Wearable artificial kidney and wearable ultrafiltration device vascular access-future directions

Detalhes bibliográficos
Autor(a) principal: Castro, Ana
Data de Publicação: 2019
Outros Autores: Neri, M., Nayak Karopadi, A., Lorenzin, A., Marchionna, N., Ronco, C.
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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spelling 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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