Disruptive Innovationen in der Nierenersatztherapie

Zusammenfassung

Die aktuellen Methoden der Nierenersatztherapie weisen erhebliche Defizite auf, die dringend innovative Lösungen erfordern. Das Ziel ist eine grundlegende Transformation der Dialyse, um eine nachhaltige, patientenzentrierte und zugleich effiziente Behandlung zu gewährleisten. Bahnbrechende Fortschritte werden insbesondere in den Bereichen der Patientenautonomie – durch selbstbestimmte Wahl von Zeit und Ort der Dialyse – sowie in der Mobilität der Behandlungsmethoden erwartet. Neuartige tragbare Dialysegeräte stehen kurz vor der Marktreife und ebnen den Weg für weitere bedeutende Verbesserungen: von der Hämodialyse ohne Punktion bis hin zur vollständigen Nachahmung der Funktion gesunder Nieren. Damit diese revolutionären Entwicklungen Realität werden, sind dringend Anpassungen der politischen und wirtschaftlichen Rahmenbedingungen erforderlich. Solche Reformen sind nicht nur im Interesse der Patienten, sondern auch der Gesundheitssysteme, da ganzheitliche Verbesserungen der Therapien sowohl Kosten senken als auch die effiziente Nutzung verfügbarer Ressourcen gewährleisten können.

Publication History

Article published online:
18 June 2025

• Literatur

• 1 Webster AC, Nagler EV, Morton RL. et al. Chronic Kidney Disease. Lancet 2017; 389: 1238-1252
• 2 Vanholder R, Annemans L, Braks M. et al. Inequities in kidney health and kidney care. Nat Rev Nephrol 2023; 19: 694-708
• 3 Vanholder R, Annemans L, Bello AK. et al. Fighting the unbearable lightness of neglecting kidney health: the decade of the kidney. Clin Kidney J 2021; 14: 1719-1730
• 4 Himmelfarb J, Vanholder R, Mehrotra R. et al. The current and future landscape of dialysis. Nat Rev Nephrol 2020; 16: 573-585
• 5 Jha V, Al-Ghamdi SMG, Li G. et al. Global Economic Burden Associated with Chronic Kidney Disease: A Pragmatic Review of Medical Costs for the Inside CKD Research Programme. Adv Ther 2023; 40: 4405-4420
• 6 Levin A, Tonelli M, Bonventre J. et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet 2017; 390: 1888-1917
• 7 Wieringa FP, Sheldon M. The Kidney Health Initiative innovation roadmap for renal replacement therapies: Building the yellow brick road, while updating the map. Artif Organs 2020; 44: 111-122
• 8 Vanholder R, Conway PT, Gallego D. et al. The European Kidney Health Alliance (EKHA) and the Decade of the KidneyTM. Nephrol Dial Transplant 2023; 38: 1113-1122
• 9 Vanholder R, Agar J, Braks M. et al. The European Green Deal and nephrology: a call for action by the European Kidney Health Alliance. Nephrol Dial Transplant 2023; 38: 1080-1088
• 10 Canaud B, Kooman JP, Selby NM. et al. Hidden risks associated with conventional short intermittent hemodialysis: A call for action to mitigate cardiovascular risk and morbidity. World J Nephrol 2022; 11: 39-57
• 11 Vanholder R, Pletinck A, Schepers E. et al. Biochemical and Clinical Impact of Organic Uremic Retention Solutes: A Comprehensive Update. Toxins 2018; 10: 33
• 12 Yamamoto S, Kazama JJ, Wakamatsu T. et al. Removal of uremic toxins by renal replacement therapies: a review of current progress and future perspectives. Ren Replace Ther 2016; 2: 43
• 13 Mehrotra R, Davison SN, Farrington K. et al. Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int 2023; 104: 441-454
• 14 Kalantar-Zadeh K, Lockwood MB, Rhee CM. et al. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nat Rev Nephrol 2022; 18: 185-198
• 15 Perl J, Brown EA, Chan CT. et al. Home dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int 2023; 103: 842-858
• 16 Brown EA, Brivio GB, Van Biesen W. Towards a better uptake of home dialysis in Europe: understanding the present and looking to the future. Clin Kidney J 2024; 17: i3-i12
• 17 Nissenson AR, Chertow GM, Conway PT. Breaking the Barriers to Innovation in Kidney Care: The Time is Now. CJASN 2022; 17: 591-593
• 18 Institut des Bewertungsausschusses. Beschluss des Bewertungsausschusses nach § 87 Abs. 1 Satz 1 SGB V in seiner 753. Sitzung am 11. Dezember 2024 zur Änderung des Einheitlichen Bewertungsmaßstabes (EBM) mit Wirkung zum 1. Januar 2025. Im Internet: Accessed March 19, 2025 at: https://institut-ba.de/ba/babeschluesse/2024–12–11_ba753.pdf
• 19 Blüchel C. Sorbent-Technologie in der Heimdialyse. In: 14. Kölner Heimdialyse Kongress des KfH. Köln: 2024
• 20 Wieringa FP, Bolhuis D, Søndergaard H. et al. Transportable, portable, wearable and (partially) implantable haemodialysis systems: comparison of technologies and readiness levels. Clin Kidney J 2024; 17: sfae259
• 21 Ramada DL, de Vries J, Vollenbroek J. et al. Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges. Nat Rev Nephrol 2023; 19: 481-490
• 22 Groth T, Stegmayr BG, Ash SR. et al. Wearable and implantable artificial kidney devices for end-stage kidney disease treatment: Current status and review. Artif Organs 2023; 47: 649-666
• 23 Kitsche B, Bach D. Heimhämodialyse: Aktuelle Aspekte und Wandel in der Nierenersatztherapie. Nephrologe 2021; 16: 292-298
• 24 Haroon S, Davenport A. Haemodialysis at home: review of current dialysis machines. Expert Rev Med Devices 2018; 15: 337-347
• 25 NxStage System One. Im Internet: Accessed March 19, 2025 at: https://freseniusmedicalcare.com/en-us/products/treating-with-home-hemodialysis/home-hemodialysis-products/nxstage-system-one/
• 26 Your home daily hemodialysis solution. PHYSIDIA. Im Internet: Accessed March 19, 2025 at: https://www.physidia.com/en/your-home-daily-haemodialysis-solution/
• 27 Quanta Dialysis Technologies: Trinal Kidney Therapy. Quanta Dialysis Technologies – Simply Smarter DialysisTM – US 2024. Im Internet: Accessed March 19, 2025 at: https://quantadt.com/us/
• 28 Tablo Hemodialysis System. Outset Medical. Im Internet: Accessed March 19, 2025 at: https://www.outsetmedical.com/tablo/
• 29 DIMI product for home dialysis, peritoneal and hemodialysis. Im Internet: Accessed March 19, 2025 at: https://www.infomed.swiss/en/products/dimi.php
• 30 Moda-flx. Im Internet: Accessed March 19, 2025 at: https://www.diality.com/moda-flx
• 31 Bonenkamp AA, Van Eck Van Der Sluijs A, Hoekstra T. et al. Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis. Kidney Med 2020; 2: 139-154
• 32 Home hemodialysis. Nextkidney. Im Internet: Accessed January 23, 2025 at: https://nextkidney.com/
• 33 Kooman JP. The Revival of Sorbents in Chronic Dialysis Treatment. Semin Dial 2024; sdi.13203
• 34 Ash SR. Innovation in the Treatment of Uremia: Proceedings from the Cleveland Clinic Workshop: Sorbents in Treatment of Uremia: A Short History and a Great Future. Semin Dial 2009; 22: 615-622
• 35 Roberts M, Lee DBN, Ash S. et al. Sorbent Dialysis and the Wearable Artificial Kidney. In: Dialysis: History, Development and Promise. World Scient; 2012: 811-819
• 36 Van Gelder MK, Jong JAW, Folkertsma L. et al. Urea removal strategies for dialysate regeneration in a wearable artificial kidney. Biomaterials 2020; 234: 119735
• 37 Association for the Advancement of Medical Instrumentation. Sorbent-based regenerative hemodialysis systems. AAMI TIR77 2018;
• 38 DIN EN 60601–1:2022–11: Medizinische elektrische Geräte – Teil 1: Allgemeine Festlegungen für die Sicherheit einschließlich der wesentlichen Leistungsmerkmale. VDE 2022
• 39 Finkelstein FO, Schiller B, Daoui R. et al. At-home short daily hemodialysis improves the long-term health-related quality of life. Kidney Int 2012; 82: 561-569
• 40 Lau TW, Bluechel C, Khaopaibul P. et al. First-in-Human Trial of the NeoKidney Portable Hemodialysis Device Sorbent System: FR-OR23. In: ASN Kidney Week. San Diego: 2024. Im Internet: Accessed March 19, 2025 at: https://journals.lww.com/jasn/fulltext/2024/10001/first_in_human_trial_of_the_neokidney_portable.130.aspx
• 41 Ficheux M. Régénération du dialysat pour hémodialyse. In: 9ÈME CONGRÈS ANNUEL DE LA SFNDT. Bordeaux: 2024. Im Internet: Accessed March 19, 2025 at: https://www.adhesion.sfndt.org/session/media/regeneration-du-dialysat-pour-hemodialyse
• 42 Canaud B, Kooman J, Maierhofer A. et al. Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes. Front Nephrol 2022; 2: 935388
• 43 Pudil BJ, Lyu S, Grovender E. et al. Method of Zirconium Phosphate Recharging. 2018 Im Internet: Accessed March 19, 2025 at: https://patentscope.wipo.int/search/en/detail.jsf?docId=US154006766&_cid=P11-M9L3QD-46435–1
• 44 Salani M, Roy S, Fissell WH. Innovations in Wearable and Implantable Artificial Kidneys. Am J Kidney Dis 2018; 72: 745-751
• 45 Rivara MB, Himmelfarb J. From Home to Wearable Hemodialysis: Barriers, Progress, and Opportunities. CJASN 2024; 19: 1488-1495
• 46 Davenport A, Gura V, Ronco C. et al. A wearable haemodialysis device for patients with end-stage renal failure: a pilot study. Lancet 2007; 370: 2005-2010
• 47 Gura V, Rivara MB, Bieber S. et al. A wearable artificial kidney for patients with end-stage renal disease. JCI Insight 2016; 1
• 48 Products | Changing Kidney Care Forever | Vivance. Im Internet: Accessed January 24, 2025 at: https://vivance.com/products/
• 49 Technology – Nanodialysis – Dialysis and blood purification. Im Internet: Accessed March 19, 2025 at: https://www.nanodialysis.nl/technology/
• 50 Huang Y, Zhang H, Yang X. et al. A review: current urea sorbents for the development of a wearable artificial kidney. J Mater Sci 2024; 59: 11669-11686
• 51 Shao G, Himmelfarb J, Hinds BJ. Strategies for optimizing urea removal to enable portable kidney dialysis: A reappraisal. Artif Organs 2022; 46: 997-1011
• 52 Ma Y, Li S, Tonelli M. et al. Adsorption-based strategies for removing uremic toxins from blood. Microporous and Mesoporous Materials 2021; 319: 111035
• 53 Jong JAW, Guo Y, Veenhoven C. et al. Phenylglyoxaldehyde-Functionalized Polymeric Sorbents for Urea Removal from Aqueous Solutions. ACS Appl Polym Mater 2020; 2: 515-527
• 54 Jong JAW, Guo Y, Hazenbrink D. et al. A Ninhydrin-Type Urea Sorbent for the Development of a Wearable Artificial Kidney. Macromol Biosci 2020; 20: e1900396
• 55 Shao G, Zang Y, Hinds BJ. TiO2 Nanowires Based System for Urea Photodecomposition and Dialysate Regeneration. ACS Appl Nano Mater 2019; 2: 6116-6123
• 56 Vollenbroek JC, Rodriguez AP, Mei BT. et al. Light-driven urea oxidation for a wearable artificial kidney. Catalysis Today 2023; 419: 114163
• 57 US Kidney Research Corp | Artificial Kidney Research & Development. US Kidney Research. Im Internet: Accessed March 19, 2025 at: https://www.uskidneyresearchcorp.com
• 58 Inc QL. Qidni Labs Inc. Qidni Labs Inc.. . Im Internet: Accessed March 19, 2025 at: https://qidni.life/
• 59 Prize Winners Archive. KidneyX. Im Internet: Accessed March 19, 2025 at: https://www.kidneyx.org/prize-winners/
• 60 Fabiani T, Zarghamidehaghani M, Boi C. et al. Sorbent-based dialysate regeneration for the wearable artificial kidney: Advancing material innovation via experimental and computational studies. Separation and Purification Technology 2025; 360: 130776
• 61 Fabiani T, Ricci E, Boi C. et al. In silico screening of nanoporous materials for urea removal in hemodialysis applications. Phys Chem Chem Phys 2023; 25: 24069-24080
• 62 Garg R, Vitale F. Latest advances on MXenes in biomedical research and health care. MRS Bulletin 2023; 48: 283-290
• 63 Meng F, Seredych M, Chen C. et al. MXene Sorbents for Removal of Urea from Dialysate: A Step toward the Wearable Artificial Kidney. ACS Nano 2018; 12: 10518-10528
• 64 Zhao Q, Seredych M, Precetti E. et al. Adsorption of Uremic Toxins Using Ti3C2T MXene for Dialysate Regeneration. ACS Nano 2020; 14: 11787-11798
• 65 Anasori B, Gogotsi Y. Hrsg. 2 D Metal Carbides and Nitrides (MXenes): Structure, Properties and Applications. Cham: Springer; 2019
• 66 Jahromi AM, Khedri M, Ghasemi M. et al. Molecular insight into COF monolayers for urea sorption in artificial kidneys. Sci Rep 2021; 11: 12085
• 67 Karimi K, Rahsepar M. Optimization of the Urea Removal in a Wearable Dialysis Device Using Nitrogen-Doped and Phosphorus-Doped Graphene. ACS Omega 2022; 7: 4083-4094
• 68 Zhang J, Yan B, He C. et al. Urease-Immobilized Magnetic Graphene Oxide as a Safe and Effective Urea Removal Recyclable Nanocatalyst for Blood Purification. Ind Eng Chem Res 2020; 59: 8955-8964
• 69 De Pascale M, De Angelis M, Boi C. Mixed Matrix Membranes Adsorbers (MMMAs) for the Removal of Uremic Toxins from Dialysate. Membranes 2022; 12: 203
• 70 Geremia I, Stamatialis D. Innovations in dialysis membranes for improved kidney replacement therapy. Nat Rev Nephrol 2020; 16: 550-551
• 71 Ter Beek OEM, Van Gelder MK, Lokhorst C. et al. In vitro study of dual layer mixed matrix hollow fiber membranes for outside-in filtration of human blood plasma. Acta Biomater 2021; 123: 244-253
• 72 The Kidney Project. The Kidney Project. University of California: Im Internet: Accessed January 24, 2025 at: https://pharm.ucsf.edu/kidney
• 73 KIDNEW. imec. Im Internet: Accessed March 19, 2025 at: https://www.imec-int.com/en/kidnew
• 74 About | Kidnew. Im Internet: Accessed March 19, 2025 at: https://www.kidnew.eu/about/
• 75 Pino CJ, Humes HD. Bioartificial Kidneys, Renal Epithelial Cell Systems, and Biomimetic Membrane Devices. In: Bezerra da Silva Junior G, Nangaku M. Hrsg. Innovations in Nephrology: Breakthrough Technologies in Kidney Disease Care. Cham: Springer; 2022: 217-236
• 76 Humes HD, Buffington D, Westover AJ. et al. The bioartificial kidney: current status and future promise. Pediatr Nephrol 2014; 29: 343-351
• 77 Nissenson AR, Ronco C, Pergamit G. et al. The Human Nephron Filter: Toward a Continuously Functioning, Implantable Artificial Nephron System. Blood Purif 2005; 23: 269-274
• 78 Kensinger C, Karp S, Kant R. et al. First Implantation of Silicon Nanopore Membrane Hemofilters. ASAIO J 2016; 62: 491-495
• 79 Moyer J, Wilson MW, Sorrentino TA. et al. Renal Embolization-Induced Uremic Swine Model for Assessment of Next-Generation Implantable Hemodialyzers. Toxins 2023; 15: 547
• 80 Kim EJ, Chen C, Gologorsky R. et al. Feasibility of an implantable bioreactor for renal cell therapy using silicon nanopore membranes. Nat Commun 2023; 14: 4890
• 81 Sánchez-Ospina D, Mas-Fontao S, Gracia-Iguacel C. et al. Displacing the Burden: A Review of Protein-Bound Uremic Toxin Clearance Strategies in Chronic Kidney Disease. JCM 2024; 13: 1428
• 82 Rosner MH, Reis T, Husain-Syed F. et al. Classification of Uremic Toxins and Their Role in Kidney Failure. CJASN 2021; 16: 1918-1928
• 83 Ahmed S, De Vries JC, Lu J. et al. Animal Models for Studying Protein-Bound Uremic Toxin Removal—A Systematic Review. IJMS 2023; 24: 13197
• 84 Ash SR. Precision Hemodialysis Using Sorbents to Remove Protein-Bound Uremic Toxins. Kidney360 2023; 4: e715-e716
• 85 Meyer TW, Lee S, Whitmer LC. et al. Increasing the Clearance of Protein-Bound Solutes by Recirculating Dialysate through Activated Carbon. Kidney360 2023; 4: e744-e750
• 86 Rodrigues FSC, Faria M. Adsorption- and Displacement-Based Approaches for the Removal of Protein-Bound Uremic Toxins. Toxins 2023; 15: 110
• 87 Saar-Kovrov V, Zidek W, Orth-Alampour S. et al. Reduction of protein-bound uraemic toxins in plasma of chronic renal failure patients: A systematic review. J Intern Med 2021; 290: 499-526
• 88 MI-TRAM: Smart Module for Implantable, Wearable, Portable, or Bedside Artificial Kidneys. KidneyX. Im Internet: Accessed March 19, 2025 at: https://www.kidneyx.org/prize-winners/mi-tram-smart-module/
• 89 Madero M, Cano KB, Campos I. et al. Removal of Protein-Bound Uremic Toxins during Hemodialysis Using a Binding Competitor. CJASN 2019; 14: 394-402
• 90 Research Innovations. Im Internet: Accessed January 24, 2025 at: https://renalresearch.com/research/research-innovations/
• 91 Nobakht E, Raru W, Dadgar S. et al. Precision Dialysis: Leveraging Big Data and Artificial Intelligence. Kidney Med 2024; 6: 100868
• 92 Fayos De Arizón L, Viera ER, Pilco M. et al. Artificial intelligence: a new field of knowledge for nephrologists?. Clin Kidney J 2023; 16: 2314-2326
• 93 Yuan Q, Zhang H, Deng T. et al. Role of Artificial Intelligence in Kidney Disease. Int J Med Sci 2020; 17: 970-984
• 94 Zhang H, Wang L-C, Chaudhuri S. et al. Real-time prediction of intradialytic hypotension using machine learning and cloud computing infrastructure. Nephrol Dial Transplant 2023; 38: 1761-1769
• 95 Jimenez R. Fresenius Medical Care erreicht wichtigen KI-Meilenstein mit Abschluss der ersten Phase der weltweit größten klinischen Dialysedatenbank. Presseinformation: Fresenius. Im Internet: Accessed March 19, 2025 at: https://www.fresenius.com/sites/default/files/2023–10/2023–10–26_%20Apollo%20Database_Pressemitteilung.FINAL_.pdf
• 96 DaVita Seeks to Transform Kidney Care Management With New CWOWTM Technology Platform. DaVita Newsroom. Im Internet: Accessed March 19, 2025 at: https://newsroom.davita.com/Technology-Center-Without-Walls
• 97 Lew SQ, Ronco C. Use of eHealth and remote patient monitoring: a tool to support home dialysis patients, with an emphasis on peritoneal dialysis. Clin Kidney J 2024; 17: i53-i61
• 98 Kooman JP, Wieringa FP, Han M. et al. Wearable health devices and personal area networks: can they improve outcomes in haemodialysis patients?. Nephrol Dial Transplant 2020; 35: ii43-ii50
• 99 Wieringa FP, Kooman JP. Smart sensors for real-time monitoring of patients on dialysis. Nat Rev Nephrol 2020; 16: 554-555
• 100 Foo MWY, Htay H. Innovations in peritoneal dialysis. Nat Rev Nephrol 2020; 16: 548-549
• 101 Sharma S, Shamy OE, Wilmington A. et al. Performance Evaluation of an Automated Peritoneal Dialysis Solution Generation System in Patients Using Automated Peritoneal Dialysis. Kidney Int Reports 2024; 9: 1752-1757
• 102 Htay H, Gow SK, Jayaballa M. et al. Preliminary safety study of the Automated Wearable Artificial Kidney (AWAK) in Peritoneal Dialysis patients. Perit Dial Int 2022; 42: 394-402
• 103 Foo MWY, Brown EA, Jain A. et al. Prepivotal Study Exploring Safety, Efficacy, and Usability of the Automated Wearable Artificial Kidney (AWAK) PD Device. In: ASN Kidney Week. San Diego: 2024. Im Internet: Accessed March 19, 2025 at: https://journals.lww.com/jasn/fulltext/2024/10001/prepivotal_study_exploring_safety,_efficacy,_and.69.aspx
• 104 Gerritsen K. WEAKID – Clinical validation of miniature wearable dialysis machine – H2020. impact 2018; 2018: 55-57
• 105 Tonelli M, Wiebe N, Knoll G. et al. Systematic Review: Kidney Transplantation Compared With Dialysis in Clinically Relevant Outcomes. Am J Transplant 2011; 11: 2093-2109
• 106 Mohan S, Chiles MC, Patzer RE. et al. Factors leading to the discard of deceased donor kidneys in the United States. Kidney Int 2018; 94: 187-198
• 107 Cooper DKC, Riella LV, Kawai T. et al. The Time Has Come: The Case for Initiating Pilot Clinical Trials of Pig Kidney Xenotransplantation. Ann Surg 2025; 281: 204-209
• 108 Yang S, Zhang M, Wei H. et al. Research prospects for kidney xenotransplantation: a bibliometric analysis. Ren Fail 2024; 46: 2301681
• 109 Cooper DKC, Hara H. Xenotransplantation—A Basic Science Perspective. Kidney360 2023; 4: 1147-1149
• 110 Zhou Q, Li T, Wang K. et al. Current status of xenotransplantation research and the strategies for preventing xenograft rejection. Front Immunol 2022; 13: 928173
• 111 Cooper DKC, Pierson RN. Milestones on the path to clinical pig organ xenotransplantation. Am J Transplant 2023; 23: 326-335
• 112 Xi J, Zheng W, Chen M. et al. Genetically engineered pigs for xenotransplantation: Hopes and challenges. Front Cell Dev Biol 2023; 10: 1093534
• 113 Anderson DJ, Jones-Carr M, Perry J. et al. Genetically Modified Porcine Kidneys Have Sufficient Tissue Integrity for Use in Pig-to-Human Xenotransplantation. Ann Surg 2024;
• 114 Raza SS, Hara H, Eyestone W. et al. Pigs in Transplantation Research and Their Potential as Sources of Organs in Clinical Xenotransplantation. Comp Med 2024; 74: 33-48
• 115 Kuta S. An Alabama Woman Got a Gene-Edited Pig Kidney Transplant. Three Weeks Later, She Has „Never Felt Better“ | Smithsonian. 2024 Im Internet: Accessed March 19, 2025 at: https://www.smithsonianmag.com/smart-news/an-alabama-woman-got-a-gene-edited-pig-kidney-transplant-three-weeks-later-she-has-never-felt-better-180985692/
• 116 Neergaard L. An Alabama woman is doing well after the latest experimental pig kidney transplant. AP News 2024 Im Internet: Accessed January 22, 2025 at: https://apnews.com/article/pig-kidney-transplant-xenotransplant-revivicor-844b33450a9c228d1138827c1de8549d
• 117 Cooper DKC, Kobayashi T. Xenotransplantation experiments in brain-dead human subjects–A critical appraisal. Am J Transplant 2024; 24: 520-525
• 118 Anand RP, Layer JV, Heja D. et al. Design and testing of a humanized porcine donor for xenotransplantation. Nature 2023; 622: 393-401
• 119 Kano M, Mizutani E, Homma S. et al. Xenotransplantation and interspecies organogenesis: current status and issues. Front Endocrinol 2022; 13: 963282
• 120 Little MH, Rabelink TJ. Replacing renal function using bioengineered tissues. Nat Rev Bioeng 2023; 1: 576-588
• 121 Wragg NM, Burke L, Wilson SL. A critical review of current progress in 3 D kidney biomanufacturing: advances, challenges, and recommendations. Ren Replace Ther 2019; 5: 18
• 122 Nonaka T, Nagaishi Y, Murata D. et al. 3 D Printing in Nephrology. In: Bezerra da Silva Junior G, Nangaku M. Hrsg. Innovations in Nephrology: Breakthrough Technologies in Kidney Disease Care. Cham: Springer; 2022: 141-156
• 123 Yamanaka S, Yokoo T. Generation of Whole Kidney and Other Possible Strategies to Renal Replacement Therapy in the Future. In: Bezerra da Silva Junior G, Nangaku M. Hrsg. Innovations in Nephrology: Breakthrough Technologies in Kidney Disease Care. Cham: Springer; 2022: 201-216
• 124 Novikoff S, Câmara NOS, Semedo-Kuriki P. Stem Cells: Use in Nephrology. In: Bezerra da Silva Junior G, Nangaku M. Hrsg. Innovations in Nephrology: Breakthrough Technologies in Kidney Disease Care. Cham: Springer; 2022: 29-67
• 125 Correa-Rotter R, Wheeler DC, McEwan P. The Broader Effects of Delayed Progression to End-Stage Kidney Disease: Delaying the Inevitable or a Meaningful Change?. Advances in Therapy 2024; 41: 3739
• 126 Kalantar-Zadeh K, Bellizzi V, Piccoli GB. et al. Caring for Patients With Advanced Chronic Kidney Disease: Dietary Options and Conservative Care Instead of Maintenance Dialysis. J Ren Nutr 2023; 33: 508-519
• 127 Rhee CM, Edwards D, Ahdoot RS. et al. Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings. Kidney Int Rep 2022; 7: 1951-1963
• 128 Zarantonello D, Rhee CM, Kalantar-Zadeh K. et al. Novel conservative management of chronic kidney disease via dialysis-free interventions. Curr Opin Nephrol Hypertens 2021; 30: 97
• 129 Laville SM, Massy ZA, Kamel S. et al. Intestinal Chelators, Sorbants, and Gut-Derived Uremic Toxins. Toxins 2021; 13: 91
• 130 Berillo D, Ermukhambetova A. The review of oral adsorbents and their properties. Adsorption 2024; 30: 1-23
• 131 Morales E, Cravedi P, Manrique J. Management of Chronic Hyperkalemia in Patients With Chronic Kidney Disease: An Old Problem With News Options. Front Med (Lausanne) 2021; 8: 653634
• 132 Zhang Y, Xu R, Wang F. et al. Effects and Safety of a Novel Oral Potassium-Lowering Drug-Sodium Zirconium Cyclosilicate for the Treatment of Hyperkalemia: a Systematic Review and Meta-Analysis. Cardiovasc Drugs Ther 2021; 35: 1057-1066
• 133 Sekercioglu N, Thabane L, Díaz Martínez JP. et al. Comparative Effectiveness of Phosphate Binders in Patients with Chronic Kidney Disease: A Systematic Review and Network Meta-Analysis. PLoS ONE 2016; 11: e0156891
• 134 Yamaguchi J, Tanaka T, Inagi R. Effect of AST-120 in Chronic Kidney Disease Treatment: Still a Controversy?. Nephron 2017; 135: 201-206
• 135 Kee YK, Han SY, Kang D-H. et al. Comparison of Different Types of Oral Adsorbent Therapy in Patients with Chronic Kidney Disease: A Multicenter, Randomized, Phase IV Clinical Trial. Yonsei Med J 2021; 62: 41
• 136 Richards E, Ye S-H, Ash SR. et al. A Perfluorocarbon-Coated ZrP Cation Exchanger with Excellent Ammonium Selectivity and Chemical Stability: An Oral Sorbent for End-Stage Kidney Disease (ESKD). Langmuir 2023; 39: 7912-7921
• 137 Ash SR. Oral sorbents for small, charged uremic toxins, and carbon block for regeneration of dialysate: Fourth down and long. Artif Organs 2023; 47: 217-221
• 138 Song Y, Ye S-H, Ash SR. et al. Thermal Vapor Deposition of a Hydrophobic and Gas-Permeable Membrane on Zirconium Phosphate Cation Exchanger: An Oral Sorbent for the Urea Removal of Kidney Failure. Langmuir 2024; 40: 16502-16510
• 139 Chan CT, Collins K, Ditschman EP. et al. Overcoming Barriers for Uptake and Continued Use of Home Dialysis: An NKF-KDOQI Conference Report. Am J Kidney Dis 2020; 75: 926-934
• 140 Poinen K, Mitra S, Quinn RR. The integrated care model: facilitating initiation of or transition to home dialysis. Clin Kidney J 2024; 17: i13-i20
• 141 Gedney N, Sipma W, Søndergaard H. Innovations in dialysis: the user’s perspective. Nat Rev Nephrol 2020; 16: 544-545
• 142 Hope J. A patient perspective on the barriers to home dialysis. J Ren Care 2013; 39: 3-8
• 143 Urquhart-Secord R, Craig JC, Hemmelgarn B. et al. Patient and Caregiver Priorities for Outcomes in Hemodialysis: An International Nominal Group Technique Study. Am J Kidney Dis 2016; 68: 444-454
• 144 Weiner DE, Delgado C, Flythe JE. et al. Patient-Centered Quality Measures for Dialysis Care: A Report of a Kidney Disease Outcomes Quality Initiative (KDOQI) Scientific Workshop Sponsored by the National Kidney Foundation. Am J Kidney Dis 2024; 83: 636-647
• 145 Wieringa FP, Sheldon MI, Hidalgo-Simon A. Regulatory approaches to stimulate innovative renal replacement therapies. Nat Rev Nephrol 2020; 16: 546-547
• 146 Htay H, Alrukhaimi M, Ashuntantang GE. et al. Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project. Kidney Int Suppl 2018; 8: 64-73