Increasing quality of life for dialysis patients with portable machines

Smaller and more efficient, a new generation of water purification membranes could help make home dialysis machines more portable, increasing quality of life for thousands of hemodialysis patients worldwide.

Studies show that patients receiving renal replacement therapy at home experience higher quality of life than patients undergoing in-center treatment. Home treatment is more convenient, recovery times are shorter, and the therapy can be delivered more often and be better tailored to individual patients. It’s no wonder, therefore, that many policy makers are looking to increase home dialysis uptake – some on a large scale.

In the US, for example, officials say that by 2025 80% of end-stage kidney disease patients should receive home dialysis or kidney transplants. This is a significant jump from the status quo. Today, there are around 725,000 people with end-stage kidney disease in the US. Of these, less than 10% perform dialysis at home. The rest receive treatment at one of the 7,500 dialysis centers across the country. Those numbers are even smaller in the rest of the world. Globally, there are around 3.4 million dialysis patients – and only around 1% perform treatment at home.

So, what can be done to increase uptake of home hemodialysis? And, can machine design be improved to further increase quality of life for those patients already performing home treatment?

Making home dialysis treatment more accessible

For home dialysis to be a success, patients must be willing to take responsibility for their own treatment, and they have to be strong enough to handle it, both mentally and physically. They also need a care provider – most usually a husband or wife – who is prepared to share the burden. But even with all these things in place, up to a third of patients who try home dialysis end up switching to dialysis centers within three months. Why?

“For most patients, the barriers to home dialysis still outweigh the benefits,” says Esben Gad, Vice President of Business Development at Aquaporin. “It takes real drive and determination, and a lot of courage. On top of that, most home dialysis machines are large, hard to move and complex to use, with a huge amount of consumables and pre-packaged fluids. Managing the logistics around this just isn’t feasible for many home users. And, because treatments have to happen a few times a week, most patients are confined to their immediate area – unable to travel or even to spend the night with family on the other side of the city.”

A new freedom for home dialysis patients with portable water treatment systems

Currently, most home dialysis solutions consist of two machines: the dialysis machine itself and a home water treatment system. According to Esben, making water treatment machines smaller and more portable, with less reliance on pre-packaged fluids, could have a big impact on quality of life – and therefore the retention – of home users.

The technology to do this is already in place. A new wave of forward osmosis water treatment systems are gaining traction in a number of applications, including healthcare and pharma. Due to their design and efficiency, forward osmosis water treatment systems can be significantly smaller than the reverse osmosis systems currently used in dialysis machines – a key consideration for home dialysis patients.

“Imagine a portable home water treatment system that was half the size of a microwave, smaller than that even, and ran straight from the tap without requiring re-plumbing,” says Esben. “The patient would be able to put the machine away when not in use and could even take it when they travel. The increase in quality of life could be a real game-changer.”

Improved sustainability

As well as reducing machine size, weight and complexity, forward osmosis solutions have one other significant benefit: They can also improve efficiency when treating water, meaning less water is required per treatment. This is a very important consideration in a world where water is an increasingly scarce resource.

Today, it can require around 3,000 liters (8,000 gallons) of tap water to create a single patient’s monthly pure-water requirements. Due to their efficiency, forward osmosis systems using Aquaporin Inside® membranes could reduce that by 40-85%, a saving of around 1,300 liters (340 gallons) per patient per month.

“In a world where water is a precious and limited resource, that’s a very significant saving – and could be very appealing to both patients and healthcare providers who are increasingly focused on sustainability and aware of water scarcity issues,” says Esben.

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