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Friday, December 3, 2010

Indian-origin doc builds first artificial kidney

Country's Fight Against Disease Gets Boost

New Delhi: A US-based Indian-origin researcher, Shuvo Roy, has created the world's first implantable artificial kidney. What's sensational about Roy's creation is that the organ, no larger than the size of a coffee cup, will be able to mimic the kidney's most vital functions like filtering toxins out of the bloodstream, regulating blood pressure and producing the all-important vitamin D.
    The artificial kidney has been tested successfully on animals, and its human trials are expected to be held over the next five years. Once available, and if affordable, this creation by the Roy-led team at the University of California will do away with the need for kidney dialysis. This will be a great help for all patients with chronic kidney disease (CKD). In India, of the 1.5 lakh new patients who suffer from end-stage renal failure annually, only 3,500 get kidney transplants and 6,000-10,000 undergo dialysis. The rest perish due to an acute shortage of dialysis centres and nephrologists to man them.
    CKD is rising at a rapid pace in India and the majority of those who die are either unable to find a suitable organ for transplantation or are unable to pay the high dialysis costs. According to Roy, the device has a filtration section to remove toxins from the blood, alongside a compartment with renal cells to conduct other func
tions of a normal kidney. He believes the artificial kidney will last for years, maybe decades, and require no pumps or batteries. Patients would also not require antirejection drugs (as is required after transplants) because there would be no exposed natural tissues for the immune system to attack.
    The University of California team is now waiting for approval to conduct
larger scale animal and human trials. It has already succesfully tested the implant in a dozen rats and a handful of pigs.
    Roy, who is working with a team of engineers, biologists and physicians, said, "The payoff to the patient community is tremendous. It could have a transformative impact on their lives."
'Artificial kidney will be a boon for Indians'
    With financial support, I think we could reach clinical trials in as little as five years. But it's hard to say how long after that it becomes commercially available due to uncertainties of the FDA and commercialisation prospects," says Shuvo Roy.
    So what would this artificial kidney mean
for India? "It will be a real boon," said Dr S C Tiwari, director of nephrology and renal transplantion medicine at Fortis Health Care. He added, "The biggest problem with CKD patients in India is that a majority of them are diagnosed in the final stages where they either require constant dialysis or a transplant. They require dialysis three times a week. However, of the two lakh CKD patients requiring dialysis, only 10,000 get it, mainly because they can't afford it. Maybe only 1,000 such patients get it for free or at a subsidized rate in government hospitals. The artificial kidney, when available and if affordable, will be a miracle."
    Dr Madan Bahadur, nephrologist with
Mumbai's Jaslok Hospital added, "Work on creating tubular cells (that perform the biochemical work of the kidney) began a decade back. But bio-chemical engineering has so far not managed to replicate the human kidney. If this new device delivers on its promise, it will be fantastic." According to Dr Jitendra Kumar, head of nephrology at Asian Institute of Medical Sciences, the main reason this artificial kidney will be a real breakthrough is because it will be able to mimic the vital functions of a kidney, like regulating BP and producing vitamin D—things a dialysis can't do.
    "Around 40% of diabetics have some form of kidney disease. And with over 50 million diabetics in India, you can understand what the burden of kidney failure patients will be. Most of these patients will require 40 hours of dialysis per month, which completely curtails their lifestyle. If the artificial kidney, which can be worn or transplanted, is available, the patient will be free to live a normal life without having to spend most of his/her time at dialysis centres," Dr Kumar said.

The artificial, implantable kidney developed by Dr Shuvo Roy is the size of a coffee cup and is ready for test on humans. If successful, it could replace the need for dialysis and transplants for lakhs of people suffering from chronic kidney disease

Roy's father is from India while his mother is Bangladeshi. Born in Bangladesh, young Roy spent some time in India as well. Studied in Uganda, where his father was a doctor. Went to the US for higher studies

Every year, 1.5 lakh new patients end up suffering from end-stage renal failure. Only 3,500 get transplants and 6,000 undergo dialysis. The rest die due to shortage of dialysis centres and nephrologists
Patient undergoing dialysis
spends 10,000 a month, with
the process taking 72 hours



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