How can we advance in renal replacement therapy techniques?
End-Stage Renal Disease (ESRD) is one of the major causes of morbidity and mortality worldwide. Although the incidence of ESRD is relatively stable, the prevalence of maintenance dialysis is increasing, and it is expected to reach a staggering 5439 million patients worldwide by 2030. Despite the gre...
| Publicado en: | Nefrología Vol. 39; no. 4; pp. 372 - 379 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
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Revista Nefrologia
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| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=138240800&site=ehost-live header: @attributes: shortDbName: lth uiTerm: 138240800 longDbName: MedicLatina uiTag: AN controlInfo: bkinfo: jinfo: jid: 02116995 50C3 jtl: Nefrología issn: 02116995 maglogo: N pubinfo: dt: jul/ago2019 vid: 39 iid: 4 pid: 39358 pub: Revista Nefrologia artinfo: ui: 138240800 10.1016/j.nefro.2018.08.012 ppf: 372 ppct: 7 formats: fmt: @attributes: type: P size: 745KB tig: atl: How can we advance in renal replacement therapy techniques? aug: au: Castro, Ana Neri, Mauro Karopadi, Akash Nayak Lorenzin, Anna Marchionna, Nicola Ronco, Claudio affil: Department of Nephrology, Dialysis and Transplantation, Oporto Hospital Centre, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal International Renal Research Institute of Vicenza (IRRIV), IRRIV-San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy Dr. Nayak Dialysis Centres Private, Limited, 12-2-718, Nanal Nagar, X Roads, Toli Chowki, Hyderabad, Telangana 500008, India Department of Nephrology, Dialysis and Transplantation, Ospedale San Bortolo, San Bortolo Hospital AULSS 8 Berica, Viale Rodolfi, 37, 36100 Vicenza, Italy su: Chronic kidney failure Quality of life sug: subj: Chronic kidney failure Quality of life keyword: End-Stage Renal Disease Health-related quality of life Renal replacement therapy Vascular access Wearable Artificial Kidney Wearable Ultrafiltration device Acceso vascular Calidad de vida relacionada con la salud Dispositivo de ultrafiltración Enfermedad renal crónica portátil RiŞón Artificial Portátil Terapia de sustitución renal terminal ab: End-Stage Renal Disease (ESRD) is one of the major causes of morbidity and mortality worldwide. Although the incidence of ESRD is relatively stable, the prevalence of maintenance dialysis is increasing, and it is expected to reach a staggering 5439 million patients worldwide by 2030. Despite the great technological evolution that has taken place in recent years, most patients are still treated with in-centre haemodialysis and their prognosis remains far from desirable. Since 1980, there has been an increasing interest in the development of a portable device for renal replacement therapy (RRT), which ultimately led to the creation of the Wearable Artificial Kidney (WAK) and the Wearable Ultrafiltration (WUF) system. Portable RRT devices may be acceptable alternatives that deal with several unmet clinical needs of ESRD patients. So far, 3 important human studies with WAK and WUF have been carried out and, although these devices require considerable technological improvement, their safety and efficacy in solute clearance and fluid removal is undeniable. In this article, we review the evolution of the WAK and the WUF and the main clinical trials performed, highlighting some of their technical features. Some of the main possible clinical advantages that could be achieved with these devices, as well as some economic aspects, are also pointed out. In the future, all renal replacement therapy techniques should evolve to perfectly match the clinical and personal needs of each patient, allowing for an improved health-related quality of life. La enfermedad renal crónica terminal (ERCT) es una de las principales causas de morbimortalidad mundial. Aunque la incidencia de esta enfermedad es relativamente estable, la prevalencia en diálisis está aumentando, y se espera que llegue a la cifra de 5.439 millones de pacientes en todo el mundo en el aŞo 2030. A pesar de la gran evolución tecnológica ocurrida en los últimos aŞos, la mayoría de los pacientes continúan siendo tratados con hemodiálisis, y su pronóstico queda lejos de lo deseable. Desde 1980, existe un interés creciente en el desarrollo de dispositivos portátiles para la terapia de sustitución de la función renal (TSFR), y que llevaron a la creación del Wearable Artificial Kidney (WAK) y del Wearable Ultrafiltration (WUF) system. Estos pueden ser alternativas aceptables que permiten alcanzar las necesidades de los pacientes con ERCT, que hasta ahora no se han alcanzado. A pesar de que estos dispositivos necesitan mejoras tecnológicas, su seguridad y eficacia en el aclaramiento de solutos y la eliminación de fluidos es innegable. Revisamos la evolución del WAK y del WUF, y los principales ensayos clínicos desarrollados, destacando algunas de sus particularidades tecnológicas. Adicionalmente, seŞalamos algunas de las posibles ventajas clínicas que podrían ser alcanzadas con estos dispositivos, así como algunos aspectos económicos. En el futuro, todas las TSFR deben evolucionar para satisfacer todas las necesidades clínicas y personales de cada paciente, permitiendo una mejor calidad de vida relacionada con la salud. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: Copyright of Nefrología is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. item: Nefrología holder: Revista Nefrologia dt: @attributes: year: 2019 holdings: @attributes: islocal: N |
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