Advanced surfaces for next generation hemodialysis technology.

尽管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，它极其昂贵--每个患者每年的平均费用超过12万美元，如果出现并发症，可能会大大高于这一数字。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肾功能正常的75岁老人的预期寿命相似。第三，血液透析治疗导致极低的生活质量--平均每个血液透析患者愿意用十年的血液透析生命换取正常健康状态下的六年生命。第四，临床上没有诊断透析有效性的方法--只有两种尿毒症毒素用质谱学方法进行评估。第五，尽管尿毒症毒素被认为是进行性肾功能障碍的诱因，但还没有已知的方法来靶向这些分子来将它们从患者血液中移除。第六，膜方法永远不会清除这些毒素中的一些，因为它们与蛋白质密切相关。我们需要发展透析技术，以克服患者、医疗保健系统和与血液透析相关的环境破坏的巨大成本。为了克服这个问题，设计新的聚合物修饰表面的最先进技术将被用于结合和去除血液中的尿毒症毒素-与作为这些毒素的人工结合剂的蛋白质竞争。这将通过使用聚合物和生物聚合物结构形成人工结合口袋来实现，其唯一目的是开发结合尿毒症毒素的可重复使用的表面。Unsworth实验室在这种方法所需的表面上构建聚合物方面拥有丰富的经验。我们将把这项先进技术转移到离线诊断、在线诊断领域的新产品，并通过增强现有的膜透析技术来增加治疗潜力。

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.