Decision-makers are pushing for more dialysis patients to be treated at home, but uptake among patients remains low. A simplification of water treatment could pave the way to portable home dialysis machines – which could vastly improve patient life quality and uptake.
“One of the biggest challenges we’re facing is an aging dialysis population needing more care. We’re facing a shortage of in-center dialysis capacity, meaning we would like to increase the possibilities of treating our patients at home,” says Marianne Rix, Head of Dialysis at the University Hospital of Copenhagen in Denmark.
The University Hospital of Copenhagen isn’t alone. A number of governments and healthcare providers around the globe are trying to increase uptake of home hemodialysis, including the US, Australia, Canada and New Zealand. Despite this, uptake among patients remains low and, of those that do try home treatment, up to a third give up within three months – many due to the complexity of current home dialysis treatment.
“The majority of home hemodialysis systems today require complicated machines and complicated water supply and purification systems. In order to enhance the uptake of home hemodialysis, a simplification of the equipment would be much in demand,” Marianne Rix explains.
Using forward osmosis to increase machine simplicity and portability
According to Esben Gad, Vice President of Business Development at Aquaporin, the easiest place to begin would be the water treatment system. “The technology already exists to make smaller, lighter, more portable and efficient water treatment systems, without a large-scale investment from machine producers,” he says.
Today, home water treatment machines use reverse osmosis to purify water. In reverse osmosis, the water is pushed at high pressure through a purification membrane, which filters out unwanted particles. It’s an age-old way of purifying water, and very inefficient. Luckily, there’s now an alternative – forward osmosis.
Forward osmosis uses the natural driving force of osmotic pressure to push the water through the membrane. This means it can provide a tighter and more selective barrier – able to deliver ultra-pure water – without the need for high pressure pumping. This reduces the system’s size and energy requirements, paving the way to smaller and more lightweight machines that can easily be moved around the home or transported, giving patients far greater freedom and quality of life.
Using nature’s own water filters
One of the keys to success with forward osmosis is the filtration membrane – which needs to be exceptionally efficient. At Aquaporin, researchers and engineers have spent more than a decade perfecting an extremely efficient membrane solution, which is now being used in a number of commercial applications.
Called Aquaporin Inside®, the membranes use aquaporin proteins to filter water. Aquaporin proteins are present in the cells of all living organisms, from bacteria and plants to man. They facilitate rapid and highly selective water transport across the cell membrane and, due to their special architecture, they allow only water molecules to pass. All other compounds are rejected. As part of the Aquaporin Inside® membrane, they enable extreme fast and energy-efficiently water filtration.
“If applied in home hemodialysis, a forward osmosis solution using our membranes should make it possible to reduce water treatment system size by 30-40%,” Esben says. “A reduction like this paves the way for portable home dialysis machines, which would mean patients could move them or put them away after use, or even take them when visiting family for the holidays. For most patients, the increase in quality of life – and so treatment success – could be huge.”
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