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Bioartificial Kidney Reduces Risk of Death from Acute Kidney Failure

Most patients with acute kidney failure receive hemodialysis -- a cleansing of the blood using a dialysis machine, a "man-made" kidney. However, acute kidney failure is associated with a high mortality rate, and researchers have been interested in whether the outcomes from kidney failure could be improved through the use of a "bioartificial kidney," which have the potential to more closely replicate the many functions of the human kidney.

The "renal assist device" (RAD) is a bioartificial kidney with tubules lined with actual donated human kidney cells. In an upcoming issue of the Journal of the American Society of Nephrology, Dr. H. David Humes demonstrates that the use of the RAD in patients with acute kidney failure is associated with improved mortality and recovery of renal function. While this device is still experimental, it raises the hope that outcomes from acute kidney failure can be improved with bioengineered devices like the RAD. From the press release:
"The cells are made available to carry out subtle metabolic and endocrine functions that the patient's failing kidneys can no longer perform, thereby staunching a cascading decline in the patient's health and allowing time for the patient's own organs to recover," Dr. Humes explains.

Outcomes were significantly better for AKI patients treated with the RAD. After one month, 33 percent of patients in the RAD group had died, compared to 61 percent of those treated with renal replacement therapy only. Patients who received the RAD were also more likely to be alive after six months. With adjustment for other factors, the risk of death was about 50 percent lower in the RAD group.

Patients in the RAD group also had a shorter time to return of kidney function. Overall, kidney function recovered in 53 percent of patients with RAD, compared to 28 percent without RAD. In both groups, about 20 percent of patients survived but never recovered kidney function, requiring chronic dialysis.

Although the initial results are encouraging, the benefits of RAD treatment need to be confirmed in larger studies. In addition, the researchers need to study the effects of changes in the design of the RAD, which are needed to accommodate mass production.
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Dr. Schwimmer's blog explores the intersection of medicine, new technologies, and the Internet.