Inside This Issue

NEW Kidney on the Block

U-M team develops bioartificial kidney

The ConceptNew KidneyH. David Humes, M.D., leads a team that
developed a bioartificial kidney.

Despite improvements in medical care and dialysis therapy, only about half of patients with acute kidney failure caused by kidney injury survive.The reason for their kidney failure is distinctly different from those whose kidneys have been worn out from years of diabetes or hypertension. Rather, the damage to the kidney cells is from shock, chemotherapy agents or even some antibiotics.But promising results from a clinical trial led by H. David Humes, M.D., a professor of Internal Medicine at the U-M Medical School, show that a bioartificial kidney—one that may one day be worn as a backpack or on a belt—can reduce deaths and speed recovery of kidney function for patients with renal failure resulting from acute injury.Humes’ device replaces the work done by the kidneys, the powerful clearinghouses that, when working normally, clean the blood of toxins and help with immune regulation.

Proof of Concept

New KidneyHumes with research assistants Deborah
Buffington and Gretchen Hageman.

Humes’ latest study, published in April, reveals that short-term replacement of renal cell function using the renal tubule assist device, or RAD—the living-cell cartridge that is key to the function of the bioartificial kidney—reduces deaths by 50 percent.“ New KidneyThe device’s cartridge filters
blood and is connected to a renal
tubule assist device, which is
made up of hollow fibers lined
with a type of kidney cell that
helps the body fight infection.

Our study results are encouraging, and they raise expectations that our new approach may yield a better treatment for life-threatening acute renal failure, for which a high mortality rate has remained unchanged despite years of advances in conventional therapies,” Humes says of the Phase II trial, which included 58 patients at 12 medical centers across the country. “Even more promising, the nature of our new approach—using living cells as therapeutic agents—argues for the feasibility of developing whole classes of new cell-based and tissue-engineered therapies.”

Treatment Today

Dialysis has been the go-to standard for caring for patients with kidney failure, but Humes came to believe that something must be missing after years of seeing patients living, but hardly thriving.“They’re debilitated and don’t feel well most of the time,” he said. “That’s because an artificial membrane does not replace a lot of the things that the cells do.”

Treatment Tomorrow

The missing link—the key to patient survival and quality of life— is natural living cells.The bioartificial kidney includes a cartridge that filters blood as in traditional kidney dialysis. That cartridge is connected to a renal tubule assist device, which is made up of hollow fibers lined with a type of kidney cell.These adult cells, retrieved from donated kidneys that cannot be transplanted, are intended to reclaim vital electrolytes, salt, glucose and water, as well as control production of immune system molecules called cytokines, which help the body fight infection.The benefits of the device, initially tested in animals in 1999, must be confirmed in larger trials. Humes is also continuing to address the challenges of mass producing, miniaturizing and shipping the living-cell device.

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