Scientific Publication

September 2009

Martin Roberts and David B. N. Lee:  Wearable Artificial Kidney: A Historical Perspective.  Proceedings of the World Congress on Medical Physics and Biomedical Engineering, 11th International Congress of the IUPESM, September 7-12, 2009, Munich, Germany. 

Abstract- A wearable artificial kidney (WAK) allows the patient to have a more normal life style and provides continuous fluid and electrolyte balance.  Only four WAKs have been tested in patients and none marketed.  Two hemofiltration WAKs used the heart as the blood pump. Neff required the patient to drink 450 ml of dialysate every hour to replace the fluid lost.  Murisasco regenerated the ultrafiltrate with a miniature REDY cartridge.  In both instances the artificial kidneys clotted within 5 days.  Two WAKs were based on hemodialysis. Bazzato used the heart to pump the blood through a dialyzer without a casing, placed in a plastic bag.  The patient changed the dialysate in the bag periodically.  Gura uses a blood pump and regenerates the used hemodialysate with a REDY type cartridge.  His unit has been clinically tested for only 8 hours.  To develop an extracorporeal WAK, problems of clotting and possible accidental fatal disconnects need to be solved.

A number of WAKs are under development.  Lande presented a hemodialysis unit on the arm, which uses the heart as a pump by intermittently blocking the fistula.  Nissenson has proposed a kidney based upon a G membrane and T membrane. The G membrane filters the blood.  The T ‘smart” membrane blocks undesired substances while passing desirable substances.  Humes and also Saito have proposed a hybrid kidney but have not formulated a wearable configuration.

Two peritoneal-based kidneys are under development. Ronco uses activated carbon and polystyrene resins for the removal of creatinine, b2 microglobulin and angiogenin from used dialysate.  Other metabolites such as urea and phosphate were not addressed.    Lee and Roberts use a REDY type cartridge for complete regeneration of used peritoneal dialysate. Use of peritoneal dialysis eliminates the problem of clotting and accidental fatal disconnects.

Keywords- Peritoneal Dialysis, Wearable kidney, Wearable Artificial Kidney, Hemodialysis, Hemofiltration.

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September 2009

David B. N. Lee and Martin Roberts:  Automated Wearable Kidney (AWAK): A Peritoneal Dialysis Approach.  Proceedings of the World Congress on Medical Physics and Biomedical Engineering, 11th International Congress of the IUPESM, September 7-12, 2009, Munich, Germany. 

April 2008

David B. N. Lee and Martin Roberts:  A peritoneal-based automated wearable artificial kidney.  Clinical and Experimental Nephrology:  12:171-180, 2008.

November 2006

Martin Roberts and David B. N. Lee:  Wearable artificial kidneys: A peritoneal dialysis approach.  Dialysis and Transplantation 36:780-2, 2006.

November 1991

M Roberts, PC Niu and DBN Lee: Regeneration of peritoneal dialysate (PD): a step towards a continuous wearable artificial kidney (CWAK).  24th Annual Meeting of the American Society of Nephrology, November 17-20, 1991, Baltimore, Maryland.  J Am Soc Nephrology 2:367, 1991.