Bioreactor

22. Long Term Barrier Function

24. Current Limitations
• Is not available for personal use (as of right
now).
• Because it is not available for humans,
transplants and dialysis are the only ways to
effectively treat kidney failure.
• Will be costly when first coming out (~$25,000
from $75,000).

25. Future of the Artificial Kidney
• Will go through clinical trials and be on the
market.
• Will be more affordable.
• Remove need for constant dialysis.
• Will be able to function without rejection or
malfunction.

26. Thank You

27. Bibliography
• Bole, Kristen. "UCSF Unveils Model for Implantable Artificial Kidney to Replace Dialysis." UCSF Unveils Model for
Implantable Artificial Kidney to Replace Dialysis. University of California-San Francisco, 2 Sept. 2010. Web. 17
Oct. 2012. <http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial- kidney-replace-dialysis>.
• Bole, Kristen. "Artificial Kidney Project at UCSF Receives $3 Million in New Funding." University of California, San
Francisco. The Regents of the University of California, 1 Oct. 2012. Web. 22 Oct. 2012.
<http://www.ucsf.edu/news/2012/10/12810/artificial-kidney-project-ucsf-receives-3-million-new-funding>.
• Boyle, Rebecca. "Researchers Announce First Implantable Artificial Kidney Prototype." Popular Science. Bonnier
Corporation, 3 Sept. 2010. Web. 17 Oct. 2012. <http://www.popsci.com/science/article/2010- 09/researchers-
announce-first-artificial-kidney-prototype>.
• OneIndiaNews. "Implantable Artificial Kidney Set to Make Dialysis History." OneIndiaNews. Greynium Information
Technologies Pvt. Ltd., 3 Sept. 2010. Web. 17 Oct. 2012.
<http://news.oneindia.in/2010/09/03/implantableartificial-kidney-set-to-make-dialysishistory.html>.
• Shadiq, Sheraz. "Scientists Work on New Artificial Kidney." QUEST. S. D. Bechtel, Jr. Foundation, 21 Sept. 2010. Web. 17
Oct. 2012. <http://science.kqed.org/quest/2010/09/21/scientists-work-to-develop-artificial kidney/>.
• UCSF. "Roy Unveils Model of Bioartificial Kidney - School of Pharmacy." UCSF School of Pharmacy. The Regents of the
University of California, 03 Sept. 2010. Web. 17 Oct. 2012. <http://pharmacy.ucsf.edu/news/2010/09/03/1/>.
• U.S. Department of Health and Human Services. "National Kidney and Urologic Diseases Information
Clearinghouse (NKUDIC)." The Kidneys and How They Work Page. National Institute of Diabetes and Digestive
and Kidney Diseases, 23 Mar. 2012. Web. 17 Oct. 2012.
<http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/>.