Urea removal strategies for dialysate regeneration in a wearable artificial kidney
van Gelder, Maaike K.; Jong, Jacobus A.W.; Folkertsma, Laura; Guo, Yong; Blüchel, Christian; Verhaar, Marianne C.; Odijk, Mathieu; Van Nostrum, Cornelus F.; Hennink, Wim E.; Gerritsen, Karin G.F.
(2020) Biomaterials, volume 234
(Article)
Abstract
The availability of a wearable artificial kidney (WAK) that provides dialysis outside the hospital would be an important advancement for dialysis patients. The concept of a WAK is based on regeneration of a small volume of dialysate in a closed-loop. Removal of urea, the primary waste product of nitrogen metabolism,
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is the major challenge for the realization of a WAK since it is a molecule with low reactivity that is difficult to adsorb while it is the waste solute with the highest daily molar production. Currently, no efficient urea removal technology is available that allows for miniaturization of the WAK to a size and weight that is acceptable for patients to carry. Several urea removal strategies have been explored, including enzymatic hydrolysis by urease, electro-oxidation and sorbent systems. However, thus far, these methods have toxic side effects, limited removal capacity or slow removal kinetics. This review discusses different urea removal strategies for application in a wearable dialysis device, from both a chemical and a medical perspective.
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Keywords: Artificial kidney, Electro oxidation, Hemodialysis, Sorbent, Urea, Urease, Biophysics, Bioengineering, Ceramics and Composites, Biomaterials, Mechanics of Materials
ISSN: 0142-9612
Publisher: Elsevier
Note: Funding Information: The Dutch Kidney Foundation (grant NT 12.05) and the European Commission (WEAKID, Horizon 2020 research and innovation program, grant agreement no. 733169) supported the work of M.K. van Gelder and K.G.F. Gerritsen. J.A.W. Jong and Y. Guo are supported by the Dutch organization for Scientific Research (NWO-TTW, project 14433) and the Dutch Kidney Foundation. All authors acknowledge the financial support of the strategic alliance of the University of Twente, University of Utrecht and University Medical Center Utrecht. J.A.W. Jong, Y. Guo, W.E. Hennink, C.F. van Nostrum and K.G.F. Gerritsen are currently working on new covalent urea sorbents and have recently filed a patent on this topic (WO2019110557). M.K. van Gelder, K.G.F. Gerritsen and C. Blüchel are involved in the development of urease-based portable artificial kidney devices supported by NeoKidney – an initiative of the Dutch Kidney Foundation. M.K. van Gelder, L. Folkertsma, M. Odijk and K.G.F. Gerritsen are working on an electro-oxidation based urea removal system. Funding Information: The Dutch Kidney Foundation (grant NT 12.05 ) and the European Commission ( WEAKID , Horizon 2020 research and innovation program , grant agreement no. 733169 ) supported the work of M.K. van Gelder and K.G.F. Gerritsen. J.A.W. Jong and Y. Guo are supported by the Dutch organization for Scientific Research ( NWO-TTW , project 14433) and the Dutch Kidney Foundation . All authors acknowledge the financial support of the strategic alliance of the University of Twente , University of Utrecht and University Medical Center Utrecht . J.A.W. Jong, Y. Guo, W.E. Hennink, C.F. van Nostrum and K.G.F. Gerritsen are currently working on new covalent urea sorbents and have recently filed a patent on this topic (WO2019110557). M.K. van Gelder, K.G.F. Gerritsen and C. Blüchel are involved in the development of urease-based portable artificial kidney devices supported by NeoKidney – an initiative of the Dutch Kidney Foundation . M.K. van Gelder, L. Folkertsma, M. Odijk and K.G.F. Gerritsen are working on an electro-oxidation based urea removal system. Publisher Copyright: © 2020 The Author(s)
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