REPORT

ON
“TECHNOLOGICAL ADVANCES IN RENAL DIAGNOSIS & TREATMENT”

SUBMITTED BY
BINEETA BISWAS
E&I
 INDEX
Topics Page no.
1. Introduction 1
2. Intervensions in CKD 2
3. An insight to dialysis 3
4. Dynamic innovations in treating CKD 4
5. Wearable artificial kidney 5
6. Technology of WAK 6-7
7. WAK vs Dialysis machine 8
8. Limitations 9
9. Future 10
10. Conclusion 11
 1

INTRODUCTION
The technological advances in RENAL treatments
includes the breakthrough(WAK) in Biomedical
Instrumentation domain that has proved to be the
most efficient working model in treating the
end-stage renal failures .HEMODIALYSIS is the
most common method used to treat advanced and
permanent kidney failure. Since the 1960s, when
hemodialysis first became a practical treatment for
kidney failure,doctors learned much about how to
make hemodialysis treatments more effective and
minimize side effects. In recent years, more
compact and simpler dialysis machines have made
home dialysis increasingly attractive. But even
with better procedures and equipment,
hemodialysis is still a complicated and
inconvenient therapy that requires a coordinated
effort from your whole health care team, including
yo ur ne p hr o l o g i st , di a l y si s nu r se , di a l y si s
technician, dietitian, and social worker. The most
important members of the health care team are us
and our family. By learning about the
treatment,one can work with their health care
team to give themselves the best possible results.
 2

INTERVENSIONS IN CKD
The abbreviated form CKD stands for CHRONIC
KIDNEY DISEASE or DISORDER that ranges up from
stage 1 to stage 5 where stage 5 is marked as the
end-stage renal failure.This condition indicates the
complete failure of the kidneys to carry out the
process of filtration which makes the patient
dependent on the artificial filtration of blood and
removal of waste products from the
body,commonly known as DIALYSIS,the machine
thus used in this process is known as DIALYSER or
DIALYSING MACHINE.

HEMODIALYSIS & PERITONIAL are the two

different forms of dialysis. Among them
hemodialysis is the major one where the patient
needs to visit the clinic atleast three times a week
And the procedure generally lasts for 3-5 hours.

Peritonial dialysis involves a Catheter placed inside

the belly where the cleansing fluid allows the
waste materials to get separated from the blood
and then leaves through the catheter.
 3

AN INSIGHT TO DIALYSIS
Two thin needles will be inserted into AV fistula or
graft and taped into place. One needle will slowly
remove blood and transfer it to a machine called a
DIALYSER or DIALYSIS machine.

The dialysis machine is made up of a series of

membranes that act as filters and a special liquid
called DIALYSATE.

The membranes filter waste products from blood,

which are passed into the DIALYSATE fluid.

The used DIALYSATE fluid is pumped out of the

dialyser, and the filtered blood is passed back into
the body through the second needle.

During the process of dialysis the patient need to

be in a reclining position that makes him/her stick
to bed for atleast 4 hours.This is somewhat
cumbersome to deal with.The effects during the
process of dialysis includes MUSCLE CRAMPS,
SHIVERING(due to less SpO2 level in blood).
 4

DYNAMIC INNOVATIONS IN CKD

Three ways to get supported by an artificial renal

procedure includes
 WEARABLE
 IMPLANTABLE
 BIO-ARTIFICIAL

These techniques are indeed making the mortality

rate decrease of patients with renal failures and do
provide a painless aura filled up with spirit.Among
the above mentioned techniques the WEARABLE
ARTIFICIAL KIDNEY(WAK) is the latest development
in the BIOMEDICAL INSTRUMENTATION domain.

WAK is clinically proven and came out with a

positive test result.U.S first patient CHUCK LEE
responded fit while undergoing the dialysis
procedure through this artificial kidney belt.He
was under supervision for 24 hours round the
clock and allowed to walk through the halls of the
hospital,eat whatever he likes with less restriction
in fluid consumption instead of lying on the bed.
 5

WEARABLE ARTIFICIAL KIDNEY

Kidney-on-a-Belt

The wearable artificial kidney, or WAK, looks

rather like a bulky utility belt. In a recent clinical
trial, patients wore the WAK for 24 hours of
continuous treatment, with mixed results.
Technical problems halted the study early, but the
inventors say those problems are fixable, and they
stress that the device provided both effective
treatment and a better quality of life for the test
subjects.

In typical dialysis machines, blood flows into a

tube called the dialyzer, where waste particles
pass through a membrane into a solution that
carries them away. Fresh solution continuously
flows into the dialyzer. On the 5-kilogram WAK
belt, the solution cycles through a miniature
dialyzer and then back to cartridges where the
toxins are absorbed so the solution can be cycled
through again.
 6

TECHNOLOGY OF WAK PROCEDURE

 The advances in WAK includes

 Miniaturization of sensors and pumps

 Small long lasting batteries

 Ultra-permeable membrane that reduces

dialyser's size

 Materials to cleanse and reduce the dialysate

solutions without the need for large quantities
of purified water.

The WAK belt just requires 400 ml of sterile water

to carry out the entire procedure.The battery
powered pump power up the flow of both blood
and dialysate and additional micro-pumps to carry
out ULTRAFILTRATION(fluid removal),the infusion
of anticoagulants and the delivery of the other
substances to the dialysate.Safety mechanisms
includes bubble detectors and wetness sensors at
the arterial and venous access sites to detect
blood leaks.
 7

Fig: LINE DIAGRAM OF THE WAK BELT

Uses a 3 watt Faulhaber DC motor

 Faulhaber motors are designed to achieve
maximum performance in minimum dimension
and weight
 Mechanism with two metal arms that
alternatively compress two elastic chambers
 Valves open and close at the entry and exit of
these chambers.Allows for alternating pulsatile
flow of the blood and dialysate(fluid used to
filter the blood)into the dialyser.
 While one chamber propels fluid out of one
pump the other is filling fluid into the other
pump
 Contains disposal catridges to purity the water
so that it can be recirculated.
 Current prototype weigh about 10 pounds and
it worn like a construction workers tool belt.
 This version is still an experimental
prototype,improvements are under process.
 8

WAK BELT Vs DIALYSIS MACHINE

WAK BELT:
Weighs less than 10lbs
Operates on 9 volt batteries
Uses less than 400 ml of fluid
Can be worn 24/7

DIALYSIS MACHINE:
Weighs 300 lbs
Must be plugged into 110-volts wall
outlet
Uses 120 litres of fluid
Requires frequent visits
 9

LIMITATIONS

1. Devices related issues (excessive carbon dioxide

bubbles in dialysate circuit and carriable blood
and dialysate flows) forced the trial to stop
short after the 7th subject

2. Finding a way to incorporate other chemicals

among them sorbents and enzymes,used in
current dialysis machines

3. In the trial there were reports at the tubing

kinking which disrupted blood and fluid flow

4.In the trial there were also issues with the

battery dying in the middle of treatment.

5. Risks of the upcoming trial are similar to those

of regular dialysis such as infection in the access
sites of the catheter.
 10

FUTURE

 Making the machine itself lighter and smaller

 More durable batteries and better plastics
 Anew type of pump that manages the flow of
blood and water inside the device and has
different flow pattern from current dialysis
machines
 The redesign will include more effective
degassing in the dialysis circuit through the use
of larger venting
 Less flexible tubing will be included to prevent
kinking
 Additional funding required improvements
finding it from gifts and donation.
 11

CONCLUSION
1. The technological advances of the renal
treatments are rising at an alarming scale
making the job to get pursued with ease,with
perfection and the most important agenda was
to make it painless for the patients.The WAK
belt is one of the latest development that has
proven to be a boon in the field of Biomedical
Instrumentation Domain to treat the end stage
renal failures.Nevertheless the miniatured
version of the device has made the lives of the
patients less cumbersome and let them get rid
off the frequent visits to the hospitals and
staying recline to the bed for atleast 5 hours.
Looking for the better versions of the advance
treatments, hopefully the shortage of organ
donars will be minimised. Implantation of
Bio-artificial kidneys is under process,when
clinically tested and proven will replace the
need for donars and make the organ function as
if it is performing naturally.