Victor Gura, a clinical professor at the UCLA School of Medicine, has been developing a portable, wearable dialysis machine, as we’ve been reporting before (see flashbacks below). Now, as more data has been analyzed from clinical trials, Gura’s research team has published additional details about the WAK in the latest Clinical Journal of the American Society of Nephrology.
Here’s from the abstract:
Design: The battery-powered WAK pump has a double channel pulsatile counter phase flow. This study clarifies the role of pulsatile blood and dialysate flow, a high-flux membrane with a larger surface area, and the optimization of the dialysate pH. Flows and clearances from the WAK pump were compared with conventional pumps and with gravity steady flow.
Results: Raising dialysate pH to 7.4 increased adsorption of ammonia. Clearances were higher with pulsatile flow as compared with steady flow. The light WAK pump, geometrically suitable for wearability, delivered the same clearances as larger and heavier pumps that cannot be battery operated. Beta2 microglobulin ({beta}2M) was removed from human blood in vitro. Activated charcoal adsorbed most {beta}2M in the dialysate. The WAK V1.0 delivered an effective creatinine clearance of 18.5 ± 3.2 ml/min and the WAK V1.1 27.0 ± 4.0 ml/min in uremic pigs.
Conclusions: Half-cycle differences between blood and dialysate, alternating transmembrane pressures (TMP), higher amplitude pulsations, and a push-pull flow increased convective transport. This creates a yet undescribed type of hemodiafiltration. Further improvements were achieved with a larger surface area high-flux dialyzer and a higher dialysate pH. The data suggest that the WAK might be an efficient way of providing daily dialysis and optimizing end stage renal disease (ESRD) treatment.
Abstract in Clinical Journal of the American Society of Nephrology: Technical Breakthroughs in the Wearable Artificial Kidney (WAK)
Press release: Hello wearable kidney, goodbye dialysis machine …
Flashbacks: Wearable Artificial Kidney (WAK) ; Bloodless Wearable Kidney Does Dialysis on the Move …
