Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2368 |
Resumo: | Background: Since 2005, three human clinical trials have been performed with the Wearable Artificial Kidney (WAK) and Wearable Ultrafiltration (WUF) device. The lack of an adequate vascular access (VA) has been pointed out as the main limitation to their implementation. Based on the current level of understanding, we will make the first conceptual proposal of an adequate VA suitable for the WAK and the WUF. Methods: All the literature related to WAK and WUF was reviewed. Based on eight main publications the VA major characteristics were defined: a mean blood flow of 100 mL/min; the capability to allow prolonged and frequent dialysis treatments, without interfering in activities of daily living (ADL); safe and convenient connection/disconnection systems; reduced risk of biofilm formation and coagulation; high biocompatibility. A research was done in order to answer to each necessary technological prerequisites. Results: The use of a device similar to a CVC with a 5Fr lumen, seems to be the most feasible option. Totally subcutaneous port devices, like the LifeSite(R) or Dialock (R) systems can be a solution to allow WAK or WUF to operate continuously while patients carry out their ADL. Recently, macromolecules that reduce the risk of thrombosis and infection and are integrated into a CVC have been developed and have the capability of overcoming these major limitations. Conclusion: With an adequate VA, portable HD devices can be acceptable options to address several unmet clinical needs of HD patients. |
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Wearable artificial kidney and wearable ultrafiltration device vascular access-future directionsend-stage renal diseaserenal replacement therapyvascular accesswearable artificial kidneywearable ultrafiltration deviceBackground: Since 2005, three human clinical trials have been performed with the Wearable Artificial Kidney (WAK) and Wearable Ultrafiltration (WUF) device. The lack of an adequate vascular access (VA) has been pointed out as the main limitation to their implementation. Based on the current level of understanding, we will make the first conceptual proposal of an adequate VA suitable for the WAK and the WUF. Methods: All the literature related to WAK and WUF was reviewed. Based on eight main publications the VA major characteristics were defined: a mean blood flow of 100 mL/min; the capability to allow prolonged and frequent dialysis treatments, without interfering in activities of daily living (ADL); safe and convenient connection/disconnection systems; reduced risk of biofilm formation and coagulation; high biocompatibility. A research was done in order to answer to each necessary technological prerequisites. Results: The use of a device similar to a CVC with a 5Fr lumen, seems to be the most feasible option. Totally subcutaneous port devices, like the LifeSite(R) or Dialock (R) systems can be a solution to allow WAK or WUF to operate continuously while patients carry out their ADL. Recently, macromolecules that reduce the risk of thrombosis and infection and are integrated into a CVC have been developed and have the capability of overcoming these major limitations. Conclusion: With an adequate VA, portable HD devices can be acceptable options to address several unmet clinical needs of HD patients.Oxford University PressRepositório Científico do Centro Hospitalar Universitário de Santo AntónioCastro, AnaNeri, M.Nayak Karopadi, A.Lorenzin, A.Marchionna, N.Ronco, C.2020-05-06T22:27:52Z2019-042019-04-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2368engCastro AC, Neri M, Nayak Karopadi A, Lorenzin A, Marchionna N, Ronco C. Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions. Clin Kidney J. 2019;12(2):300‐307. doi:10.1093/ckj/sfy0862048-850510.1093/ckj/sfy086info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T11:00:29Zoai:repositorio.chporto.pt:10400.16/2368Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:34.391496Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
title |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
spellingShingle |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions Castro, Ana end-stage renal disease renal replacement therapy vascular access wearable artificial kidney wearable ultrafiltration device |
title_short |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
title_full |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
title_fullStr |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
title_full_unstemmed |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
title_sort |
Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions |
author |
Castro, Ana |
author_facet |
Castro, Ana Neri, M. Nayak Karopadi, A. Lorenzin, A. Marchionna, N. Ronco, C. |
author_role |
author |
author2 |
Neri, M. Nayak Karopadi, A. Lorenzin, A. Marchionna, N. Ronco, C. |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Castro, Ana Neri, M. Nayak Karopadi, A. Lorenzin, A. Marchionna, N. Ronco, C. |
dc.subject.por.fl_str_mv |
end-stage renal disease renal replacement therapy vascular access wearable artificial kidney wearable ultrafiltration device |
topic |
end-stage renal disease renal replacement therapy vascular access wearable artificial kidney wearable ultrafiltration device |
description |
Background: Since 2005, three human clinical trials have been performed with the Wearable Artificial Kidney (WAK) and Wearable Ultrafiltration (WUF) device. The lack of an adequate vascular access (VA) has been pointed out as the main limitation to their implementation. Based on the current level of understanding, we will make the first conceptual proposal of an adequate VA suitable for the WAK and the WUF. Methods: All the literature related to WAK and WUF was reviewed. Based on eight main publications the VA major characteristics were defined: a mean blood flow of 100 mL/min; the capability to allow prolonged and frequent dialysis treatments, without interfering in activities of daily living (ADL); safe and convenient connection/disconnection systems; reduced risk of biofilm formation and coagulation; high biocompatibility. A research was done in order to answer to each necessary technological prerequisites. Results: The use of a device similar to a CVC with a 5Fr lumen, seems to be the most feasible option. Totally subcutaneous port devices, like the LifeSite(R) or Dialock (R) systems can be a solution to allow WAK or WUF to operate continuously while patients carry out their ADL. Recently, macromolecules that reduce the risk of thrombosis and infection and are integrated into a CVC have been developed and have the capability of overcoming these major limitations. Conclusion: With an adequate VA, portable HD devices can be acceptable options to address several unmet clinical needs of HD patients. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-04 2019-04-01T00:00:00Z 2020-05-06T22:27:52Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2368 |
url |
http://hdl.handle.net/10400.16/2368 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Castro AC, Neri M, Nayak Karopadi A, Lorenzin A, Marchionna N, Ronco C. Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions. Clin Kidney J. 2019;12(2):300‐307. doi:10.1093/ckj/sfy086 2048-8505 10.1093/ckj/sfy086 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press |
publisher.none.fl_str_mv |
Oxford University Press |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799133646925332480 |