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Vol. 23, No. 4, 2005
Issue release date: 2005
Section title: Perspectives
Free Access
Blood Purif 2005;23:269–274
(DOI:10.1159/000085882)

The Human Nephron Filter: Toward a Continuously Functioning, Implantable Artificial Nephron System

Nissenson A.R.a · Ronco C.b · Pergamit G.c · Edelstein M.c · Watts R.c
aDepartment of Medicine, Division of Nephrology, David Geffen School of Medicine, Los Angeles, Calif., USA; bDepartment of Nephrology, St. Bortolo Hospital, Vicenza, Italy, and cBiophiltre, Inc., Burlingame, Calif., USA
email Corresponding Author

Abstract

Background: Nearly 900,000 patients worldwide have end-stage renal disease and require dialysis or kidney transplantation, and this number is expected to more than double by 2010, placing considerable stress on healthcare systems throughout the world. Despite the availability of these forms of renal replacement therapy for nearly four decades, mortality and morbidity is high and patients often have a poor quality of life. Methods: We have developed a human nephron filter (HNF) utilizing nanotechnology that would eventually make feasible a continuously functioning, implantable artificial kidney. The device consists of two membranes operating in series within one device cartridge. The first membrane mimics the function of the glomerulus, while the second membrane mimics the function of the renal tubules. Findings: The device has been computer-modeled and operating 12 h/day, 7 days/week, the HNF provides the equivalent of 30 ml/min glomerular filtration rate (compared to half that amount for conventional thrice weekly hemodialysis). Conclusions: The HNF system, by eliminating dialysate and utilizing a novel membrane system created through applied nanotechnology may represent a breakthrough in renal replacement therapy based on the functioning of native kidneys. The enhanced solute removal and wearable design should substantially improve patient outcomes and quality of life.

© 2005 S. Karger AG, Basel


  

Key Words

  • Dialysis
  • Nanotechnology
  • Membranes
  • Hemodialysis
  • Renal replacement therapy

References

  1. US Renal Data System, 2003 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2003.
  2. Kjellstrand CM, Evans RL, Petersen RJ, Shideman JR, von Hartitzsch B, Buselmeier TJ: The ‘unphysiology’ of dialysis: A major cause of dialysis side effects? Hemodial Int 2004;8:24–29.

    External Resources

  3. Depner TA: Daily hemodialysis efficiency: An analysis of solute kinetics. Adv Ren Replace Ther 2001;8:227–235.
  4. Lindsay RM, Kortas C, Daily/Nocturnal Dialysis Study Group: Hemeral (daily) hemodialysis. Adv Ren Replace Ther 2001;8:236–249.
  5. Pierratos A: Daily (quotidian) nocturnal home hemodialysis: Nine years later. Hemodial Int 2004;8:45–50.

    External Resources

  6. Fagette P: Hemodialysis 1912–1945: No medical technology before its time. Part 1. ASAIO J 1999;45:238–249.
  7. Fagette P: Hemodialysis 1912–1945: No medical technology before its time. Part 2. ASAIO J 1999;45:379–391.
  8. Ronco C, Ghezzi PM, La Greca G: The role of technology in hemodialysis. J Nephrol 1999;12:S68–S81.
  9. Petitclerc T: Recent developments in conductivity monitoring of haemodialysis session. Nephrol Dial Transplant 1999;14:2607–2613.
  10. Zimmerman DL: Hemofiltration as a treatment for end-stage renal disease. Hemodial Int 2004;8:183–187.

    External Resources

  11. Clark WR, Winchester JF: Middle molecules and small-molecular-weight proteins in ESRD: Properties and strategies for their removal. Adv Ren Replace Ther 2003;10:270–278.
  12. Nissenson AR, Prichard SS, Cheng IK, Gokal R, Kubota M, Maiorca R, Riella MC, Rottembourg J, Stewart JH: Non-medical factors that impact on ESRD modality selection. Kidney Int 1993;40:S120–S127.
  13. Nissenson AR, Prichard SS, Cheng IKP, Gokal R, Kobuta M, Maiorca R, Riella MC, Rottembourg J, Stewart JH: ESRD modality selection into the 21st century: The importance of non-medical factors. ASAIO J 1997;43:142–150.

    External Resources

  14. Woffindin C, Hoenich NA: Hemodialyzer performance: A review of the trends over the past two decades. Artif Organs 1995;19:1113–1119.
  15. Clark WR: Quantitative characterization of hemodialyzer solute and water transport. Semin Dial 2001;14:32–36.
  16. Ronco C: What clinically important advances in understanding and improving dialyzer function have occurred recently? Semin Dial 2001;3:164–169.

    External Resources

  17. Nissenson AR, Pergamit G, Edelstein M, Watts R: The human nephron filter-1 (HNF-1): Toward a continuously functioning, implantable artificial nephron system by applying nanotechnology (NT) (abstract). Am Soc Nephrol Annu Meet, 2003, www.asn-online.org.
  18. Drexler KE: Introduction to nanotechnology; in Krummenacker M, Lewis J (eds): Prospects in Nanotechnology: Toward Molecular Manufacturing. New York, Wiley, 1995, p 7.
  19. Voss D: Nanomedicine nears the clinic. Tech Rev 2000;Jan/Feb:60–65.
  20. Rotman D: Quantum Dot Com. Tech Rev 2000;Jan/Feb:51–57.
  21. Ronco C, Nissenson AR: Does nanotechnology apply to dialysis? Blood Purif 2001;19:347–352.

  

Author Contacts

Allen R. Nissenson
UCLA Medical Center
200 Medical Plaza, Suite 565
Los Angeles, CA 90095 (USA)
Tel. +1 310 825 9464, Fax +1 310 206 2985, E-Mail anissenson@mednet.ucla.edu

  

Article Information

Accepted: September 10, 2004
Published online: May 20, 2005
Number of Print Pages : 6
Number of Figures : 6, Number of Tables : 2, Number of References : 21

  

Publication Details

Blood Purification

Vol. 23, No. 4, Year 2005 (Cover Date: 2005)

Journal Editor: Leunissen, K.M.L. (Maastricht)
ISSN: 0253–5068 (print), 1421–9735 (Online)

For additional information: http://www.karger.com/bpu


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: Nearly 900,000 patients worldwide have end-stage renal disease and require dialysis or kidney transplantation, and this number is expected to more than double by 2010, placing considerable stress on healthcare systems throughout the world. Despite the availability of these forms of renal replacement therapy for nearly four decades, mortality and morbidity is high and patients often have a poor quality of life. Methods: We have developed a human nephron filter (HNF) utilizing nanotechnology that would eventually make feasible a continuously functioning, implantable artificial kidney. The device consists of two membranes operating in series within one device cartridge. The first membrane mimics the function of the glomerulus, while the second membrane mimics the function of the renal tubules. Findings: The device has been computer-modeled and operating 12 h/day, 7 days/week, the HNF provides the equivalent of 30 ml/min glomerular filtration rate (compared to half that amount for conventional thrice weekly hemodialysis). Conclusions: The HNF system, by eliminating dialysate and utilizing a novel membrane system created through applied nanotechnology may represent a breakthrough in renal replacement therapy based on the functioning of native kidneys. The enhanced solute removal and wearable design should substantially improve patient outcomes and quality of life.

© 2005 S. Karger AG, Basel


  

Author Contacts

Allen R. Nissenson
UCLA Medical Center
200 Medical Plaza, Suite 565
Los Angeles, CA 90095 (USA)
Tel. +1 310 825 9464, Fax +1 310 206 2985, E-Mail anissenson@mednet.ucla.edu

  

Article Information

Accepted: September 10, 2004
Published online: May 20, 2005
Number of Print Pages : 6
Number of Figures : 6, Number of Tables : 2, Number of References : 21

  

Publication Details

Blood Purification

Vol. 23, No. 4, Year 2005 (Cover Date: 2005)

Journal Editor: Leunissen, K.M.L. (Maastricht)
ISSN: 0253–5068 (print), 1421–9735 (Online)

For additional information: http://www.karger.com/bpu


Article / Publication Details

First-Page Preview
Abstract of Perspectives

Published online: 10/4/2005
Issue release date: 2005

Number of Print Pages: 6
Number of Figures: 6
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: http://www.karger.com/BPU


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. US Renal Data System, 2003 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2003.
  2. Kjellstrand CM, Evans RL, Petersen RJ, Shideman JR, von Hartitzsch B, Buselmeier TJ: The ‘unphysiology’ of dialysis: A major cause of dialysis side effects? Hemodial Int 2004;8:24–29.

    External Resources

  3. Depner TA: Daily hemodialysis efficiency: An analysis of solute kinetics. Adv Ren Replace Ther 2001;8:227–235.
  4. Lindsay RM, Kortas C, Daily/Nocturnal Dialysis Study Group: Hemeral (daily) hemodialysis. Adv Ren Replace Ther 2001;8:236–249.
  5. Pierratos A: Daily (quotidian) nocturnal home hemodialysis: Nine years later. Hemodial Int 2004;8:45–50.

    External Resources

  6. Fagette P: Hemodialysis 1912–1945: No medical technology before its time. Part 1. ASAIO J 1999;45:238–249.
  7. Fagette P: Hemodialysis 1912–1945: No medical technology before its time. Part 2. ASAIO J 1999;45:379–391.
  8. Ronco C, Ghezzi PM, La Greca G: The role of technology in hemodialysis. J Nephrol 1999;12:S68–S81.
  9. Petitclerc T: Recent developments in conductivity monitoring of haemodialysis session. Nephrol Dial Transplant 1999;14:2607–2613.
  10. Zimmerman DL: Hemofiltration as a treatment for end-stage renal disease. Hemodial Int 2004;8:183–187.

    External Resources

  11. Clark WR, Winchester JF: Middle molecules and small-molecular-weight proteins in ESRD: Properties and strategies for their removal. Adv Ren Replace Ther 2003;10:270–278.
  12. Nissenson AR, Prichard SS, Cheng IK, Gokal R, Kubota M, Maiorca R, Riella MC, Rottembourg J, Stewart JH: Non-medical factors that impact on ESRD modality selection. Kidney Int 1993;40:S120–S127.
  13. Nissenson AR, Prichard SS, Cheng IKP, Gokal R, Kobuta M, Maiorca R, Riella MC, Rottembourg J, Stewart JH: ESRD modality selection into the 21st century: The importance of non-medical factors. ASAIO J 1997;43:142–150.

    External Resources

  14. Woffindin C, Hoenich NA: Hemodialyzer performance: A review of the trends over the past two decades. Artif Organs 1995;19:1113–1119.
  15. Clark WR: Quantitative characterization of hemodialyzer solute and water transport. Semin Dial 2001;14:32–36.
  16. Ronco C: What clinically important advances in understanding and improving dialyzer function have occurred recently? Semin Dial 2001;3:164–169.

    External Resources

  17. Nissenson AR, Pergamit G, Edelstein M, Watts R: The human nephron filter-1 (HNF-1): Toward a continuously functioning, implantable artificial nephron system by applying nanotechnology (NT) (abstract). Am Soc Nephrol Annu Meet, 2003, www.asn-online.org.
  18. Drexler KE: Introduction to nanotechnology; in Krummenacker M, Lewis J (eds): Prospects in Nanotechnology: Toward Molecular Manufacturing. New York, Wiley, 1995, p 7.
  19. Voss D: Nanomedicine nears the clinic. Tech Rev 2000;Jan/Feb:60–65.
  20. Rotman D: Quantum Dot Com. Tech Rev 2000;Jan/Feb:51–57.
  21. Ronco C, Nissenson AR: Does nanotechnology apply to dialysis? Blood Purif 2001;19:347–352.