Group B Presenters: Erinne Munie, Tyler Roneker, Peter Marcote, Erik Freedmen Supported by our lovely researchers and assistants

The Basis of the CAMELWAK No loose tubes Secure fixtures No exposed surfaces Quick replacement procedures Quick water release Water regenerating system Minimal costs No hospitalizations Normal life activity Individualization of dialysis treatment X http://www.medgadget.com/2014/09/wearable-artificial-kidney-a-dialysis-machine-to-clean-blood-while-on-the-go-video.html

You can go anywhere and do anything with the CamelWak

Toxin and Solute Removal Function of dialysis Remove uremic toxins and retain endotoxins through diffusion, convection, and ultrafiltration The Reliable hemodialysis filter Electrochemical filtration water regenerating system Maintaining X Flow rate with continuous renal replacement therapy

Solute Removal Diagram Key features Additional slack in blood tubing Easily chargeable at nights Easy water release mechanism Simple nightly replacement procedures Inexpensive because mostly reusable

Hemodialysis Filter Utilization of countercurrent flow Traditional filter: Multiflow M60 hemofilter with SA of 0.6m^2 and K=1.5 Utilizes pulsatile push pull internal hemodiafiltration mechanism of the WAK Dialysate and blood with a half cycle phase differential Enhances transfer of middle molecular weight molecules through dialyzer membrane

Traditional vs. Sorbent vs. Electrochemical Solute Removal systems Traditional The good 4 hours dialysis High Kt/V The bad immobilization Hospitalizations 200 L of water High urea fluctuations High water losses Sorbent System The good Filters dialysate into ultra pure water Uses 375 milliliters of water The bad Non reusable sorbent filters High cost due to constant replacement of sorbent filters Electrochemical system The good Filters dialysate into ultra pure water Uses 375 milliliters of water Reusable Inexpensive because not replaced regularly No hospitalizations

Electrochemical Filtration Water Regenerating System Input: dialysate from hemodialysis filter with the addition of urease Objective: Remove all remaining solutes to create purified H2O Ions pass through semi-permeable membrane from an electric potential gradient Negative and positive ions or proteins are attracted to the electrically charged surface The only non-charged molecule is urea Which is broken down by urease into a charged particle

Electrochemical Filtration System Negative Na+ K+ CO2- Ca+ Mg+ Cr+ Positive Cl- HCO3- P- Albumin Molecules leaving Dialysate Need Citation http://www.fumatech.com/EN/Membrane-technology/Membrane-processes/Electrodialysis

Dialysate in the CamelWak Electrolyte sensor after dry acid addition Future: Individualization of bulk concentrated solutions Patient’s clinical hemostatic electrolyte concentration Concentrate added through a dry acid addition line with constant release Electrochemical sensor included as a check Bicarbonate buffer at 30-35mol/L will be released at a controlled rate

Dialysis Comparisons Old Method 1 Liter of acid concentrate 1.575 Liters of liquid bicarbonate concentration 42.425 Liters of purified water Total: 45 Liters of Dialysis Amplified to about 200L for hospital dialysis New Method Dry Acid Concentrates Dissolves in pure water Our pulsatile flow would help dissolve the concentrate Dry on Line Bicarbonate Concentrates Microbiologically safe Chemically stable Small and lightweight All dialysates tend to have the same concentations to a certain degree. With dry acid concentrates we can personalize treatments http://www.fmc-au.com/therapy-systems-and-services/chronic-hemodialysis/disposables/dialysis-concentrates-and-solutions

Diagram In the back is the water removal reservoir In the front is a hard piece of plastic where dialysis components can snap into to ensure security and control space On the bottom you can see the release valve

Nightly Procedure Charge batteries while sleeping (1 minute) Disconnect aseptic connections and throw away hemodialysis filter unit and tubing (2 minutes) Connect the new hemodialysis filter unit (5 minutes) Disconnect, Urea enzyme, concentrate, buffer and hormones (2 minutes) Drain electrochemical filtration regenerating system (5 minutes) Reload entire system with water (5minutes) In the morning, add new concentrates (2 minutes) Your ready to GO! Total time: (22 minutes) Insert picture of draining and filling unit

Questions for water group Are we doing an app to check blood pressure before and returning What about electrolyte sensor What about a water sensor on the water reservoir Are all these Bluetooth to the cell phone