Aim is to develop a system that uses electromagnetic (EM) waves for the enhanced clearance of protein bound uremic toxins during dialysis treatment. Additionally, the more fundamental mechanism behind the EM field induced toxin release will be investigated. The project is part of the prestigious KidneyX prize winning initiative 'Multi-compatible Implantable Toxin Removal Augmentation Module (MI-TRAM)', a collaboration between the UMC Utrecht, Research Hub Imec NL, Utrecht University and RWTH Aachen). For more information and a video, see https://www.kidneyx.org/prize-winners/mi-tram-smart-module/
Patients with end stage kidney disease - who are either not eligible for transplantation or on the waiting list - are treated by dialysis to replace kidney function. Although lifesaving, dialysis has major shortcomings. The treatment is time consuming, and removal of waste molecules and excess water is inadequate, contributing to reduced quality of life, severe health problems and high mortality (15-20% per year). Current dialysis techniques only partially replace glomerular filtration, but not tubular function of the kidney. As such, toxin removal efficiency of standard dialysis decreases with molecule size & hydrophobicity and ultimately stops at the size of albumin (which must be retained in the blood). Extremely difficult to remove are the so-called protein-bound uremic toxins (PBUTs), due to their strong binding with plasma proteins like albumin. PBUT accumulation affects a host of biological systems and has, amongst others, been linked to the uremic syndrome, cardiovascular morbidity and cognitive function decline in CKD patients. Thus, any artificial kidney would profit from improved PBUT removalImportantly, one of the consortium partners (RWTH Aachen) has shown that strong high frequency EM fields shift the dynamic equilibrium of protein-binding for toxins further to a non-bound state, thereby enabling improved removal of the freed toxins via the dialysis membrane. Producing such strong EM fields currently requires large devices, which limits present use to non-portable/non-implantable devices. Furthermore, this approach causes strong stray fields to the environment, thereby compromising electromagnetic compatibility (EMC). To solve these problems, consortium partner Imec NL has recently patented a miniature system-on-chip, that enables producing the EM fields more selectively across the pores of any hemodialyzer membrane, thereby loosening PBUTs exactly at the location where they can be filtered out (thereby strongly reducing stray fields and improving EMC). This disruptive system-on-chip is so small that it can be used in implantable artificial kidneys.,. Goal of this PhD project is to determine the optimal settings to loosen PBUTs (frequency, power, configuration of electrodes/ setup, continuous vs pulsed EM-fields), investigate EMC and further develop the system-on-chip while exploring the mechanism behind the EM field induced toxin release.