Artificial kidney
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2008-06-23T18:10:08Z
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'''Artificial kidney''' is often a [[synonym]] for [[hemodialysis]], but may also, more generally, refer to [[renal replacement therapy|renal replacement therapies]] (with exclusion of [[renal transplantation]]) that are in use and/or in development. This article deals with [[bioengineering|bioengineered]] [[kidney]]s/bioartificial kidneys that are grown from renal [[cell (biology)|cell]] lines/renal tissue.
== Need for a bioartificial kidney ==
Over 300,000 Americans are dependent on hemodialysis as
treatment for renal failure, but according to data from the 2005 USRDS 452,000 Americans have end-stage renal disease (ESRD). <ref>{{citejournal|author=Fissell WH, Humes HD, Fleishcman AJ, Roy S|title=Dialysis and Nanotecnology: Now, 10 years, or Never?|journal=Blood Purification|issue=25|pages=12–17|year=2007|doi=10.1159/000096391|volume=25}}</ref>Scarcity of donor organs for kidney transplantation has prompted research in developing alternative therapies, including the development of a wearable or implantable device. <ref>{{citejournal |author=Fissell W, Manley S, Westover A, Humes HD, Fleischman AJ, Roy S | title=Differentiated Growth of Human Renal Tubule Cells on Thin-Film and Nanostructured Materials|journal=ASAIO Journal 2006 | issue =52| pages= 221–227 | year=2006 | doi= 10.1097/01.mat.0000205228.30516.9c | volume=52}}</ref>
==Bioengineered kidneys==
Currently, no viable bioengineered kidneys exist. Numerous barriers exist to their creation.<ref>{{cite journal |author=Saito A, Aung T, Sekiguchi K, Sato Y, Vu D, Inagaki M, Kanai G, Tanaka R, Suzuki H, Kakuta T |title=Present status and perspectives of bioartificial kidneys |journal=J Artif Organs |volume=9 |issue=3 |pages=130–5 |year=2006 |pmid=16998696 |doi=10.1007/s10047-006-0336-1}}</ref><ref>{{cite journal |author=Saito A, Aung T, Sekiguchi K, Sato Y |title=Present status and perspective of the development of a bioartificial kidney for chronic renal failure patients |journal=Ther Apher Dial |volume=10 |issue=4 |pages=342–7 |year=2006 |pmid=16911187 |doi=10.1111/j.1744-9987.2006.00387.x}}</ref><ref>{{cite journal |author=Wang P, Takezawa T |title=Reconstruction of renal glomerular tissue using collagen vitrigel scaffold |journal=J Biosci Bioeng |volume=99 |issue=6 |pages=529–40 |year=2005 |pmid=1623
3828 |doi=10.1263/jbb.99.529}}</ref>
However, manufacturing a membrane that mimics the kidney's ability to filter blood and subsequently excrete toxins while reabsorbing water and salt would allow for a wearable and/or implantable artificial kidney. Developing a membrane using microelectromechanical systems (MEMS) technology is a limiting step in creating an implantable, bioartificial kidney.
The BioMEMS and Renal Nanotechnology Laboratories at the Cleveland Clinic's Lerner Research Institute have focused on advancing membrane technology to develop an implantable or wearable therapy for end-stage renal disease (ESRD). Current dialysis cartridges are too large and require superphysiologic pressures for blood circulation, and pores in current polymer membranes have too broad of a size distribution and irregular features. Manufacturing a silicon, nanoporous membrane with narrow pore size distributions improves the membrane's ability to discriminate between filtered and retained molecules. It also increases hydraulic permeability by allowing the mean pore size to approach the desired cutoff of the membrane. Using a batch-fabrication process allows for strict control over pore size distribution and geometry. <ref>{{cite journal|author=Fissell W, Fleischman AJ, Roy S, Humes HD | title=Development of continuous implantable renal
replacement: past and future| journal= Translational Research |volume=150 | issue=6 | pages=327–336 | year=2007 |doi=10.1016/j.trsl.2007.06.001}}</ref>
In recent studies, human kidney cells were harvested from donated organs unsuitable for transplatation, and grown on these membranes. The cultured cells covered the membranes and appear to retain features of adult kidney cells. The differentiated
growth of renal epithelial cells on MEMS materials suggests that a miniaturized device suitable for implantation may be feasible.
==References==
<references/>
==See also==
* [[Artificial organ]]
* [[Kidney]]
* [[Dialysis]]
* [[Tissue engineering]]
* [[Wearable kidney]]
* [[Microelectromechanical Systems]]
* [[Nanotechnology]]
* [[Hemodialysis]]
==External links==
*[http://www.med.umich.edu/intmed/nephrology/STAFF/humes_hd.htm Tissue engineering and kidneys] - umich.edu.
[[Category:Nephrology]]
[[Category:Artificial organs]]
{{treatment-stub}}
[[es:Riñón artificial]]
[[nl:kunstnier]]
*[http://www.lerner.ccf.org/bme/mems/ BioMEMS & Nanotechnology] -lerner.ccf.org/bme/mems/