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Los dispositivos portátiles miniaturizados el futuro del riñón artificial
The future of the artificial kidney: moving towards wearable and miniaturized devices
, C.. RONCOb, C.. RONCOb, A.. DAVENPORTc, V.. GURAd
b Department of Nephrology, Dialysis and Transplantation, Ospedale San Bortolo, and International Renal Research Institute of Vicenza (IRRIV)., Vicenza, Italy,
c UCL Center for Nephrology, Royal Free & University College Medical School, London, UK,
d The David Geffen School of Medicine, Cedars Sinai Medical Center,UCLA, Los Angeles, California USA,
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        "resumen" => "<p class="elsevierStylePara">Los nuevos enfoques en la investigaci&#243;n en di&#225;lisis incluyen el abaratamiento de los tratamientos&#44; las terapias domiciliarias y m&#233;todos m&#225;s sencillos de purificaci&#243;n sangu&#237;nea&#46; Probablemente estos objetivos se consigan gracias a los avances en ri&#241;ones artificiales mediante el uso de nuevas t&#233;cnicas&#44; como la miniaturizaci&#243;n&#44; los microfluidos o la nanotecnolog&#237;a&#46; Esta l&#237;nea de investigaci&#243;n podr&#237;a llevarnos a una nueva era en el campo de la di&#225;lisis&#44; en la que los nuevos retos ser&#225;n la transportabilidad&#44; la portabilidad y&#44; por qu&#233; no&#44; la posibilidad de desarrollar dispositivos implantables&#46; A pesar de no haber alcanzado a&#250;n ese punto&#44; recientemente se han publicado una serie de trabajos en los que los resultados sobre los sistemas de ultrafiltraci&#243;n port&#225;tiles y los ri&#241;ones artificiales port&#225;tiles se revelan prometedores y de gran inter&#233;s&#46; Algunos de ellos recurren a la modalidad extracorp&#243;rea como m&#233;todo de purificaci&#243;n sangu&#237;nea&#44; mientras que otros recurren a la di&#225;lisis peritoneal como modalidad de tratamiento &#40;ViWAK&#44; <span class="elsevierStyleItalic">Vicenza Wearable Artificial Kidney</span>&#44; y AWAK&#44; <span class="elsevierStyleItalic">Automated Wearable Artificial Kidney</span>&#41;&#46; Merece menci&#243;n especial el sistema de ultrafiltraci&#243;n port&#225;til para la terapia de la sobrehidrataci&#243;n y la insuficiencia card&#237;aca congestiva &#40;WAKMAN&#41;&#46; Este sistema permitir&#225; reducir el n&#250;mero de hospitalizaciones&#44; el tratamiento de pacientes con menor comorbilidad y una mayor tolerancia&#46; Durante la investigaci&#243;n en el ri&#241;&#243;n artificial port&#225;til se han ido sucediendo nuevos avances&#44; como el desarrollo de un sistema completo de hemofiltraci&#243;n para reci&#233;n nacidos &#40;CARPEDIEM&#44; <span class="elsevierStyleItalic">Cardio Renal Pediatric Dialysis Emergency Machine</span>&#41;&#46; El neonato&#44; de hecho&#44; es el paciente que m&#225;s podr&#237;a beneficiarse de la miniaturizaci&#243;n del circuito de di&#225;lisis&#46;</p> <p class="elsevierStylePara">Esta revisi&#243;n analiza los fundamentos de esta tendencia y los obst&#225;culos que se le presentan a la hora de alcanzar un sistema de di&#225;lisis totalmente ambulatorio&#46;</p> <p class="elsevierStylePara">Se presentan los resultados iniciales de estos nuevos dispositivos&#46; Con este trabajo nos gustar&#237;a promover un esfuerzo com&#250;n para dar un salto cuantitativo tecnol&#243;gico y hacer que el ri&#241;&#243;n artificial port&#225;til sea una realidad y no una quimera&#46;</p>"
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        "resumen" => "<p class="elsevierStylePara">New directions in dialysis research include cheaper treatments&#44; home based therapies and simpler methods of blood purification&#46; These objectives may be probably obtained with innovations in the field of artificial kidney through the utilization of new disciplines such as miniaturization&#44; microfluidics&#44; nanotechnology&#46; This research may lead to a new era of dialysis in which the new challenges are transportability&#44; wearability and why not the possibility to develop implantable devices&#46; Although we are not there yet&#44; a new series of papers have recently been published disclosing interesting and promising results on the application of wearable ultrafiltration systems &#40;WUF&#41; and wearable artificial kidneys &#40;WAK&#41;&#46; Some of them use extracorporeal blood cleansing as a method of blood purification while others use peritoneal dialysis as a treatment modality &#40;ViWAK and AWAK&#46;&#41; A special mention deserves the wearable&#47;portable ultrafiltration system for the therapy of overhydration and congestive heart failure &#40;WAKMAN&#41;&#46; This system will allow dehospitalization and treatment of patients with less comorbidity and improved tolerance&#46; On the way to the wearable artificial kidney&#44; new discoveries have been made such as a complete system for hemofiltration in newborns &#40;CARPEDIEM&#41;&#46; The neonate in fact is the typical patient who may benefit from miniaturization of the dialysis circuit&#46;</p> <p class="elsevierStylePara">This review analyzes the rationale for such endeavour and the challenges to overcome in order to make possible a true ambulatory dialysis treatment&#46; Some initial results with these new devices are presented&#46; We would like to stimulate a collaborative effort to make a quantum leap in technology making the wearable artificial kidney a reality rather than a dream&#46;&#160;</p>"
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Información del artículo
ISSN: 02116995
Idioma original: Español
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