Artificial kidney

I have a somewhat fanciful thought of what an artificial kidney would look like.

I see a device that is shaped like a kidney (of course) but is completely clear so you could see all the blood circulating through it. Granted, once it's implanted no one's going to see it but - hey - it's my vision. The closest picture I can find of what's in my mind's eye is this image.

Granted, that's a picture of a kidney-shaped paper weight and it's a little cloudy, but I know you can picture it too.

My, oh my. My imagination is not even close to reality.

According to a post from the American Journal of Kidney Diseases, there are three new approaches being explored right now: the automated wearable artificial kidney ('AWAK'), the wearable artificial kidney ('WAK') and the implantable artificial kidney ('IAK'). My money's on the IAK and you'll understand why once I show you the concept pictures of the other two.

The AWAK is said to weight just under 2 kg (4+ pounds) and is fluid-based, an extension of peritoneal dialysis. To be crude, it looks like one of those portable oxygen machines you can sling over your shoulder only instead of connecting to your nose, the AWAK is connected to a tube that goes into your abdomen. It's basically portable peritoneal dialysis.

The WAK is a blood-based exchange and weighs in at 11 pounds! (< 5kg). They say that it gives you the freedom of being stuck going to a center for dialysis, but between the weight of the thing and the ugly look of it (below), I'm not sure how quickly people will adopt it. Can you image lugging that around with you? It might make you more mobile but it's not like I'd go out in public with it. WAK is basically portable - but bulky - hemodialysis.

Finally, there's the IAK which would weigh in at 500 g (just over a pound) and would be implanted via a surgical procedure. Unlike current transplants, anti-rejection drugs would not be needed (yay!). For most probably asthetic, shallow reasons, this is the development I'm rooting for. It looks NOTHING like my ideal, but once it's available I'll be first in line. [And isn't the human body amazing?!? A little nugget of a kidney performs the duties of things the size of a large purse, a sumo wrestling belt or a coffee mug.]

None of these approaches is ready for prime time. AWAK is conducting human trials, WAK is proceeding with FDA clinical trials and IAK has only made it through animal trials. Regardless, it's an exciting time for those of us with chronic kidney disease. R&D dollars are becoming available. The US government is actively seeking innovation in the treatment of kidney disease (most likely due to the sticker shock from treatment cost projections).

Whatever the reason, I'm excited and I'm hopeful. With the addition of Tolvaptan to my treatment plan, I'm crossing my fingers and toes that my body can hold out until that IAK is tested and viable.

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