Development of home hemodialysis system with navigator

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In recently, more than 300,000 patients with chronic renal failure receive hemodialysis (HD) therapy in Japan. However, life expectancy of those dialysis patients estimates roughly half as that in healthy subjects. Further improvements of the dialysis system are required for promoting health and longevity of the patient. In this situation, the aim of this study is development of home hemodialysis system with navigator in safety. Concretely, continuous monitoring systems for dialyzer performances and solute removal characteristics during the treatment have been developed to navigate the optimal dialysis conditions for each patient.We carried out in vitro experiments with whole bovine blood or bovine plasma to evaluate the dialyzer performance such as solute clearances and hydraulic permeability. Furthermore, internal filtration flow rate of a dialyzer was measured using laser Doppler sonography during bovine plasma experiments. And, continuous monitoring of solute concentration in the spent dialysate was done for the development of the dialysis system with navigator.From these results, we obtained time courses of data for hydraulic permeability, internal filtration flow rate and solute removal efficiency during the experiments. Time dependency of those performances seems to be induced by membrane fouling, namely, protein plugging to the membrane.We have developed an analytical model for estimating the dialyzer performances based on mass transport and momentum change in the dialyzer. And some parameters such as hydraulic permeability were determined using the fitting method to the experimental data.During our study, we have reached some conclusionsDevelopment of fundamental techniques and collecting some knowledge are done for the dialysis system with navigator at home. Development of a dialysis machine with navigation system is required for optimum dialysis for each patient in the near future.