A New Report From the Kidney Health Initiative Targets Innovations In Fluid Management

By Zach Cahill and Juanita Rogers

khi fluid_0.PNGFluid management is an area ripe for innovation that has a significant impact on the quality of life of people with kidney failure. The Kidney Health Initiative (KHI) recently released a supplement to its Technology Roadmap for Innovative Approaches to Renal Replacement Therapy entitled Fostering Innovation in Fluid Management. This report provides guidance to spur innovation in fluid management devices and techniques. Similar to the original roadmap, this new report is built around patient preferences and provides details on design requirements, functional areas, and development timelines.

Fluid management is a critical part of renal replacement therapy, and too much or too little volume can result in severe complications. “Giving up fluids, even water, in pursuit of an elusive dry weight is frustrating. Especially when dialysis ends up taking out too much or too little fluid anyway, causing cramps, fatigue, headaches, and more,” says Derek Forfang, a kidney patient and KHI Workgroup Co-Chair. He continues, “people with kidney diseases deserve to see the kind of advances seen in blood glucose monitors and fitness trackers come to fluid management.” Despite the unmet patient need, there are no approved devices to objectively measure volume status.

Successfully solving this problem requires patient centered development. In the report, people with kidney failure identified three characteristics needed for novel fluid management devices: personalization, interactivity, and freedom. Each person with kidney failure is different and novel technologies should be customizable. Additionally, real time feedback or alerts are important, as well as the ability to self-manage fluid status. Finally, new devices and techniques must be usable outside of the clinical setting to offer the ability to live a “normal” life.

To give innovators a context for the environment they are developing in, the report surveys current devices and techniques. While eleven current devices and techniques are described, the report notes that current offerings are inadequate or unproven. By understanding the status quo, innovators will be better equipped to identify and overcome the gaps and challenges in fluid management.

Based on feedback from clinicians and people with kidney failure, the report identifies obstacles that innovators will have to overcome. Many of the obstacles relate to the priorities that people with kidney failure have placed on new technology. Innovative fluid management advances that address the outlined challenges could significantly impact patients on maintenance dialysis.

The report concludes by separating device design guidelines into three areas for consideration between treatments, during treatments, and innovations beyond dialysis. Specific functional areas of interest to innovators are also defined, and include volume status measurement, analysis and real time feedback, and fluid removal. Additionally, timelines are provided to give innovators a context for which short- and long-term goals to target.

The technology that must be developed for innovative fluid management devices will serve a variety of advances, from enhanced dialysis to the artificial kidney. Many companies are currently developing in this area and prospective innovators can apply the concepts within this report to the development of new technology that will improve the lives of people with kidney diseases.

For more information, see KHI's website.

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Author:
Zach Cahill and Juanita Rogers
Body:

khi fluid_0.PNGFluid management is an area ripe for innovation that has a significant impact on the quality of life of people with kidney failure. The Kidney Health Initiative (KHI) recently released a supplement to its Technology Roadmap for Innovative Approaches to Renal Replacement Therapy entitled Fostering Innovation in Fluid Management. This report provides guidance to spur innovation in fluid management devices and techniques. Similar to the original roadmap, this new report is built around patient preferences and provides details on design requirements, functional areas, and development timelines.

Fluid management is a critical part of renal replacement therapy, and too much or too little volume can result in severe complications. “Giving up fluids, even water, in pursuit of an elusive dry weight is frustrating. Especially when dialysis ends up taking out too much or too little fluid anyway, causing cramps, fatigue, headaches, and more,” says Derek Forfang, a kidney patient and KHI Workgroup Co-Chair. He continues, “people with kidney diseases deserve to see the kind of advances seen in blood glucose monitors and fitness trackers come to fluid management.” Despite the unmet patient need, there are no approved devices to objectively measure volume status.

Successfully solving this problem requires patient centered development. In the report, people with kidney failure identified three characteristics needed for novel fluid management devices: personalization, interactivity, and freedom. Each person with kidney failure is different and novel technologies should be customizable. Additionally, real time feedback or alerts are important, as well as the ability to self-manage fluid status. Finally, new devices and techniques must be usable outside of the clinical setting to offer the ability to live a “normal” life.

To give innovators a context for the environment they are developing in, the report surveys current devices and techniques. While eleven current devices and techniques are described, the report notes that current offerings are inadequate or unproven. By understanding the status quo, innovators will be better equipped to identify and overcome the gaps and challenges in fluid management.

Based on feedback from clinicians and people with kidney failure, the report identifies obstacles that innovators will have to overcome. Many of the obstacles relate to the priorities that people with kidney failure have placed on new technology. Innovative fluid management advances that address the outlined challenges could significantly impact patients on maintenance dialysis.

The report concludes by separating device design guidelines into three areas for consideration between treatments, during treatments, and innovations beyond dialysis. Specific functional areas of interest to innovators are also defined, and include volume status measurement, analysis and real time feedback, and fluid removal. Additionally, timelines are provided to give innovators a context for which short- and long-term goals to target.

The technology that must be developed for innovative fluid management devices will serve a variety of advances, from enhanced dialysis to the artificial kidney. Many companies are currently developing in this area and prospective innovators can apply the concepts within this report to the development of new technology that will improve the lives of people with kidney diseases.

For more information, see KHI's website.

Date:
Wednesday, September 4, 2019