Authors: František Lopot
Authors‘ workplace: General University Hospital, Department of Medicine, Prague-Strahov, & 1st Medical Faculty, Institute of biophysics and medical informatics, Charles University, Prague
Published in: Lékař a technika - Clinician and Technology No. 2, 2013, 43, 5-12
Category: Review


Shortly after intermittent haemodialysis became established treatment of chronic renal failure, the first wearable artificial kidney (WAK) device projected or even constructed to solve the problem of intermittent treatment unphysiology. Successful development of hollow fibres enabled construction of a sufficiently small dialyzer to be worn and recirculation of dialysate through a sorbent cartridge lead to tremendous drop in dialysate volumes needed. Tested were WAK devices based both on haemodialysis (HD) or on haemofiltration (HF) (after highly permeable membranes became available) as well as on peritoneal dialysis (PD). Later, some other techniques and processes appeared in armamentarium of WAK designers, such as charged membranes, electrodialysis, nanotechnological processes enabling to create membranes with solute-specific pores. Also a few hybride constructions appeared during the last decade using membranes coated with tubular epithelial cells to mimic tubular resorption of biological kidney. With current trends towards more frequent HD with higher material costs, WAK effort got another impetus, this time purely economical. The first commercially available WAK (although still waiting for a CE mark in Europe and FDA clearing in USA) was developed by a Singaporean company AWAK Technologies in 2011. A European WAK is being developed as a joint project in frame of FP7 and is expected to be ready by 2014. However, acceptance of WAK instead of conventional intermittent therapy both by physicians and by the patients themselves still remains unresolved.

Wearable artificial kidney, haemodialysis, peritoneal dialysis, sorption, bioartificial device


1. Kjellstrand C, Evans LR, Petersen RJ eta al: et al:The unphysiology of dialysis: A major cause of dialysis side efffects?, Kidney International, 1975, vol 7, Suppl. 2, 30-34.

2. Lopot F, Válek A: Time-Averaged Concentration - Time-Averaged Deviation: A New Concept in Mathematical Assessment of Dialysis Adequacy, Nephrol. Dial. Transpl., 1988, vol 3, 846-848.

3. Yatzidis H: A convenient hemoperfusion micro-apparatus over charcoal for the treatment of endogenous and exogenous intoxication, Proc. Dial Transpl Forum, 1964, vol 1, 83.

4. Blaney TL, Lindan O, Sparks RE: Adsorption: A step toward a wearable artificial kidney, Trans. Am Soc Artif Internal Organs, 1966, vol 12, 7.

5. Dharnidharka SG, Kirham R, Kolff WJ: Towards a wearable artificial kidney, Trans. Am Soc Artif Internal Organs, 1973, vol 19, 92-97.

6. Blackshear PL: Two new concepts that might lead to a wearable artificial kidney, Kidney International, 1978, vol 13, Suppl. 8, 133-137.

7. Gordon A, Gral T, DePalma JR et al: A sorbent-based, low-volume dialysate regeneration systém: Preliminary studies in human subjects, Proc. EDTA, 1970, vol 7, 63-68.

8. Stephen RL, Jacobsen SC, Kablitz C, Kolff WJ et al: Combined technological-clinical approach to wearable dialysis, Kidney International, 1978, 13 (Suppl. 8): 125-132.

9. Henne W, Scheuren J, Bandel W: A wearable artificial kidney, Proc. ISAO, vol 1, 1977, Artif Organs, 1978,vol 2, Suppl, 344-346.

10. Otubo O, Muto M, Tohyama K et al: Wearable artificial kidney using continuous plasma separating systém from induced blood, Proc. ISAO, vol 1, 1977, Artif Organs, 1978, vol 2, Suppl, 347-350.

11. Neff MS, Sadjadi S, Slifkin R: A wearable artificial glomerulus, Trans. Am Soc Artif Internal Organs,1979, vol 25, 71-73.

12. Murisasco A, Reynier JP, Ragon A et al: Continuous arterio-venous hemofiltration in a wearable device to treat end stage renal disease, Trans. Am Soc Artif Internal Organs, 1986, vol 32, 567-571.

13. Tada Y, Horiuchi T, Ohta Y, Dohi T: A new approach for the filtrate regeneration system in the wearable artificial kidney, Artif. Org., 1990, vol 14, No 6, 405-409.

14. International Quotidian Dialysis Registry (IQDR): http://www.quotidiandialysis.org/.

15. Gura V et al: Technical breakthroughs in the Wearable Artificial Kidney (WAK), Clin J Am Soc Nephrol, 2009, vol 4, No 9, 1441-1448.

16. Ronco C, Fecondini L: The Vicenza wearable artificial kidney for peritoneal dialysis (ViWAK PD), Blood Purif, 2007, vol 25, 383-3885.

17. Ronco C, Dawenport A, Gura V: The future of the artificial kidney: moving towards wearable and miniaturized devices, Nefrologia, 2011, vol 31, No 1, 9-16.

18. Shaldon S, Beau MC, Deschodt G et al: Continuous ambulatory hemofiltration, Trans. Am Soc Artif Internal Organs, 1980, 26, 210-212.

19. Bleyer AJ, Russell GB, Satko SG: Sudden and cardiac death rates in hemodialyis patients, Kidney International, 1999, vol 55, 1553-1559.

20. Harashima T, Otani Y, Kokubo K et al: Urea concentration ability of artificial renal tubule based on countercurrent multiplier system using electrodialysis, dialysis and filtration, World conference on portable-wearable and miniaturized systems for dialysis and ultrafiltration, Vicenza, 30. 9.-2. 10. 2010, Programme and abstract book, p. 23.

21. Nephron Plus project, www.nephronplus.eu

22. AWAK Technologies, http://www.awak.com/ wearable _ dialysis.htm

23. Herrmann I, Bernabei RE, Urner M et al: Device for continuous extracorporeal blood purification using target-specific metal nanomagnets, Nephrol Dial Transpl, 2011, vol 26, 2948-2954.

24. Nissenson A et al: Towards implantable artificial nephron, Blood Purif, 2005, vol 25, 269-274.

25. Humes HD, Weitzel WF, Bartlett RH et al: Initial clinical results of the bioartificial kidney containing human cells in ICU patients with acute renal silure, Kidney International, 2004, vol 66, 1578-1588.

26. Saito A, Sawada K, Fujimura S et al: Present status and future perspectives on the development of bioartificial kidneys for the treatment of acute and chronic renal failure patients, Hemodial. Inernational, 2011, vol 15, 183-192.

27. Fissell WH, Roy S: The Implantable Artificial Kidney, Seminars in Dialysis, 2009, vol 22, No6, 665-670.

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