Kidney Week

Abstract: TH-PO0862

Replacing Hollow-Fiber Dialyzers with a Scalable, Biomimetic Micro-Macrofluidic Dialyzer-on-Chip for Wearable Low-Flow Kidney Replacement Therapy

Session Information

• Dialysis: Prescription, Physiology, and Treatment Optimization
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Author

• Nosrati, Mordechai S., University of Southern California, Los Angeles, California, United States

Mordechai S. Nosrati, MD

Background

Hemodialysis remains a 60-year-old, high-flow, intermittent hollow-fiber system that is misaligned with renal physiology and carries high morbidity and mortality. Hollow-fiber design creates long diffusion paths, flow maldistribution, boundary-layer resistance, and high extracorporeal volume, requiring high blood and dialysate flows and limiting efficiency, miniaturization, and portability. A low-flow, high-efficiency, physiologically compatible dialyzer is needed to enable wearable renal replacement therapy.

Methods

²We developed a Dialyzer-on-Chip (DOC) chipset integrating micro–macrofluidic flow via patented chipset technology, enabling clinical scalability. DOC comprises parallel blood channels flanked by two dedicated dialysate channels separated by dual PES semipermeable membranes in a biomimetic multilayer design. It supports low-flow, low-shear transport with minimal extracorporeal volume under countercurrent laminar flow. In vitro whole-blood studies in open- and closed-loop systems characterized performance; across studies, transport behavior was consistent under varying flow conditions.

Results

DOC chipsets achieved efficient solute clearance at physiologic low flow. At BFR 1.5 mL/min (closed loop), DOC produced 42% urea reduction at 2 hours (K≈0.64 mL/min; ~225 mL/min/m²), confirming meaningful low-flow clearance. Extraction decreased with increasing flow, consistent with NTU transport. Uniform flow and reduced boundary-layer resistance enabled clearance comparable to hollow-fiber dialyzers at much higher flows. Membrane resistance from 240 µm PES was the main limitation; thinner membranes (~50 µm) are expected to further improve efficiency and reduce unit requirements.

Conclusion

Parallel compilation of DOC chipsets replaces hollow-fiber dialyzers with a biomimetic micro–macrofluidic architecture enabling continuous, physiologic low-flow dialysis with improved hemodynamic stability. A single DOC delivers meaningful low-flow clearance, while scalable parallelization increases performance; thinner membranes and optimized (e.g., serpentine) channels enhance mass transfer and enable compact, portable systems. This modular platform supports continuous renal replacement from neonates to adults across wearable, ICU, and home settings.

Funding

• Private Foundation Support