For Better Life

xKidney

Introduction

The incidence of kidney disease is rapidly increasing worldwide - , and maintenance hemodialysis has become an established protocol for treating end-stage renal disease (ESRD) patients. Better outcomes achieved by convective hemodialysis treatment have encouraged the use of synthetic high-flux membranes in clinical setups, and hemodiafiltration (HDF) and high-flux hemodialysis (HD) are now regarded as preferred forms of convective hemodialysis. High-flux HD adequately clears mid-size solutes without sterile fluid infusion, because forward filtration exceeding desired volume removal is compensated for by backfiltration; thus, HD has been entitled to a simplest form of dialysis treatment. However, overall patient survival remains comparable to that of low-flux HD. This is presumably due to the limited amount of internal filtration involved. In contrast, HDF, which describes an intermittent renal supportive therapy of combined simultaneous diffusive and convective solute transport, is characterized by a large filtration volume that far exceeds the desired amount. Hence, this modality has been reported to improve middle-to-large sized molecular removal, allow better erythropoietin (EPO) control, and reduce oxidative stress and inflammation. It has been even reported to have a positive influence on patient survival rates. However, the far higher filtration volume during HDF must be compensated by external substitution fluid infusion in real time. HDF is therefore a complex and costly procedure. Therefore, novel HDF strategies that do not require external infusion have been developed to deliver maximally available convective efficiency for kidney failure patients.

Clinical Application

xKidney is the simplest HD device, but this unit is designed to deliver maximum convective efficiency exceeding conventional HDF. Hence, xKidney is applicable for patients with kidney failure (acute and chronic), and provides treatments including high efficiency hemodialysis, hemodiafiltration, and high-volume hemofiltration. The xKidney can not only replace conventional hemodialysis devices currently available in dialysis centers, but can also be used for home or portable hemodialysis.

Core Components and Technologies

xKidney is the simplest form of HD device. Specifically, this unit is designed to enable the convective mass transfer to reach its maximally available amount. Plasma water flow across a membrane resulting from the transmembrane pressure gradient between blood and dialysate leads to the simultaneous movement of solutes through the membranes, which is referred to as convective mass transfer. Excess water and mid-sized molecules are removed by the convective mass transfer. The enhanced convective mass transfer leads to increased clearances of mid- to large-sized uremic toxins. Resulting concentrations of these molecules in-vivo remain at a low level, which in turn has a positive influence on reducing patient mortality. The enhanced convective mass transfer is achieved by a patented DPDS technology involving dual dialysate pulsation and unique flow control. The xKidney also eschews a blood pump to transfer blood; thus, blood cell damage otherwise caused by the blood pump can be prevented. The lack of blood pump renders the complicated blood pump controls and monitors unnecessary, making the xKidney system lighter and more simplified. This reduces both manufacturing and treatment costs. ​ The xKidney hemodialysis circuit and its key components are illustrated below, and its key features follow the diagram. 1. Dual Pulsation Dialysate Supply (DPDS) ​​2. Pumpless Blood Transfer (PLBT) ​3. Single Needle Blood Access 4. Optimal Use of Membrane Hydraulic Permeability