Novel Ultra-Permeable Membrane-based Dialyzer for Home Hemodialysis

用于家庭血液透析的新型超渗透膜透析器

• 批准号: 9109925
• 负责人: Dean G Johnson
• 金额: $ 13.11万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-22 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9109925
• 关键词: Accounting; Address; Adoption; Albumins; Animal Model; Animals; Area; Award; Biomedical Engineering; Blood; Blood Pressure; Cessation of life; Characteristics; Chemicals; Clinical; Clinical Trials; Development; Devices; Dialysis procedure; Diet; Diffusion; Disease model; End stage renal failure; Engineering; Eye; Finite Element Analysis; Fistula; Frequencies; Future; Goals; Health Benefit; Health Care Costs; Heart Rate; Hemodialysis; Home Hemodialysis; Home environment; Hour; Incentives; Injury; Interdisciplinary Study; Journals; Lead; Measures; Medicare; Membrane; Mentors; Mentorship; Metabolic Clearance Rate; Microfluidics; Miniaturization; Modeling; Nature; Nephrology; Operative Surgical Procedures; Patients; Proteins; Quality of life; Rattus; Renal Replacement Therapy; Research; Research Infrastructure; Resolution; Risk; Safety; Series; Sheep; Structure; Surface; System; Technology; Testing; Thick; Time; Toxin; Training; Translating; Treatment Protocols; Ultrafiltration; Urea; Venous; Water; Weight; Work; base; beneficiary; design; flexibility; health economics; improved; improved outcome; microsystems; miniaturize; novel; pressure; public health relevance; research study; scale up; success; symposium; technology development; translational medicine; trend

 DESCRIPTION (provided by applicant): The PI aims to apply his Microsystems Engineering background to the study of hemodialysis treatment for End Stage Renal Disease (ESRD). To achieve this goal he requires additional training and mentorship in the areas of biomedical engineering, translational medicine, and nephrology (especially Renal Replacement Therapies). This will be accomplished through a combination of coursework, seminars, conferences, and close interaction with the mentor and his multidisciplinary research team as detailed below. All years of the award include participation at journal clubs, seminars, and conferences, but the first two years will include training of a didactic nature. There will be more time in those first two years as the small animal model studies will be less time consuming than those for the large animal model. This award will be used to add more structure to my studies by allowing me to attend courses, seminar series, and conferences. With the planned training and mentorship the PI will lead the research effort to explore and develop hemodialysis devices using ultrathin nanoporous membrane technology. More than 430,000 patients with End Stage Renal Disease (ESRD) in the US undergo routine dialysis either in dialysis centers or in their homes. Hemodialysis (HD) treatments account for > 6% of all Medicare spending ($34B), despite the fact that ESRD patients account for less than 1% of the total number of Medicare beneficiaries. This disproportionate impact on the US health care costs is expected to worsen. Home hemodialysis (HHD) is significantly less expensive than in-center dialysis owing to reduced staffing and infrastructure requirements. HHD also enables frequent dialysis on a flexible treatment schedule. The numerous health benefits associated with increasing the frequency of hemodialysis beyond the 3-days-per-week regiment are now well- documented. Despite these economic, health, and quality-of-life incentives for home dialysis, HHD accounts for only 1.5% of all HD treatments. This number should be compared to an estimate that 30% of ESRD patients are candidates for HHD. A major reason for the lack of home adoption is patient and doctor concern over the risk of injury or death during a patient-managed, high flow rate (>300 mL/min) HD session. These facts lead us to draw two conclusions about the future of HD treatments for ESRD. First, both economic and health drivers will push HD therapies away from the traditional center-based treatment model and toward more frequent, patient-managed, dialysis in the home. Second, the rate at which this trend progresses will depend on the simplicity and safety of alternatives to standard in-center HD. The purpose of our proposal is to validate the benefits of a breakthrough membrane technology that we believe can help hastening the adoption of home based HD therapies.

 描述（由申请人提供）：PI 旨在将其微系统工程背景应用于终末期肾病 (ESRD) 的血液透析治疗研究。为了实现这一目标，他需要在生物医学工程、转化医学领域接受额外的培训和指导。和肾脏病学（特别是肾脏替代疗法）这将通过课程作业、研讨会、会议以及与导师及其多学科研究团队的密切互动来完成。以下所有年份的奖项都包括参加期刊俱乐部、研讨会和会议，但第一年除外。 两年将包括教学性质的培训，因为小动物模型研究比大型动物模型花费的时间更少，该奖项将用于为我的研究添加更多结构。通过允许我参加课程、研讨会系列和会议，PI 将领导研究工作，利用超薄纳米多孔膜技术探索和开发超过 430,000 名终末期肾病患者。在美国，疾病 (ESRD) 在透析中心或在家中进行常规透析，血液透析 (HD) 治疗占所有医疗保险支出 ($34B) 的 6% 以上，尽管 ESRD 患者仅占不到 1%。由于人员配备和基础设施需求的减少，家庭血液透析 (HHD) 的费用明显低于中心透析。尽管有这些经济、健康和生活质量方面的激励措施，但现在已经有充分证据表明，在灵活的治疗计划下进行频繁的透析，与增加每周 3 天的血液透析频率相关的众多健康益处。对于家庭透析，HHD 只占所有 HD 治疗的 1.5%，这一数字应该与 30% 的 ESRD 患者适合 HHD 的估计进行比较，缺乏家庭采用的主要原因是患者和医生的担忧。在患者管理的高流量（>300 mL/min）HD 治疗过程中存在受伤或死亡的风险。这些事实使我们对 ESRD 的 HD 治疗的未来得出两个结论：首先，经济和健康驱动因素都将增加。推动 HD 疗法远离传统的中心治疗模式，转向更频繁、患者管理的家庭透析。其次，这一趋势的进展速度将取决于标准中心 HD 替代方案的简单性和安全性。 .我们提案的目的是验证突破性膜技术的优势，我们相信该技术有助于加速家庭 HD 疗法的采用。