Most of us have heard the term “nanotechnology,” but what image do you get when you hear the word? Perhaps you think of a science fiction or horror movie where millions of very tiny little robots rapidly build or disassemble a large object. One definition of nanotechnology is the science of manipulating materials on an atomic or molecular scale especially to build microscopic devices such as robots. How is this science important to those with kidney disease? A recent editorial in NKF’s journal, Advances in Chronic Kidney Disease, by Dr. Jerry Yee, discussed some of the interesting technological advances coming soon in nephrology.
Let’s take a broader view of the nanotechnology concept and think in terms of miniaturization of machines. One exciting new development in this area is the wearable artificial kidney (WAK). Prototypes of these miniaturized dialysis devices (less than 10 lbs) are now being studied. They can be worn 24 hours a day and provide blood filtering similar or better than any of the other hemodialysis techniques. Another example of smaller can be better are blood sensors that can fit in the blood lines of dialysis machines and provide instantaneous feedback on the levels of blood components, such as calcium, phosphorus and glucose. This allows for adjustments in dialysis that will make it safer and more effective. Research is also being done on a small device weighing less than ½ pound that can be used in the home to test for urine protein levels and send the results directly to your doctor through a smart phone. This would be very beneficial for kidney disease patients that require regular urine testing but live in remote areas.
If we want to get truly nano-sized, there is very interesting work being done on filters that are small enough to remove even the smallest contaminants from dialysate water, such as viruses and bacteria, or selectively remove other organic elements from the blood. Other researchers are looking at slight manipulations of the genes in cells to change their bad behavior such as suppressing immune cells in diseases such as lupus and certain types of kidney diseases that are caused by an overactive immune response.
So thinking small can lead to big things when it comes to science and medicine. There may come a time when an army of microscopic robots can be sent in to repair our kidneys (anybody remember the movie Fantastic Voyage?), but in the meantime let’s just appreciate the small things in life.