Around 10 percent of the world’s population has some form of Chronic Kidney Disease (CKD). But most affected people don’t even realize they have it.
CKD knows several stages with progressive severity. Due to the vagueness of the early-stage symptoms, it’s often only detected when it already progressed to stage 3. Once in stage 5, patients die, unless they get a kidney transplant or receive frequent dialysis treatments.
Chronic dialysis patients must literally schedule their life around their therapy. Unfortunately, current dialysis technologies:
- Cost a lot of money – while the average survival on dialysis is limited to about 5 to 6 years.
- Need a developed infrastructure – with reliable electricity and good quality drinking water.
- Take a lot of time – the patient being tied to a dialysis machine or infusion set.
- Make for exhausting treatments – that even cause collateral damage and accelerated aging.
- Restrict the freedom to work and travel.
- Require a strict diet and severely limit the allowed drinking volume between treatments – making patients constantly thirsty.
It’s no wonder that millions of people are yearning for new solutions that enhance their quality of life. Moreover, the International Society for Nephrology (ISN) and the WHO estimate that about 75% of people that need a kidney transplant or dialysis don’t even have access to the existing means of therapy.
Therefore, lower costs, higher portability and better functionality are all needed.
Challenges for renal dialysis technology
During the first decades after the second world war, the artificial kidney was one of the most exciting medical advances. But since then, renal dialysis technology has barely changed. What are the reasons for this standstill in innovation?
- technical – Kidney functions are very complex. In absence of a sufficient amount of transplant kidneys, they can only be replaced by a personalized and integrated combination of advanced technological solutions.
- economical – Innovators face a long time to market, whereas reimbursement is only granted locally. And they must obtain market access before any negotiation on reimbursement even can start.
- regulatory – To obtain market access, new technologies must fulfil strict government regulations and standards on safety and essential performance. Innovators are often unfamiliar with these topics. This makes investment risks high. Imec cooperates with international regulatory agencies on finding ways to innovate upon regulations.
The answer to these challenges lies in increased cooperation to actively stimulate innovation. This is why the Kidney Health Initiative (KHI) – a public-private partnership that unites patients, health professionals, research organizations and industry – developed an international innovation roadmap for new approaches to renal replacement therapy (RRT).
Imec is a KHI member and involved in the ongoing actualization of this roadmap, by sharing its decades of experience in technology road mapping within semiconductor technology with the Renal community.
Added value of microelectronics & nanotechnology to renal dialysis
While the developments in renal replacement technology slowed down, the semiconductor industry boomed. Electronic devices became cheaper, smaller and more powerful – up to the point where we all have a computer in our pockets.
This reduction in price and size of electronics also led to the development of connected health solutions: wearable, ingestible or implantable devices that:
- collect reliable data
- process and analyze that data to yield actionable insights
- act on that information
It’s obvious that such technologies offer great benefits to renal care. For instance, unobtrusive wearable devices can collect longitudinal multiparameter data, to facilitate earlier diagnosis and help adhering to a healthier lifestyle.
The international KHI roadmap for innovative approaches to renal replacement therapy (RRT) lists advanced technologies from other fields (e.g., sensors, nanotechnology, novel materials) as enablers that can bring us closer to a portable or implantable artificial kidney. Imec is at the heart of this, in close cooperation with the Dutch Kidney Foundation.
For instance, imec researches how its on-chip fluid sensors can be used to monitor, on a personal level, the electrolyte balance during a dialysis treatment. Imec realized a complete multiparameter monitor on a 4.4x4.4-mm chip. And we enable a wearable bio-impedance spectroscopy, to monitor the moisture balance during daily activities.
Want to work with us on the renal dialysis technologies of tomorrow?
Publications and conferences on dialysis technology
- F.P. Wieringa et al. “Smart sensors for real- time monitoring of patients on dialysis", Nature Reviews Nephrology, (2020)
- F.P. Wieringa et al. “Regulatory approaches to stimulate innovative renal replacement therapies”, Nature Reviews Nephrology. E-pub ahead of print, (2020)
- J.P. Kooman et al. “Wearable health devices and personal area networks: can they improve outcomes in haemodialysis patients?”, Nephrol Dial Transplant, (2020)
- F.P. Wieringa et al. “The Kidney Health Initiative innovation roadmap for renal replacement therapies: Building the yellow brick road, while updating the map”, Artificial Organs, (2020)
- C. Smeets et al. “The Added Value of In-Hospital Tracking of the Efficacy of Decongestion Therapy and Prognostic Value of a Wearable Thoracic Impedance Sensor in Acutely Decompensated Heart Failure With Volume Overload”, JMIR Cardio, (2020)
- S. Song et al. “A 769 μW battery powered single-chip SoC with BLE for multi-modal vital sign monitoring health patches”, IEEE Trans Biomed Circuits Syst, (2019)
- F.P. Wieringa et al. “Wearable sensors: can they benefit patients with chronic kidney disease?”, Expert Review of Medical Devices, (2017)
- S. Lee et al. “Congestive heart failure patient monitoring using wearable Bio-impedance sensor technology”, 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), (2015)