What if people with kidney failure no longer had to depend on dialysis in the future? Under the leadership of UMC Utrecht, a new research program into a bioartificial kidney has started. Researchers aim to combine innovative blood filters with living kidney cells to better mimic the function of a real kidney. Ultimately, this research should contribute to the development of an implantable bioartificial kidney that could replace dialysis.
For people with kidney failure, dialysis is often vital. But the treatment takes over only a limited part of kidney function and has a major impact on daily life. Patients spend several hours on their treatment multiple times a week.
That is why researchers are working on new ways to better take over kidney functions and improve treatment for patients. The new BioHybrid Kidney Crossing Borders (XB) research program marks the next step in this effort. Led by UMC Utrecht, the program officially started this month.
What makes a bioartificial kidney special is the combination of technology and living human cells. These cells are key to enabling the bioartificial kidney to take over more functions of a healthy kidney than current dialysis can.
Karin Gerritsen
“While a dialysis machine uses an artificial kidney to filter waste products from the blood with the help of a dialysis membrane and dialysis fluid, a bioartificial kidney also contains living kidney cells,” says Karin Gerritsen, internist-nephrologist at UMC Utrecht. “These cells can help recover water and useful substances from the filtrate, remove waste products even more effectively, and bring the treatment closer to the function of a real kidney.”
“To purify the blood sufficiently, we need to filter a considerable number of liters per day. In the process, water and useful substances need to be recovered; otherwise, the body would lose too much fluid, minerals, and amino acids. Just as in a normal kidney, the living kidney cells can recover these substances.”
These cells are therefore important for eventually developing a system that can function entirely within the body. In addition, protein-bound waste products are difficult to remove with standard dialysis. Kidney cells can do this very efficiently. By using living kidney cells, the bioartificial kidney could therefore potentially achieve better blood purification as well.
The development of the bioartificial kidney does not stand on its own. Since the beginning of this year, patients at UMC Utrecht have been testing the NeoKidney, a wearable artificial kidney for people with severe kidney failure. The compact dialysis device is designed for use at home and while traveling. The NeoKidney is intended to make dialysis more flexible and patient-friendly, but it remains a form of dialysis. The bioartificial kidney goes a step further: the ultimate goal is a device that can function continuously inside the body and replace dialysis.
“The bioartificial kidney therefore forms an important link between dialysis as we know it today and the distant dream of one day being able to fully restore or replace a failing kidney,” says Gerritsen. “Many scientific and technological breakthroughs are still needed to achieve this, but every step brings that future closer.”
Within BioHybrid Kidney XB, researchers from UMC Utrecht are working together with Utrecht University, the University of Twente and imec, various medtech companies, RegMed XB, NXTGEN Hightech, and the Dutch Kidney Foundation. The program is made possible by the Dutch Kidney Foundation and Health~Holland.
UMC Utrecht is leading the implementation of the research program. Jeroen Vollenbroek, assistant professor at UMC Utrecht, coordinates the program. “The challenge is to ultimately bring the blood filter, the living kidney cells and all the other components together in a single device that functions safely and effectively. To achieve this, we need the expertise of all the partners.”
Photo credit: Nationaal Groeifonds-programma NXTGEN Hightech
UMC Utrecht contributes expertise in blood filters, microfluidics, and the integration of the filter and cell components: the design of the complete device. There is also extensive expertise in how materials can safely come into contact with blood, and components of the device are tested in Utrecht. Based on its knowledge of kidney physiology – what does a bioartificial kidney need to be able to do to take over the functions of a healthy kidney? – UMC Utrecht also serves as the medical lead within the program.
An implantable bioartificial kidney will not be available overnight. Several scientific and technological breakthroughs are still needed before it can be used in patients. One important challenge, for example, is ensuring that the technology and the living kidney cells can function together safely and over a long period of time inside the human body.
Nevertheless, the potential is significant. The long-term ambition is to make people with severe kidney failure much less – or eventually no longer – dependent on dialysis.
As part of Kidney Week (September 13–20), BNR Podcast covered BioHybrid Kidney Crossing Borders. Listen to the podcast Dutch researchers work on implantable artificial kidney made from cultured kidney cells, featuring Karin Gerritsen and Jasper Boomker from the Dutch Kidney Foundation (in Dutch).
A bioartificial kidney combines blood filters with living kidney cells to mimic various functions of a real kidney. Among other things, the kidney cells can recover water and useful substances and remove certain waste products that are difficult to remove from the blood with standard dialysis.
The NeoKidney is a wearable artificial kidney that allows patients to undergo dialysis at home and while traveling and is currently being tested in patients. The bioartificial kidney is at an earlier stage of research and is ultimately intended to take over more functions of a real kidney.
That is ultimately the goal. But we are still a long way from that point. Many scientific and technological steps are still needed before a bioartificial kidney can be used in patients.
The development of the bioartificial kidney is still in the research phase. It is therefore not yet possible to say when it could become available to patients.
UMC Utrecht leads the implementation of BioHybrid Kidney Crossing Borders and coordinates the development and integration of the various components of the bioartificial kidney. In addition, UMC Utrecht serves as the medical lead within the program.
BioHybrid Kidney Crossing Borders is being carried out under the leadership of UMC Utrecht, in collaboration with Utrecht University, the University of Twente, imec, various medtech companies, NXTGEN Hightech, RegMed XB and the Dutch Kidney Foundation. The program is made possible by the Dutch Kidney Foundation and Health~Holland.
