New Delhi: US-based Indian origin researcher Shuvo Roy has created the world's first implantable artificial kidney. What's sensational about Roy's creation is that the organ, no larger than a coffee cup, will be able to mimic the kidney's most vital functions like filtering toxins out of the bloodstream, regulate blood pressure and produce the all- important vitamin D.
The artificial kidney has been tested successfully on a small number of animals. Large-scale trials on animals and humans are expected over the next five years. Once available, and if affordable, this creation by the Roy-led team at University of California will do away with the need for kidney dialysis.
This will be a boon for all patients with chronic kidney disease (CKD). At present in India, of the 1.5 lakh new patients who suffer from end-stage renal failure annually, only 3,500 get kidney transplants and 6,000-10,000 undergo dialysis. The rest perish due to an acute shortage of dialysis centres and nephrologists to man them.
CKD is rising at a rapid pace in India and the majority of those who perish are either unable to find a suitable organ for transplantation or are unable to pay for the high dialysis costs.
According to Roy, the device has a filtration section to remove toxins from the blood, alongside a compartment with renal cells to conduct other functions of a kidney. He believes the artificial kidney could last for decades and require no pumps or batteries. Patients wouldn't require anti-rejection drugs (as is required after transplants) either because there would be no exposed natural tissues for the immune system to attack.
The University of California team is awaiting approval to conduct larger scale animal and human trials. Already, it has successfully tested the implant in a few rats and pigs.
"The payoff to the patient community is tremendous," said Roy. "It could have a transformative impact on their lives...With the right financial support, I think we could reach clinical trials in five years. But it's hard to say how long after that it becomes commercially available due to the uncertainties of the FDA and commercialization prospects.''
So what would this artificial kidney mean for India? ''It will be a real boon,'' said Dr S C Tiwari, director of nephrology and renal transplantation medicine at Fortis health care. He added: ''The biggest problem with CKD patients in India is that majority of them are diagnosed in the final stages where they would either require constant dialysis or a transplant. They would require dialysis three times week. However, of the two lakh CKD patients requiring dialysis, only 10,000 get it, mainly because they can't afford it. Maybe only 1,000 such patients get it for free or at a subsidized rate in government hospitals. The artificial kidney, when available and if affordable, will be a miracle.'' Dr Madan Bahadur, nephrologist with Mumbai's Jaslok Hospital added, ''Work on creating tubular cells (that perform the biochemical work of the kidney) began a decade back. But bio-chemical engineering has so far not managed to replicate the kidney.''
According to Dr Jitendra Kumar, head of nephrology at Asian Institute of Medical Sciences, the main reason why this artificial kidney will be a real breakthrough is because it will be able to mimic the vital functions of a kidney like regulate BP and produce vitamin D — things a dialysis can't do.
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