New dialysis approaches using microelectronics & nanotechnology

After more than 50 years of near-standstill, renal medicine is ready for major technological leaps forward. With microelectronics & nanotechnology as powerful ingredients.

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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.

 

Partners in new dialysis technology

Some of the core members from the KHI roadmap team. From left to right: Richard Fissel (kidney patient, KHI board member),
Prabir Roy-Chaudhury (nephrologist, ASN), Murray Sheldon (associate director for Technology and Innovation FDA),
Carolyn Neuland (manager Renal Devices FDA), Fokko Wieringa (imec the Netherlands & technology advisor to the Dutch Kidney Foundation),
Frank Hurst (nephrologist, Renal Devices FDA) and Melissa West (director KHI).

 

Moreover, our knowledge of semiconductor and MEMS technologies as well as artificial intelligence can contribute to the development of new technologies to improve the life of kidney patients.

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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.

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