Past and present of portable blood purification devices_West China Medical Journal

Authors：

ZHAO Yuliang ¹ , LIU Caihong ¹ , ZHANG Ling ¹ , FU Ping ¹ ,  LI Zhengchi ²

1. Department of Nephrology and Institute of Kidney Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Institute of Disaster Medicine / Institute of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Zhengchi, Email: lizhengchi@wchscu.cn

Keywords：

Portable blood purification devices; artificial intelligence; development history; research directions

DOI：

10.7507/1002-0179.202406149

Video：

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Blood purification is not only an effective treatment for patients with acute and chronic renal failure, but also plays an important role in the rescue of various critically ill patients. The current blood purification devices is relatively bulky and not suitable for use in daily life and disaster rescue sites. Portable blood purification devices can be divided into portable artificial kidney, wearable artificial kidney, implantable artificial kidneys and mobile continuous renal replacement therapy machine, which have not yet been widely applied in clinical practice. In recent years, with the advancement of materials science and computer science, efficient regeneration of dialysate and intelligent operation of equipment have become possible, and portable blood purification devices is also expected to experience rapid development. This article briefly reviews the development history and future research directions of portable blood purification devices.

Citation： ZHAO Yuliang, LIU Caihong, ZHANG Ling, FU Ping, LI Zhengchi. Past and present of portable blood purification devices. West China Medical Journal, 2024, 39(7): 1005-1009. doi: 10.7507/1002-0179.202406149 Copy

1.	Gura V, Macy AS, Beizai M, et al. Technical breakthroughs in the wearable artificial kidney (WAK). Clin J Am Soc Nephrol, 2009, 4(9): 1441-1448.
2.	陈丽婷, 宋明阳, 赵建成, 等. 便携式人工肾设备的研究进展. 中国血液净化, 2022, 21(6): 385-388,397.
3.	Kolff WJ, Berk HT, ter Welle M, et al. The artificial kidney: a dialyser with a great area. 1944. J Am Soc Nephrol, 1997, 8(12): 1959-1965.
4.	Jacobsen SC, Stephen RL, Bulloch EC, et al. A wearable artificial kidney: functional description of hardware and clinical results. Proc Clin Dial Transplant Forum, 1975, 5: 65-71.
5.	Neff MS, Sadjadi S, Slifkin R. A wearable artificial glomerulus. Trans Am Soc Artif Intern Organs, 1979, 25: 71-73.
6.	Blumenkrantz MJ, Gordon A, Roberts M, et al. Applications of the Redy sorbent system to hemodialysis and peritoneal dialysis. Artif Organs, 1979, 3(3): 230-236.Blumenkrantz MJ, Gordon A, Roberts M, et al. Applications of the Redy sorbent system to hemodialysis and peritoneal dialysis. Artif Organs, 1979, 3(3): 230-236.
7.	Murisasco A, Baz M, Boobes Y, et al. A continuous hemofiltration system using sorbents for hemofiltrate regeneration. Clin Nephrol, 1986, 26(Suppl 1): S3-S7.Murisasco A, Baz M, Boobes Y, et al. A continuous hemofiltration system using sorbents for hemofiltrate regeneration. Clin Nephrol, 1986, 26(Suppl 1): S3-S7.
8.	Gura V, Rivara MB, Bieber S, et al. A wearable artificial kidney for patients with end-stage renal disease. JCI insight, 2016, 1(8): e86397.
9.	van Gelder MK, Mihaila SM, Jansen J, et al. From portable dialysis to a bioengineered kidney. Expert Rev Med Devices, 2018, 15(5): 323-336.
10.	Ito T, Ota T, Kono R, et al. Pump-free microfluidic hemofiltration device. Micromachines (Basel), 2021, 12(8): 992.
11.	Tumlin J, Wali R, Williams W, et al. Efficacy and safety of renal tubule cell therapy for acute renal failure. J Am Soc Nephrol, 2008, 19(5): 1034-1040.
12.	Rivara MB, Himmelfarb J. From home to wearable hemodialysis: barriers, progress, and opportunities. Clin J Am Soc Nephrol, 2024.
13.	Thajudeen B, Issa D, Roy-Chaudhury P. Advances in hemodialysis therapy. Fac Rev, 2023, 12: 12.
14.	周春华, 唐文宏, 李平, 等. 一种新型的血液净化设备——便携式连续性血液净化机的研制. 生物医学工程研究, 2010, 29(3): 215-218.
15.	李洪艳, 周春华, 董珍, 等. 车载运动状态下便携式连续性血液净化机的操作方法及技巧. 中国急救复苏与灾害医学杂志, 2012, 7(4): 326-327,330.
16.	余永武, 周春华, 李洪艳, 等. 便携式连续性血液净化机海上犬试验性能测试. 中华航海医学与高气压医学杂志, 2009, 16(5): 305-307.
17.	侯世科, 樊毫军, 丁辉, 等. 野战便携式血液净化机. 中国: CN201610428083.3. 2016-06-17.
18.	吴禹希, 杨亦彬. 可穿戴式人工肾的研究进展. 实用医院临床杂志, 2020, 17(3): 259-261.
19.	Meng F, Seredych M, Chen C, et al. MXene sorbents for removal of urea from dialysate: a step toward the wearable artificial kidney. ACS Nano, 2018, 12(10): 10518-10528.
20.	Shao G, Tang H, Ren S, et al. Dialysate regeneration via urea photodecomposition with TiO(2) nanowires at therapeutic rates. Artificial organs, 2023, 47(7): 1174-1183.
21.	Ramada DL, de Vries J, Vollenbroek J, et al. Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges. Nat Rev Nephrol, 2023, 19(8): 481-490.
22.	Davenport A, Gura V, Ronco C, et al. A wearable haemodialysis device for patients with end-stage renal failure: a pilot study. Lancet, 2007, 370(9604): 2005-2010.
23.	Zhang Q, Lu X, Yang S, et al. Preparation of anticoagulant polyvinylidene fluoride hollow fiber hemodialysis membranes. Biomed Tech (Berl), 2017, 62(1): 57-65.
24.	Fu X, Ning JP. Synthesis and biocompatibility of an argatroban-modified polysulfone membrane that directly inhibits thrombosis. J Mater Sci Mater Med, 2018, 29(5): 66.
25.	Dai Y, Dai S, Xie X, et al. Immobilizing argatroban and mPEG-NH₂ on a polyethersulfone membrane surface to prepare an effective nonthrombogenic biointerface. J Biomater Sci Polym Ed, 2019, 30(8): 608-628.
26.	DesOrmeaux JP, Winans JD, Wayson SE, et al. Nanoporous silicon nitride membranes fabricated from porous nanocrystalline silicon templates. Nanoscale, 2014, 6(18): 10798-10805.
27.	Tijink MS, Wester M, Glorieux G, et al. Mixed matrix hollow fiber membranes for removal of protein-bound toxins from human plasma. Biomaterials, 2013, 34(32): 7819-7828.
28.	Fabiani T, Ricci E, Boi C, et al. In silico screening of nanoporous materials for urea removal in hemodialysis applications. Phys Chem Chem Phys, 2023, 25(35): 24069-24080.
29.	Zhao X, Wang LY, Li JM, et al. Redox-mediated artificial non-enzymatic antioxidant MXene nanoplatforms for acute kidney injury alleviation. Adv Sci (Weinh), 2021, 8(18): e2101498.
30.	Ter Beek OEM, van Gelder MK, Lokhorst C, et al. In vitro study of dual layer mixed matrix hollow fiber membranes for outside-in filtration of human blood plasma. Acta Biomater, 2021, 123: 244-253.
31.	Huang W, Chen J, Yao Y, et al. Vertical organic electrochemical transistors for complementary circuits. Nature, 2023, 613(7944): 496-502.
32.	赵宇亮, 韦伟, 张凌, 等. 连续性肾脏替代治疗的信息化及人工智能. 华西医学, 2022, 37(7): 1066-1069.
33.	Rivara MB, Soohoo M, Streja E, et al. Association of vascular access type with mortality, hospitalization, and transfer to in-center hemodialysis in patients undergoing home hemodialysis. Clin J Am Soc Nephrol, 2016, 11(2): 298-307.
34.	Zhao Y, Li Z, Zhang L, et al. Citrate versus heparin lock for hemodialysis catheters: a systematic review and meta-analysis of randomized controlled trials. Am J Kidney Dis, 2014, 63(3): 479-490.
35.	Brunelli SM, Van Wyck DB, Njord L, et al. Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. J Am Soc Nephrol, 2018, 29(4): 1336-1343.
36.	Lawson JH, Glickman MH, Ilzecki M, et al. Bioengineered human acellular vessels for dialysis access in patients with end-stage renal disease: two phase 2 single-arm trials. Lancet, 2016, 387(10032): 2026-2034.
37.	Lawson JH, Niklason LE, Roy-Chaudhury P. Challenges and novel therapies for vascular access in haemodialysis. Nat Rev Nephrol, 2020, 16(10): 586-602.

1. Gura V, Macy AS, Beizai M, et al. Technical breakthroughs in the wearable artificial kidney (WAK). Clin J Am Soc Nephrol, 2009, 4(9): 1441-1448.
2. 陈丽婷, 宋明阳, 赵建成, 等. 便携式人工肾设备的研究进展. 中国血液净化, 2022, 21(6): 385-388,397.
3. Kolff WJ, Berk HT, ter Welle M, et al. The artificial kidney: a dialyser with a great area. 1944. J Am Soc Nephrol, 1997, 8(12): 1959-1965.
4. Jacobsen SC, Stephen RL, Bulloch EC, et al. A wearable artificial kidney: functional description of hardware and clinical results. Proc Clin Dial Transplant Forum, 1975, 5: 65-71.
5. Neff MS, Sadjadi S, Slifkin R. A wearable artificial glomerulus. Trans Am Soc Artif Intern Organs, 1979, 25: 71-73.
6. Blumenkrantz MJ, Gordon A, Roberts M, et al. Applications of the Redy sorbent system to hemodialysis and peritoneal dialysis. Artif Organs, 1979, 3(3): 230-236.Blumenkrantz MJ, Gordon A, Roberts M, et al. Applications of the Redy sorbent system to hemodialysis and peritoneal dialysis. Artif Organs, 1979, 3(3): 230-236.
7. Murisasco A, Baz M, Boobes Y, et al. A continuous hemofiltration system using sorbents for hemofiltrate regeneration. Clin Nephrol, 1986, 26(Suppl 1): S3-S7.Murisasco A, Baz M, Boobes Y, et al. A continuous hemofiltration system using sorbents for hemofiltrate regeneration. Clin Nephrol, 1986, 26(Suppl 1): S3-S7.
8. Gura V, Rivara MB, Bieber S, et al. A wearable artificial kidney for patients with end-stage renal disease. JCI insight, 2016, 1(8): e86397.
9. van Gelder MK, Mihaila SM, Jansen J, et al. From portable dialysis to a bioengineered kidney. Expert Rev Med Devices, 2018, 15(5): 323-336.
10. Ito T, Ota T, Kono R, et al. Pump-free microfluidic hemofiltration device. Micromachines (Basel), 2021, 12(8): 992.
11. Tumlin J, Wali R, Williams W, et al. Efficacy and safety of renal tubule cell therapy for acute renal failure. J Am Soc Nephrol, 2008, 19(5): 1034-1040.
12. Rivara MB, Himmelfarb J. From home to wearable hemodialysis: barriers, progress, and opportunities. Clin J Am Soc Nephrol, 2024.
13. Thajudeen B, Issa D, Roy-Chaudhury P. Advances in hemodialysis therapy. Fac Rev, 2023, 12: 12.
14. 周春华, 唐文宏, 李平, 等. 一种新型的血液净化设备——便携式连续性血液净化机的研制. 生物医学工程研究, 2010, 29(3): 215-218.
15. 李洪艳, 周春华, 董珍, 等. 车载运动状态下便携式连续性血液净化机的操作方法及技巧. 中国急救复苏与灾害医学杂志, 2012, 7(4): 326-327,330.
16. 余永武, 周春华, 李洪艳, 等. 便携式连续性血液净化机海上犬试验性能测试. 中华航海医学与高气压医学杂志, 2009, 16(5): 305-307.
17. 侯世科, 樊毫军, 丁辉, 等. 野战便携式血液净化机. 中国: CN201610428083.3. 2016-06-17.
18. 吴禹希, 杨亦彬. 可穿戴式人工肾的研究进展. 实用医院临床杂志, 2020, 17(3): 259-261.
19. Meng F, Seredych M, Chen C, et al. MXene sorbents for removal of urea from dialysate: a step toward the wearable artificial kidney. ACS Nano, 2018, 12(10): 10518-10528.
20. Shao G, Tang H, Ren S, et al. Dialysate regeneration via urea photodecomposition with TiO(2) nanowires at therapeutic rates. Artificial organs, 2023, 47(7): 1174-1183.
21. Ramada DL, de Vries J, Vollenbroek J, et al. Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges. Nat Rev Nephrol, 2023, 19(8): 481-490.
22. Davenport A, Gura V, Ronco C, et al. A wearable haemodialysis device for patients with end-stage renal failure: a pilot study. Lancet, 2007, 370(9604): 2005-2010.
23. Zhang Q, Lu X, Yang S, et al. Preparation of anticoagulant polyvinylidene fluoride hollow fiber hemodialysis membranes. Biomed Tech (Berl), 2017, 62(1): 57-65.
24. Fu X, Ning JP. Synthesis and biocompatibility of an argatroban-modified polysulfone membrane that directly inhibits thrombosis. J Mater Sci Mater Med, 2018, 29(5): 66.
25. Dai Y, Dai S, Xie X, et al. Immobilizing argatroban and mPEG-NH₂ on a polyethersulfone membrane surface to prepare an effective nonthrombogenic biointerface. J Biomater Sci Polym Ed, 2019, 30(8): 608-628.
26. DesOrmeaux JP, Winans JD, Wayson SE, et al. Nanoporous silicon nitride membranes fabricated from porous nanocrystalline silicon templates. Nanoscale, 2014, 6(18): 10798-10805.
27. Tijink MS, Wester M, Glorieux G, et al. Mixed matrix hollow fiber membranes for removal of protein-bound toxins from human plasma. Biomaterials, 2013, 34(32): 7819-7828.
28. Fabiani T, Ricci E, Boi C, et al. In silico screening of nanoporous materials for urea removal in hemodialysis applications. Phys Chem Chem Phys, 2023, 25(35): 24069-24080.
29. Zhao X, Wang LY, Li JM, et al. Redox-mediated artificial non-enzymatic antioxidant MXene nanoplatforms for acute kidney injury alleviation. Adv Sci (Weinh), 2021, 8(18): e2101498.
30. Ter Beek OEM, van Gelder MK, Lokhorst C, et al. In vitro study of dual layer mixed matrix hollow fiber membranes for outside-in filtration of human blood plasma. Acta Biomater, 2021, 123: 244-253.
31. Huang W, Chen J, Yao Y, et al. Vertical organic electrochemical transistors for complementary circuits. Nature, 2023, 613(7944): 496-502.
32. 赵宇亮, 韦伟, 张凌, 等. 连续性肾脏替代治疗的信息化及人工智能. 华西医学, 2022, 37(7): 1066-1069.
33. Rivara MB, Soohoo M, Streja E, et al. Association of vascular access type with mortality, hospitalization, and transfer to in-center hemodialysis in patients undergoing home hemodialysis. Clin J Am Soc Nephrol, 2016, 11(2): 298-307.
34. Zhao Y, Li Z, Zhang L, et al. Citrate versus heparin lock for hemodialysis catheters: a systematic review and meta-analysis of randomized controlled trials. Am J Kidney Dis, 2014, 63(3): 479-490.
35. Brunelli SM, Van Wyck DB, Njord L, et al. Cluster-randomized trial of devices to prevent catheter-related bloodstream infection. J Am Soc Nephrol, 2018, 29(4): 1336-1343.
36. Lawson JH, Glickman MH, Ilzecki M, et al. Bioengineered human acellular vessels for dialysis access in patients with end-stage renal disease: two phase 2 single-arm trials. Lancet, 2016, 387(10032): 2026-2034.
37. Lawson JH, Niklason LE, Roy-Chaudhury P. Challenges and novel therapies for vascular access in haemodialysis. Nat Rev Nephrol, 2020, 16(10): 586-602.

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