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Review
. 2022 Feb 2;12(2):177.
doi: 10.3390/membranes12020177.

Artificial Kidney Engineering: The Development of Dialysis Membranes for Blood Purification

Yu-Shuo Tang  1 , Yu-Cheng Tsai  2 , Tzen-Wen Chen  3 , Szu-Yuan Li  4   5
Affiliations
Review

Artificial Kidney Engineering: The Development of Dialysis Membranes for Blood Purification

Yu-Shuo Tang et al. Membranes (Basel). .

Abstract

The artificial kidney, one of the greatest medical inventions in the 20th century, has saved innumerable lives with end stage renal disease. Designs of artificial kidney evolved dramatically in decades of development. A hollow-fibered membrane with well controlled blood and dialysate flow became the major design of the modern artificial kidney. Although they have been well established to prolong patients' lives, the modern blood purification system is still imperfect. Patient's quality of life, complications, and lack of metabolic functions are shortcomings of current blood purification treatment. The direction of future artificial kidneys is toward miniaturization, better biocompatibility, and providing metabolic functions. Studies and trials of silicon nanopore membranes, tissue engineering for renal cell bioreactors, and dialysate regeneration are all under development to overcome the shortcomings of current artificial kidneys. With all these advancements, wearable or implantable artificial kidneys will be achievable.

Keywords: REDY system; artificial kidney; cell bioreactor; implantable artificial kidney; nanopore silicon membrane; wearable artificial kidney.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Modern design of the artificial kidney: the geometric designs of the modern artificial kidney are predominantly hollow-fibered. Low fluid resistance and expanded surface area facilitated the efficiency of dialysis. However, the complicated structure creates multiple dead spaces and turbulence within both compartments.
Figure 2
Figure 2
Comparison of the single pass system and the REDY system: dialysis with the single pass system requires a steady water source and used dialysate is abandoned after dialysis. In comparison, the REDY system regenerates fresh dialysate with sorbent cartridge.
Figure 3
Figure 3
Basic concepts of a wearable hemodialyzer and a peritoneal-based wearable artificial kidney: within a wearable hemodialyzer (upper), the pumps, battery, safety system, and REDY system are all installed in a vest. During dialysis, the REDY system regenerates dialysate and reduces the requirement of water. A bubble detector, blood leak detector, and flowmeter monitor all fluid compartments and shut off the system in the case of an emergent condition. The peritoneal-based wearable artificial kidney (lower) is connected to the patient’s peritoneal cavity and regenerates dialysate fluid. The disposable part of the device is exchanged after dialysis.
Figure 4
Figure 4
Implantable kidney: driven by the pressure difference in the artery and vein, blood passes through the implantable kidney, which is composed of a hemofilter and cell bioreactor. With a nanopore silicon membrane, waste fluid (yellow) created by hemofiltration flows into the patient’s urinary bladder. Dialyzed blood is transferred to the cell bioreactor after hemofiltration. Natural kidney metabolic function is restored by protected renal tubule cells in the cell bioreactor.
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