How an Implantable Dialysis Device May Extend Life for People with Kidney Failure

By Stephanie Miceli

This article is part of a series of profiles on the 2020 winners of the National Academy of Medicine’s Healthy Longevity Catalyst Awards — part of the Healthy Longevity Global Competition, a multiyear, multimillion-dollar international competition seeking breakthrough innovations to improve physical, mental, and social well-being for people as they ageRead more about the award and the winners’ research and ideas for promoting healthy aging.

A few years ago, Nikhil Shah and Hiep Nguyen were touring the German Aerospace Center after giving a presentation about the future of surgery. One of the in-house researchers showed off a model of an implantable heart, and they thought — Why can’t we do that with a kidney?

Pioneered in 1943, dialysis filters blood in order to prevent kidney failure. It was meant to be a stopgap solution and later, to keep people alive until they could get a kidney transplant — a process that could take anywhere from six months to several years.

However, the dialysis space hasn’t seen much innovation in the 80 years since its invention, says Shah, a urologist and founder of Texas-based medical device startup Nephrodite.

Pioneered in 1943, dialysis filters blood in order to prevent kidney failure. It was meant to be a stopgap solution and later, to keep people alive until they could get a kidney transplant — a process that could take anywhere from six months to several years.

However, the dialysis space hasn’t seen much innovation in the 80 years since its invention, says Shah, a urologist and founder of Texas-based medical device startup Nephrodite.

“Dialysis is now done intermittently — three times a week. In between, the blood isn’t getting filtered, which wreaks havoc on the organs. That’s not good enough for 2020,” says Shah.

Life is unsustainable with kidney failure, and that’s the premise behind “The Holly” — an implantable dialysis device that continually filters or “dialyzes” the blood in order to keep patients healthy. Shah and his team were recently named among the 21 winners of this year’s NAM Healthy Longevity Catalyst Awards, and they plan to use the funding to advance testing and animal trials of the device.

The time is ripe. In the wake of hurricanes and wildfires, power outages and road closures have prevented people from getting to dialysis centers. Patients have also been concerned about the safety precautions taken at dialysis centers during the COVID-19 pandemic — especially since having a chronic condition makes them more vulnerable to the virus.

Shah and his co-investigator, pediatric urologist Hiep “Bob” Nguyen, have had an eye on health equity from the onset. The device is named after a child, Holly, who succumbed to kidney failure while waiting for a kidney transplant. While she was on the waiting list, she missed dialysis treatments because of the time and financial burden. 

“Imagine if you need to get to a dialysis center every other day. There are transport issues for patients who are elderly or of lower socio-economic status. Now imagine a pandemic on top of that,” says Shah. “With a fully implantable hemodialysis device, you can be anywhere and not have to worry about transportation to appointments.”

Shah and his co-investigator, pediatric urologist Hiep “Bob” Nguyen, have had an eye on health equity from the onset. The device is named after a child, Holly, who succumbed to kidney failure while waiting for a kidney transplant. While she was on the waiting list, she missed dialysis treatments because of the time and financial burden. 

“Imagine if you need to get to a dialysis center every other day. There are transport issues for patients who are elderly or of lower socio-economic status. Now imagine a pandemic on top of that,” says Shah. “With a fully implantable hemodialysis device, you can be anywhere and not have to worry about transportation to appointments.”

“The Holly” prototype“The Holly” prototype

Testing ‘The Holly’

Shah and his team have developed a prototype of the device, which is about the size of a child’s fist. Before applying for the NAM Healthy Longevity Catalyst Awards, they completed bench testing — a phase in which researchers identify any mechanical and design flaws. With the award funding, the team aims to test the device on animal models.

“Basically, we want to learn, when we surgically implant the device in a model of an animal with kidney failure — does the device work as we expect?”

“The Holly” is strictly a hemofiltration or dialysis device, and doesn’t perform other kidney functions like hormone regulation, Shah emphasizes.  But he’s hopeful the implantable device model could apply to other areas of kidney health.

Kidney Health and the Longevity Connection

There are nearly 100,000 Americans waiting for a kidney transplant — and they have to be healthy enough when an organ becomes available to them. Many of the people on the waitlist become ineligible, because the dialysis is too taxing on the body, says Shah.

From the time they start dialysis, people living with chronic kidney disease usually have five to 10 years to live. That doesn’t even factor in the risk of infection acquired during dialysis or hospital visits, and the susceptibility to heart attack and stroke that comes with the disease.“There are also significant mental health issues with kidney failure that go unaddressed,” says Shah. “Our hope is that if patients get this device, they stay healthy — and happy — because their quality of life has improved. When it’s time to get a kidney transplant, they can get it in good physical condition.”

Read more: https://www.nationalacademies.org/news/2020/10/how-an-implantable-dialysis-device-may-extend-life-for-people-with-kidney-failure

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