Nanoengineering Renal Replacement Therapy

纳米工程肾脏替代疗法

• 批准号: 10690367
• 负责人: Saeed Moghaddam
• 金额: $ 10万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10690367
• 关键词: Address; Blood; Blood Pressure; Blood Vessels; Blood flow; Cessation of life; Clinical; Devices; Diabetes Mellitus; Dialysis patients; Dialysis procedure; Drops; End stage renal failure; Ensure; Excision; Fiber; Fright; Goals; Government; Growth; Health; Heart; Hemodialysis; Hemorrhage; Home; Hour; Human body; Hypertension; Kidney; Liquid substance; Measurement; Measures; Medicare; Membrane; Metabolic; Methods; Microfluidics; Miniaturization; Modeling; Nurses; Outcome; Oxides; Patient Care; Patients; Performance; Permeability; Persons; Procedures; Process; Pump; Quality of life; Renal Replacement Therapy; Renal function; Reporting; Research; Resistance; Risk; Risk Factors; Safety; Shoulder; Side; Stream; System; Technology; Testing; Transmembrane Transport; Treatment outcome; base; blood filter; blood pressure regulation; cost; design; dosage; graphene; hemocompatibility; hemodynamics; iterative design; meter; nanoengineering; nanomembrane; operation; patient safety; pressure; research and development; standard care; theories; wasting

End stage renal disease (ESRD) is currently responsible for ~50,000 deaths annually in the US. The number of patients with ESRD is progressively increasing, with diabetes and high blood pressure being the two leading causes. The standard care for these patients is lifelong hemodialysis (HD) treatment thrice weekly, but dialysis poorly mimics the natural kidney function. Filtering the blood for only 12 hours per week with dialysis is both non-physiological and inadequate. More frequent dialysis is preferred, as it allows steady waste and fluid removal resulting in superior metabolic and hemodynamic control. As patients are shifted from the typical thrice-weekly regime to one of daily in-home dialysis, significant improvements in the clinical outcome and the quality of life are reported. However, the implementation of daily dialysis on a large scale is difficult. Some of these are the inability or unwillingness of patients to dialyze at home, the lack of staffing both in nurses and technicians to provide more treatments in the dialysis units, and the reluctance of governmental payers to shoulder the expense of more frequent dialysis. In 2018, the Medicare spending alone on CKD and ESRD patients was about $120 billion. To address this great health and societal challenge, miniaturization of components and systems and reducing complexity while ensuring safety are at the heart of dialysis research and development efforts. One of the key barriers is the limitations of the current membrane technology. The current membrane module is bulky, needing an extracorporeal blood circuit consisting of meters of tubing, a pump, and other auxiliary components. Establishing the blood circuit for each dialysis session must be done by a qualified person and presents a major risk factor hampering efforts on expanding in-home frequent dialysis and patient’s independence. To address patients’ safety concerns (through reducing/eliminating the risk of bleeding), enhance affordability in the US and throughout the world and enable new vascular access options, under a recent R21 project, we have nanoengineered a new membrane that is 40x more permeable than the high-flux commercial membranes. This new membrane has demonstrated excellent sieving performance, enabling breakthrough reduction of the dialyzer size by two orders of magnitude such that it can be directly connected to the vascular access eliminating the extracorporeal blood circuit and pump (the dialyzer can be operated using just arterial blood pressure) alleviating the fear of exsanguination that is impeding the growth of in-home dialysis. The overarching objective of the proposed research is to evaluate the hydrodynamic performance of a new microfluidic dialyzer model for incorporation of the new high throughput nanomembrane and evaluate differences in flow regime relative to conventional hollow fiber membrane dialyzers.

终结肾脏疾病（ESRD）目前每年造成约50,000人死亡，糖尿病和高血压是患者的标准护理。透析模仿自然的肾功能。透析的临床结局和生活质量是较大的组件和减少的同时确保日记内的安全性，而开发的当前膜模块的关键障碍之一。每个透析会议必须由合格的人进行，并为扩大家庭频繁的透析和患者独立性做出重大风险努力。在最近的R21项目下，您的世界启用了新的血管访问，我们使新的Memebrane 40倍更加渗透性。可以直接连接到血管通道消除血液回路，并且可以使用动脉血压来操作泵，从而减轻对透析的恐惧的恐惧。为了进行插入，新的高速纳米桥，并评估流动状态相对的差异与常规的空心纤维膜透析器。