Winning Solution: Development of a Dialysate- and Cell-Free Renal Replacement Technology

Current clinical approaches to treat patients with end stage renal disease (ESRD) include hemodialysis, peritoneal dialysis, and renal transplantation. Our project was motivated by the following considerations. It would be desirable to develop a renal replacement technology (standalone, wearable, or implantable format) that for the first time did not require the use of an external dialysate solution to drive the passive flux of ions and water across a semipermeable membrane. Secondly, it would be very advantageous to have the capability of adjusting the transport of ions and water under feedback/sensor control to prevent the changes in blood chemistry that result from alterations in dietary food and fluid intake. Thirdly, a dialysate- and cell-free technology that could potentially function continuously either in an external or implantable format would more closely mimic the native kidney.

Here we describe the initial design and operation of a novel technology that has ultrafiltration and ion/water transport capabilities. The device couples for the first time new multiple wafer electrodeionization technology with pressure driven ultrafiltration, nanofiltration and reverse osmosis modules specifically developed for this project. Importantly, the device does not utilize external water/dialysate or living cells. The technologic advances and approaches employed in this proposal can be potentially utilized in the future in various configurations that include standalone, wearable, and implantable renal replacement devices to treat patients with compromised kidney function. The technology we describe represents a significant advance in the field of renal replacement therapy ever since hemodialysis was first developed as a therapeutic modality over 70 years ago.

Ira Kurtz, MD, FRCP, FASN, is Distinguished Professor of Medicine, Chief of the Division of Nephrology, Factor Chair, and a member of the University of California, Los Angeles (UCLA) Brain Research Institute. Dr. Kurtz is a scientific and medical advisor for US Kidney Research Corporation for the development of a portable and implantable artificial kidney. Dr. Kurtz is a graduate of the University of Toronto and completed his postgraduate training at both the University of California, San Francisco, and the National Institutes of Health. Dr. Kurtz has been a faculty member at UCLA since 1985 and is board-certified in Internal Medicine by the American Board of Internal Medicine and in Nephrology by the American Board of Nephrology. Dr. Kurtz is a Fellow of the Royal College of Physicians and Surgeons of Canada, and the American Society of Nephrology, and is listed in Southern California Super Doctors. He is a member of the American Society of Clinical Investigation, the American Physiological Society, the Biophysical Society, and the American Society of Nephrology.

Dr. Kurtz has authored over 300 scientific publications, book chapters, and abstracts. He is on the editorial board of several scientific journals and is an external reviewer of major scientific publications and grants. Dr. Kurtz’s primary areas of research include ion transport-related diseases, the physiology and biophysics of molecular transport processes in the kidney and extrarenal organs, structural biology, the atomic structure of membrane proteins, and the development of an artificial kidney.