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Kidney Week

Abstract: SA-PO423

Allo-Hemodialysis Feasibility Study in a Porcine Model of AKI

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Wang, Xin, Renal Research Institute, New York, New York, United States
  • Patel, Amrish U., Renal Research Institute, New York, New York, United States
  • Gothi, Anil Kalidas, Vivo Bio Tech, Hyderabad, Telangana, India
  • Nikolic, Dejan, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Heide, Alexander, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Dong, Jiaming, Fresenius Medical Care R&D (Shanghai) Co., Ltd, Shanghai, China
  • Maheshwari, Vaibhav, Renal Research Institute, New York, New York, United States
  • Grobe, Nadja, Renal Research Institute, New York, New York, United States
  • Nayak, K s, Virinchi Hospitals, Hyderabad, Telangana, India
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

Annually, millions of kidney patients, predominantly in low and low-middle income countries, die prematurely because of lacking access to affordable kidney replacement therapy. Previously (ASN Kidney Week, 2021), we have demonstrated in healthy pigs the technical feasibility of allo-hemodialysis (alloHD), an alternative, low-cost dialysis treatment where the blood of a kidney failure patient flows counter-current to the blood of a healthy subject through the dialyzer. Here we report first results from an alloHD feasibility study in a porcine acute kidney injury (AKI) model.

Methods

The protocol was approved by the Committee for the Purpose of Control and Supervision of Experiments on Animals (CPCSEA), New Delhi, India. We studied four female Yorkshire pigs (weight 30 to 80 kg) with central venous catheter as vascular access. Under general anesthesia, AKI was induced in two pigs (AKI1; AKI2) through ligation of renal blood vessels. AKI pigs were then dialyzed for 4 hours against healthy pigs (H1; H2). AKI and healthy pigs were connected to the dialysate and blood compartments, respectively, of a Nipro Cellentia 17H dialyzer and anticoagulated with heparin (5,000 IU/h). Blood samples were collected before, during, and after alloHD for measurements of blood urea nitrogen (BUN) and creatinine.

Results

We performed one alloHD session each in two pig pairs (AKI1 & H1; AKI2 & H2). During alloHD, BUN and creatinine levels declined in the AKI animals and - as expected - transiently increased in the healthy animals and declined in the second half of the dialysis (Fig. 1). We found no indication of hemolysis or dialyzer coagulation.

Conclusion

In our feasibility studies in a porcine AKI model, alloHD performed as expected. Studies exploring extended outcomes are underway.

Fig. 1. Dynamics of BUN (panel A) and serum creatinine (panel B) in healthy (blue) and AKI (red) pigs.