Artificial kidney

Artificial kidney is often a synonym for hemodialysis, but may also, refer to renal replacement therapies (with exclusion of kidney transplantation) that are in use and/or in development. This article deals with bioengineered kidneys/bioartificial kidneys that are grown from renal cell lines/renal tissue. Artificial kidney is often a synonym for hemodialysis, but may also, refer to renal replacement therapies (with exclusion of kidney transplantation) that are in use and/or in development. This article deals with bioengineered kidneys/bioartificial kidneys that are grown from renal cell lines/renal tissue. The first successful artificial kidney was developed by Willem Kolff in the Netherlands during the early 1940s. Kolff was the first to construct a working dialyzer in 1943. Kidneys are paired vital organs located behind the abdominal cavity at the bottom of the ribcage corresponding to the levels T12-L3 of the spine vertebrae. They perform about a dozen physiologic functions and are fairly easily damaged. Some of these functions include filtration and excretion of metabolic waste products, regulation of necessary electrolytes and fluids and stimulation of red blood cell-production. These organs routinely filter about 100 to 140 liters of blood a day to produce 1 to 2 liters of urine, composed of wastes and excess fluid. Kidney failure results in the slow accumulation of nitrogenous wastes, salts, water, and disruption of the body's normal pH balance. This failure occurs over a long period of time, and when the patient's renal function declines enough over the course of the disease, is commonly known as end stage renal disease (ESRD; which is also known as Level 5 or 6 kidney disease, depending on whether dialysis or renal replacement therapy is used). Detecting kidney disease before the kidneys start to shut down is uncommon, with high blood pressure and decreased appetite being symptoms that indicate a problem. Diabetes and high blood pressure are seen as the 2 most common causes of kidney failure. Experts predict that the demand for dialysis will increase as the prevalence of diabetes increases. Until the Second World War, kidney failure generally meant death for the patient. Several insights into kidney function and acute kidney failure were made during the war. One in three American adults are at a risk for developing kidney disease. Over 26 million American adults have kidney disease and most are not aware of it. More than 661,000 of them have kidney failure and 468,000 are on dialysis. The large population of individuals with kidney failure drives continuing advancements in the technology of artificial kidneys so that more people can have access to treatments. Home hemodialysis has become rare because of its disadvantages. It is expensive, time consuming and space inefficient. In 1980, 9.7% of the dialysis population was on home hemodialysis but by 1987 the proportion had dropped to 3.6%. According to a 2011 report by the Organization for Economic Cooperation and Development, the United States of America has the second-highest rate of dialysis among advanced countries after Japan. The United States has the highest mortality rate among patients with ESRD. On average 20% of American ESRD patients die annually, which is more than twice that of Japan. The growth of dialysis facilities in the United States is the result of more Americans developing end-stage renal disease. From 2001 to 2011 the number increased by about 49.7% from 411,000 citizens to 615,000 citizens. In 2001 there were only 296,000 Americans on some form of dialysis. Ten years later that number increased to more than 430,000 as a result of chronic conditions developing such as diabetes and hypertension. Over 300,000 Americans are dependent on hemodialysis as treatment for kidney failure, but according to data from the 2005 USRDS 452,000 Americans have end-stage kidney disease (ESKD). Intriguing investigations from groups in London, Ontario and Toronto, Ontario have suggested that dialysis treatments lasting two to three times as long as, and delivered more frequently than, conventional thrice weekly treatments may be associated with improved clinical outcomes. Implementing six-times weekly, all-night dialysis would overwhelm existing resources in most countries. This, as well as scarcity of donor organs for kidney transplantation has prompted research in developing alternative therapies, including the development of a wearable or implantable device. Hemodialysis is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in kidney failure. The mechanical device used to clean the patients blood is called a dialyser, also known as an artificial kidney. The other name for artificial kidney is also called a dialysis machine. Modern dialysers typically consist of a cylindrical rigid casing enclosing hollow fibers cast or extruded from a polymer or copolymer, which is usually a proprietary formulation. The combined area of the hollow fibers is typically between 1-2 square meters. Intensive research has been conducted by many groups to optimize blood and dialysate flows within the dialyser, in order to achieve efficient transfer of wastes from blood to dialysate.