Advanced surfaces for next generation hemodialysis technology.

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Although it is effective for sustaining life, modern hemodialysis has several important limitations. First, it is extremely expensive - average costs per patient exceed $120,000 per year, and may be substantially higher if complications occur. Second, it is associated with very high mortality - life expectancy for a 20-year-old hemodialysis patient is similar to life expectancy for a 75-year-old person with normal kidney function. Third, hemodialysis treatment leads to exceedingly poor quality of life - the average hemodialysis patient would trade ten years of life on hemodialysis for six years of life in normal health. Fourth, there are no means of diagnosing effectiveness of dialysis in the clinic - only two uremic toxins are evaluated using mass spectroscopy approaches. Fifth, although uremic toxins are recognized as contributors to progressive kidney dysfunction there are no known approaches for targeting these molecules to remove them from patient blood. Sixth, membrane approaches will never clear some of these toxins as they become closely associated with proteins. We need to advance dialysis technology to overcome significant costs to patients, the healthcare system, and environmental damage associated to hemodialysis.To overcome this problem state-of-the-art techniques for engineering new polymer-modified surfaces will be used to bind and remove uremic toxins from blood - competing with proteins as artificial binders of these toxins. This will be accomplished by forming artificial binding pockets using both polymer and biopolymer architectures for the sole purpose of developing reusable surfaces that bind uremic toxins. Unsworth labs has extensive experience in building polymers on surfaces as required for this approach. We will move this advanced technology to new products in the area of off-line diagnostics, in-line diagnostics, and increased therapeutic potential by augmenting existing membrane dialysis technology.