Advanced surfaces for next generation hemodialysis technology.

虽然现代血液透析对维持生命是有效的，但它有几个重要的局限性。首先，它非常昂贵——每位患者每年的平均费用超过12万美元，如果发生并发症，费用可能会高得多。其次，它与非常高的死亡率有关——20岁血液透析患者的预期寿命与75岁肾功能正常的人的预期寿命相似。第三，血液透析治疗导致生活质量极差-平均血液透析患者将用10年的血液透析生命换取6年的正常健康生命。第四，在临床中没有诊断透析有效性的方法-只有两种尿毒症毒素使用质谱方法进行评估。第五，尽管尿毒症毒素被认为是进行性肾功能障碍的原因，但目前还没有已知的方法可以靶向这些分子将其从患者血液中清除。第六，膜方法永远无法清除这些毒素，因为它们与蛋白质密切相关。我们需要推进透析技术，以克服与血液透析相关的患者、医疗保健系统和环境损害的巨大成本。

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.