Medical News Today
Article Date: 05 Mar 2008 - 5:00 PST
For patients with acute kidney injury (AKI), an external device containing human
kidney cells promotes recovery of the injured kidneys and significantly reduces
the risk of death, according to a preliminary clinical study published in the
May Journal of the American Society of Nephrology.
The
experimental renal tubule assist device (RAD) appears safe and effective for
desperately ill patients with AKI. "Deployment of the RAD was associated with
remarkably better outcomes for these patients - speeding recovery of kidney
function and reducing risk of death by half," comments Dr. H. David Humes of
University of Michigan, one of the study authors.
Patients with AKI have
sudden loss of kidney function, resulting from a wide range of possible causes
(such as blood loss or toxic injury). The goal of treatment is to replace lost
kidney function through dialysis and related techniques until the kidneys have
time to recover. However, even with treatment, the risk of death during an
episode of AKI is 50 percent or higher.
In the new study, 40 of 58
patients with AKI were randomly assigned to treatment with the RAD, in addition
to standard renal replacement therapy. The RAD is a conventional blood filter
device lined with human renal tubule cells, grown from donor kidneys. "The cells
are made available to carry out subtle metabolic and endocrine functions that
the patient's failing kidneys can no longer perform, thereby staunching a
cascading decline in the patient's health and allowing time for the patient's
own organs to recover," Dr. Humes explains.
Outcomes were significantly
better for AKI patients treated with the RAD. After one month, 33 percent of
patients in the RAD group had died, compared to 61 percent of those treated with
renal replacement therapy only. Patients who received the RAD were also more
likely to be alive after six months. With adjustment for other factors, the risk
of death was about 50 percent lower in the RAD group.
Patients in the
RAD group also had a shorter time to return of kidney function. Overall, kidney
function recovered in 53 percent of patients with RAD, compared to 28 percent
without RAD. In both groups, about 20 percent of patients survived but never
recovered kidney function, requiring chronic dialysis.
Although the
initial results are encouraging, the benefits of RAD treatment need to be
confirmed in larger studies. In addition, the researchers need to study the
effects of changes in the design of the RAD, which are needed to accommodate
mass production.
In addition to improving the outcomes of AKI, the
results may point the way toward entirely new classes of cell-based and
tissue-engineered therapies. "The ability to harness vital processes of cells,
to target their living molecular machinery on restoring critical substances
which have become disordered by disease, has vast implications for the future of
medicine," says Dr. Humes. "Particularly, we are encouraged that we can develop
a related device to treat chronic renal failure - a wearable kidney that
performs natural functions unachievable through man-made technology alone."
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Article adapted by Medical News Today
from original press release.
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The
American Society of Nephrology (ASN) is a not-for-profit organization of 10,500
physicians and scientists dedicated to the study of nephrology and committed to
providing a forum for the promulgation of information regarding the latest
research and clinical findings on kidney diseases. ASN publishes JASN, the
Clinical Journal of the American Society of Nephrology (CJASN), and the
Nephrology Self-Assessment Program (NephSAP).
Source: Shari
Leventhal
American Society of Nephrology
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