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Comment by hutzlibu | Hacker News Reader

That looks interesting, but the linked article is a bit short on details, but high on praise.

For example I would like to know, if the goal is, to actually put this inside of people?

Currently it is smartphone sized. That might work, but only if the person moves not much, because it does not seem flexible. And having a stiff smartphone in your body would mean moving like a old school robot. That still might beat the alternative, but would be a serious limitation. Maybe they get it smaller and more flexible - then I would be curious how long the bioreactor and hemofilter lasts, before they need replacement? Because that means dangerous surgery.

So the first versions would be probably carried outside the body and connected to your arteries?

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Leaving aside that it's very early days for this technology, kidneys aren't all that flexible, either. Kidney swelling or inflammation is as painful as it is (and it is very painful) because the kidney is enclosed in a protective capsule of tough connective tissue, which makes it unable to increase significantly in total volume. (This is also why kidney swelling is a medical emergency, especially when bilateral and regardless of cause: in addition to being painful, severe swelling occludes blood vessels and causes tissue-killing ischemia, which can result in partial or total loss of function.)

A kidney isn't all that different in length on the major axis from a smartphone, either, and in volume is larger besides. Speaking as someone with recurrent kidney trouble, if things do get bad enough and I can't get on the transplant list due to age or comorbidity, I'd rather take a chance on something like this than suffer the known drawbacks of periodic dialysis, especially the all but guaranteed progressive impairment of cognition.

>>especially the all but guaranteed progressive impairment of cognition

Could you expand a bit more on this? What causes the impairment in cognition?

"Filtering the Evidence: Is There a Cognitive Cost of Hemodialysis?" (https://jasn.asnjournals.org/content/29/4/1087) reviews recent research and finds cognitive impairment both significant and prevalent as a side effect of in-center hemodialysis (as opposed to peritoneal dialysis, which is less harmful). It cites among other things an RCT result entitled "Cognitive impairment in hemodialysis patients is common" (https://pubmed.ncbi.nlm.nih.gov/16864811/), which is frequently cited in studies and articles reviewing this phenomenon; the "Cited by" list on that page is a fertile ground for further review.

Dirty blood is toxic to many organs. The ears, eyes, and nose will all degrade along with the mind as kidneys fail. The worst is that dirty blood is toxic to the kidneys, so failing kidneys cause kidney failure.

This is actually an internal artificial kidney. There are other projects like you describe. https://pharm.ucsf.edu/kidney/device/faq has some helpful info about this.

This would basically replace dialysis if they are able to achieve the numbers they quote (GFR of 20-30). Occasionally having a minor surgery is likely much safer and more affordable than dialysis.

You know, I have never actually considered this aspect of "cyborg-life". Given how much I slouch at desks all day, yeh, a life saving kidney digging in my ribs would get annoying !

I suspect it would just be an internal version of the parental "stop slouching dear". Users might report better backs as well as kidneys !

And just to be clear, Science and medicine makes amazing advances each day and decade. I am astonished by the idea this even is close to working.

" Users might report better backs as well as kidneys !"

I doubt that. A healthy back needs twisting and bending in all directions.

I'm really having to rein in my SWE-desire to start pitching "what if we just" fixes to this thread.

when you're in the situation where you need a kidney replacement uncomfortable positions are the least of your worries.

Like you said: I'm amazed by the fact that were close to having a replacement. Not sure how many will be able to afford it but still. It's one step forward.

And not having the side effects and ongoing costs of imunosupressant drugs - It will be very good for BAME communities that have problems with low % of compatible donors.

I've seen the pain and eventual death 2 close family members have had to suffer due to Kidney failure and I also will face the same as my kidneys continue to gradually fail, the complications are bad and side effects can lead to death alone, the limitations of sometime like this artificial Kidney are absolutely miniscule compared to the benefits on offer.

My kidneys are failing as well. I am currently being evaluated to be on transplant list. Artificial kidney is an exciting development. It wont replace the need for transplant but will definitely improve quality of life for people on dialysis.

I wish all the best to you two!

To deal with the inflexibility, it could be encased in a soft artificial shell.

Does it have to be implanted within the body?

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