http://pharm.ucsf.edu/kidney
This device would basically cure all serious kidney diseases. So will it put nephrologists out of business?
This device would basically cure all serious kidney diseases. So will it put nephrologists out of business?
Implantable bioartificial kidney - End of nephrologists?
- Thread starter Dock1234
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Yes, in exactly the same way that insulin pumps and continuous CBG monitors have put endocrinologists out of business.
Who do you think is going to follow people who have these implanted? Urologists? B*** please. Once it's in, they're out. PCPs? Hilarious.
Nephrology's got plenty of issues to be sure but this won't be one. Especially since most dialysis units aren't owned by nephrologists anymore.
But the researcher said on lecture that can be found from youtube, that these artificial kidneys will be self-regulating. If they work perfectly and do everything that kidney does, what makes you think that they will need any follow up? Actually they will need even less follow up than healthy people because they have these mechanical kidneys that will never get sick.
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Just like that amazing implantable artificial heart, right? You're probably too young to remember that one anyway.
Sure, the kidney-in-a-box itself may never get sick, but I assume you've heard of thrombosis, right? Mechanical breakdown?
Your posting history suggests that you have no actual biomedical experience so I'm going to chalk this up to profound naivete on your part and just let it be.
I have many concerns about nephrology's future business model, but this is not one of them.
Plus, it wouldn't be the first time that researchers became overly enthusiastic about their own project (they mention on their site that animal studies won't even start b4 2017).
It's not like these patients will return to normal; I wonder how much clearance such a machine can provide? They'll still likely need epo at least and phos, acid/base, K fine tuning (as some transplant or PD guys still need). Seems like they plan to use kidney cells to do some of the regulation after filtration (as opposed to a sorbent based dialysis system). This sounds like it'd be complicated to get just right and to avoid catastrophes: For example, if the cells malfunction, you'd start losing a ton of ultrafiltrate, until you get hypotensive and stop filtering (kind of like an ATN w/o a compensatory GFR decrease) . As mentioned I'd also be surprised if clotting (or at least protein buildup or membrane integrity damage) isn't an issue over time.
Then, there is the risk of infection (like we sometimes see with LVADs...) Plus, implanting these may be difficult in vasculopathic and/or diabetic patients who make up the majority of our patients.
Plus, it wouldn't be the first time that researchers became overly enthusiastic about their own project (they mention on their site that animal studies won't even start b4 2017).
It's not like these patients will return to normal; I wonder how much clearance such a machine can provide? They'll still likely need epo at least and phos, acid/base, K fine tuning (as some transplant or PD guys still need). Seems like they plan to use kidney cells to do some of the regulation after filtration (as opposed to a sorbent based dialysis system). This sounds like it'd be complicated to get just right and to avoid catastrophes: For example, if the cells malfunction, you'd start losing a ton of ultrafiltrate, until you get hypotensive and stop filtering (kind of like an ATN w/o a compensatory GFR decrease) . As mentioned I'd also be surprised if clotting (or at least protein buildup or membrane integrity damage) isn't an issue over time.
Then, there is the risk of infection (like we sometimes see with LVADs...) Plus, implanting these may be difficult in vasculopathic and/or diabetic patients who make up the majority of our patients.
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if anything insulin pumps and CBGs have increased a need for endocrinologists…
a bionic kidney just may help the field of nephrology...
It is going to take A LOT more than a bionic kidney to help the field of nephrology..........
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Nephrology is a dying field. There is limited need for nephrologist in this era
(1) ESRD - Mid level providers(PA/ NP) can manage these patients.
(2) AKI - there is no cure and in most cases diagnosis is not clear. treatment involves monitoring creatinine and urine output and when it worsens to start dialysis,
(3) immunological disease - managed by rheumatologist
(4) CRRT - run by intensivists
(5) procedures (biopsy, lines, etc) - done by IR
(6) CKD - again it involves just monitoring and controlling BP/ diabetes and LDL which any mid level provider can do
There has been no significant advancement in field of nephrology in last 30 years or so. It involves same principle - monitor for kidney recovery. If it happens fine , else write simple orders for dialysis.
(1) ESRD - Mid level providers(PA/ NP) can manage these patients.
(2) AKI - there is no cure and in most cases diagnosis is not clear. treatment involves monitoring creatinine and urine output and when it worsens to start dialysis,
(3) immunological disease - managed by rheumatologist
(4) CRRT - run by intensivists
(5) procedures (biopsy, lines, etc) - done by IR
(6) CKD - again it involves just monitoring and controlling BP/ diabetes and LDL which any mid level provider can do
There has been no significant advancement in field of nephrology in last 30 years or so. It involves same principle - monitor for kidney recovery. If it happens fine , else write simple orders for dialysis.
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