Research - Artificial Kidney Innovation Lab

About our research

We are a research group based at the University Medical Center in Utrecht (UMCU, The Netherlands) and part of the Department of Nephrology and Hypertension. Our research focusses on implantable artificial kidney technologies, dialysis innovations, and green nephrology. Below you can read more about the various projects and collaborators that we are involved with.

If you are interested in a research project you can either check out the list with student assignments or contact us directly.

KIDNEW PROJECT

Chronic kidney disease is a worldwide and ever-growing health crisis in which end-stage patients largely depend on in-clinic dialysis, which requires them to travel to the hospital/clinic 3 times per week for a 4h dialysis session. This places a heavy burden on the patient’s life and autonomy, and on European health care systems.

KIDNEW develops ground-breaking technology to enable an implantable artificial kidney with better functional kidney replacement therapy (KRT) than currently available, without need for immunosuppressive drugs and at reduced costs.

KIDNEW provides a proof of concept on three breakthrough innovations:

Solid-state miniature ultra-high flux silicon (Si)-based filter with a high-density of uniform nanopores through novel block copolymer self-assembly, and with novel hemocompatible biomimetic polymer brush coating connected to a photonic clotting monitoring sensor and (thrombolytic) cleansing tool;
Solid-state bioreactor-grown kidney tubule cell monolayers on novel biomimetic Si-wafer based membrane with bioimpedance based monolayer integrity monitoring and monolayer repair functionality using growth-factors;
Solid-state integrated functional biohybrid filter and tubule exchange units stacked in parallel in a multichip to demonstrate functional implantable KRT in goats.

CORDIAL PROJECT

CORDIAL is a cooperation of nephrology departments of three European hospitals and two companies to clinically validate and further develop a new, portable peritoneal dialysis (PD) system for renal patients.

In traditional PD the peritoneal cavity is stagnantly filled with dialysate. This new system continuously circulates and regenerates the dialysate by adsorbing the toxins in the system. This can improve the clearance up to 2 times. In addition, in traditional PD very high glucose concentrations are used that damage the peritoneal membrane. The new system slowly releases glucose so the high glucose concentrations are no longer needed, which helps to preserve the function of the peritoneal membrane. During the project, we plan to perform a first-in-human clinical study with PD patients to validate the clinical safety and performance of the system. In addition, together with PD patients and clinical personnel, we will investigate the usability of the system and explore how to make the system available to patients.

KITNEWCARE

KitNewCare will develop a model for sustainable healthcare, with kidney care as focus. Aim of KitNewCare is to develop and pilot sustainable tools, innovative solutions, guidelines and recommendations to make kidney care as green as possible. KitNewCare unites all key-actors and experts in the ecosystem and performs an EU-wide mapping of the sustainability landscape underpinned by a 4-impact factor Life Cycle Assessment (LCA), that assesses health outcome, environmental impact, social impact, and cost.

Derived insights, hotspots and solution directions are used to develop sustainable workflow and organisational optimisations with Plan, Do, Study, Act (PDSA) cycles. KitNewCare will refine and pilot technological innovations, including novel dialysis machines and dialysate recycling technologies using Innovation Challenge methodology with SMEs and large industry. Novel solutions will be piloted in four different clinical sites. Guidelines and recommendations will be developed and an actionable dashboard will be designed to validate the solutions. This governance tool is based on the 4-factor LCA model, to monitor and benchmark interventions and healthcare centres across the four outcomes. KitNewCare will harvest insights, solutions, governance mechanisms, and policy recommendations to inform decision makers and healthcare providers. Finally, a Sustainability Network of associated pilot sites will be set up for training purposes and piloting, implementing, and upscaling of sustainability solutions beyond the EU-funding period. The entire process will be informed by intensive stakeholder interaction and a Patient and Public Involvement programme to ensure proper design, uptake, dissemination and exploitation.

NXT GEN HIGHTECH

In the project “Artificial Organs,” we are developing new technologies to create the artificial organs of the future, focusing on artificial kidneys and blood vessels. We are establishing protocols and processes for producing the first generation of portable artificial kidneys and artificial blood vessels. Additionally, we are exploring how the developed components can be optimized to make the artificial kidney increasingly smaller, with the ultimate goal of achieving implantability.

The approach is multidisciplinary, aiming to improve—or even eliminate the need for—dialysis treatment. We are working on cutting-edge components such as advanced membranes that more effectively filter waste products from the blood, materials like sorbents and catalysts that can bind and break down these waste products, and biodegradable smart biomaterials that can serve as the basis for artificial blood vessels. Finally, we are also developing micro-electromechanical systems capable of generating energy for the electronic control of future implantable artificial kidneys.

To fast-track the translation of these innovations from bench to bedside, UMCU is establishing a dedicated test facility to evaluate and optimize artificial kidney replacement modules developed within the project.

UKID

Patients with end-stage kidney disease undergo dialysis to replace kidney function. Although lifesaving, dialysis has major shortcomings. Removal of waste solutes and excess fluid is inadequate and treatment is time-consuming, requiring patients to visit the hospital 3x/week for 4h hemodialysis. This leads to a severely reduced quality of life, major health problems and high mortality (10‐15%/year). Hemodialysis machines are large and require a water purification system, hampering their use outside the hospital. A user-friendly portable device will represent a huge leap forward. The concept of a miniature dialysis device is based on the continuous regeneration of a small amount of dialysis fluid in a closed loop. Crucial for successful dialysate regeneration is the efficient removal of urea, the waste solute with the highest daily molar production. However, urea is difficult to bind and has low reactivity, which has hampered the development of a small and portable dialysis device. The goal of UKID is to determine requirements for the efficient binding of urea using a membrane.

Previously it was shown that polymers functionalized with vicinal carbonyl groups can form covalent bonds with urea and demonstrate sufficient urea chemisorption in water but with slow kinetics. We hypothesize that incorporating chemisorption particles in a non-interacting polymeric membrane (mixed-matrix-membrane4), would lead to additional physisorption of urea and thereby enhance kinetics and binding capacity. Goal of this project is to further investigate the urea-binding capacities of such a sorbent membrane. We would like to answer these two research questions:

How can we combine particles with improved chemisorption with a polymeric membrane matrix designed for urea physisorption (e.g. with urea groups) for optimal urea binding in a mixed membrane approach?
Polymeric membrane made entirely out of a material capable of urea chemisorption capable of sufficient covalent binding of urea?

At the end of the project we aim to test the efficacy of the most promising urea-removing membrane in vitro.

MI-TRAM

Healthy human kidneys work 24/7 to remove toxic waste products that the body produces. If the kidneys fail, toxic waste piles up in the blood and without kidney replacement therapy the patient will die. Hemodialysis can keep patients alive, but poorly replaces the natural kidney: Only toxic waste particles that fit through the dialysis filter pores can be washed out, but some (by themselves small enough) toxins “hide” by “sticking” to albumin (big useful particles that must not leak away through the filter pores). This type of toxic waste is bad for the heart, blood vessels, brain, and nerves.

We are working on novel methods to free this toxic waste from the albumin and can then can be taken out. Methods we are looking at include electromagnetic waves, temperature, displacer molecules, etc. Our MI-TRAM project will make this technology available to all interested innovators so that they can “turbocharge” their artificial kidney solutions.

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