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

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          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.

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          Most cited references 13

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          The “unphysiology” of dialysis: A major cause of dialysis side effects?: The “unphysiology” of dialysis: A major cause of dialysis side effects?

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            Daily (quotidian) nocturnal home hemodialysis: nine years later.

            Daily nocturnal home hemodialysis was developed to satisfy the need for a highly effective, smooth, and cost-effective home dialysis therapy. It combines the benefits of the following dialysis methods: long, frequent, and home hemodialysis. It provides a high dialysis dose for small, as well as large, molecules including beta(2)-microglobulin; improves quality if life; and leads to control of hyperphosphatemia without the need for phosphate binders, as well as dissolution for extraosseous calcifications. Furthermore, it controls blood pressure often without medications, is associated with regression of left ventricular hypertrophy, improves cardiac function, improves anemia as well as nutrition, allows an unrestricted diet, and corrects sleep apnea. Finally, it decreases the overall cost of patient care and improves cost utility when compared to conventional hemodialysis. The main obstacle to its wider utilization is the structure of the current reimbursement system. Along with short daily hemodialysis, long intermittent dialysis, and the convective dialysis techniques, daily nocturnal hemodialysis promises to improve dialysis outcomes.
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              Hemeral (Daily) Hemodialysis


                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                September 2005
                04 October 2005
                : 23
                : 4
                : 269-274
                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
                85882 Blood Purif 2005;23:269–274
                © 2005 S. Karger AG, Basel

                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. 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 government 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.

                Page count
                Figures: 6, Tables: 2, References: 21, Pages: 6
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