Patients test portable artificial kidney at home for the first time

Patients with severe kidney failure are often dependent on dialysis in the hospital. At UMC Utrecht, patients are now testing a portable artificial kidney for the first time in the Netherlands. Patients can use it at home. The first patients are participating in a clinical study with the so-called NeoKidney. The goal: more freedom and control in daily life, without compromising safety.

What is kidney failure and why is dialysis needed?

Healthy kidneys filter waste products and excess fluid from the blood. In kidney failure, the kidneys function insufficiently or not at all. To survive, a treatment is needed that replaces kidney function. A kidney transplant is usually the best option. However, many patients are on the waiting list or cannot receive a transplant, so they must rely on dialysis to stay alive. Hemodialysis typically takes four hours each time, and often three times per week.

In hemodialysis, the blood is purified several times per week via a machine. This often takes place in the hospital and takes several hours per treatment. This has a major impact on work, study, travel and social contacts for many people. In the Netherlands alone, this involves about 5,000 people; worldwide, about 2.8 million people depend on hemodialysis. In total, about 6,200 people undergo dialysis in the Netherlands. Worldwide, 3.8 million kidney patients depend on dialysis to survive.

Why a portable artificial kidney?

“Dialysis is life-saving, but also very burdensome,” says Karin Gerritsen, nephrologist at UMC Utrecht and principal investigator of the study. “With a portable artificial kidney, we want to give patients more freedom and make the treatment fit better with their daily lives.”

A portable artificial kidney makes it easier to:

• Dialyze at home and while traveling
• At flexible times

This can contribute to a better quality of life.

What is the NeoKidney?

The NeoKidney is a lightweight, portable hemodialysis device (approximately a carry-on rolling suitcase). The device is developed for home use, but in a much more compact form than current hemodialysis devices.
Unlike standard (home) hemodialysis, no home modifications are needed, such as a connection to water supply and drainage, an extra electrical group, or (medical) grounding. The device is energy-efficient and electrically safe, so it can be connected to a standard power outlet.

Important features:

• Portable and intended for home and travel
• Closed system with reuse (regeneration) of dialysis fluid
• Therefore less dialysis fluid needed than with standard dialysis (4.5 L instead of ≥30 L)

The device is designed for short, frequent hemodialysis, 4 to 7 treatments of 2 hours per week. This allows the NeoKidney to offer a more gradual treatment than the traditional schedule of three times per week four hours, with fewer fluctuations in fluid, waste products and minerals. The device is connected in the same way as regular hemodialysis, via a shunt or a catheter.

What is being investigated now?

UMC Utrecht, part of the Utrecht Science Park and affiliated with Utrecht University, is conducting research together with the Kidney Foundation and medical technology company NextKidney into the safety and effectiveness of the NeoKidney.

After earlier positive safety studies with earlier prototypes in France and Singapore:

• About fifty patients will participate in a longer-term study
• They will also use the device at home
• Safety, efficacy, ease of use and effects on daily life will be examined

Karin: “During this test phase, we are investigating whether the NeoKidney works well and safely. First of all, we investigate whether the device cleans the blood sufficiently. We do that by measuring during dialyses how effectively waste products are removed from the blood. We want to be sure that this happens at a reliable and consistent level. We keep track of how much fluid is removed and whether that is done accurately.”

Is the NeoKidney study safe?

“Additionally, safety is very important. We carefully monitor whether side effects occur during or after dialysis that are related to the device, and whether they are serious. We also follow changes in, for example, blood pressure, heart rate and blood values to check whether the body responds well to the treatment,” says Karin.

“Furthermore, we ask patients themselves how they experience the treatment and what the effect is on their daily life and quality of life. Halfway through the study, NextKidney will submit the results to an independent certification organization. This organization assesses whether the device is safe and works well enough to be allowed on the market.” The goal is to work towards CE certification, possibly in 2026 or 2027. This is necessary before the device can become available to patients in Europe.

For who is the portable artificial kidney suitable?

For patients who want to do hemodialysis at home, have stable dialysis sessions, have good vascular access and want to dialyze more often and for shorter periods.
The device is not yet suitable for children, pregnant women or patients with severe comorbidities such as severe lung or liver diseases.

Collaboration between healthcare, science, and technology

The development of the portable artificial kidney is the result of close collaboration between:

• Healthcare professionals and researchers at UMC Utrecht (Departments of Nephrology and Medical Technology and Clinical Physics)
• The Dutch Kidney Foundation, which brings in the patient perspective
• NextKidney, responsible for technological development

“By combining knowledge and experience, we can work step by step toward better kidney care,” says Karin.

What does the future of kidney care look like?

The portable artificial kidney is an intermediate step towards further innovation. Researchers are also working on a future vision in which dialysis becomes possible without large devices or needles, for example with implantable technology. This falls within the broader field of regenerative medicine. Regenerative medicine develops new treatments in which the body’s self-healing capacity is used. “That’s still in the future,” Karin emphasizes. “But every step brings us closer.”

What does this mean for patients now?

If the research is successful, the portable artificial kidney could in the future:

• Become an addition to existing forms of dialysis
• Give patients more independence, flexibility and freedom
• Reduce the number of hospital visits

The research is still ongoing. Results will be announced in 2027.

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