[HN Gopher] Can an artificial kidney finally free patients from ... ___________________________________________________________________ Can an artificial kidney finally free patients from dialysis? Author : gmays Score : 109 points Date : 2023-09-02 15:00 UTC (8 hours ago) (HTM) web link (www.ucsf.edu) (TXT) w3m dump (www.ucsf.edu) | brokenmeds wrote: | Using throw-away as this sounds dismal, BUT: who makes money from | this and who loses money? That will tell you whether this can | happen or not. | | Dialysis is big business. Technicians. Consumables. Doctors. | Repeated Vi$it$. Real estate (often owned by the Nephrologist $.) | | More saliently, Nephrologist also control the standard of care. | Do they stand to gain more from artificial kidney | surgery/maintenance, or do they stand more to lose from dialysis | going away? | zamadatix wrote: | What does it matter who loses money? This isn't a 3 person | scam, there are 10s of thousands of people capable and it only | takes a single company getting a single practice in the area to | start doing ${RADICALLY_MORE_EFFECTIVE_THING} and they get all | of the pie while these stagnant people now get none. If there | is some grand conspiracy of how they have enough power to | prevent anybody from coming in and doing it better/cheaper to | steal the larger volume then why do they need to protect this | oddly specific set of jobs to get money? Basically, how does | who from the past will lose expected income prevent someone who | wants to become rich now? | | Dialysis is indeed big business, but that means it's more | attractive to upset - not less. The sad reality is it's just | hard to upset. That's not as cool, it doesn't catch your | attention, it doesn't give you anyone to blame for why things | are shitty... but it's also a lot better supported as an | explanation. | DennisP wrote: | On the other hand, the government spends a huge amount on | dialysis. Medicare pays for it regardless of your age. Removing | the need for dialysis simplifies life for politicians by | putting off the day they need to raise taxes or cut Medicare | services. | | Dialysis is also a lot crappier than this would be. My mom was | on dialysis and quality of life is not great. Neither is the | expected lifespan. | | Free markets have their flaws but their big advantage is | competition. If the government approves this device, and it | provides significantly better outcomes, then nephrologists who | use it will take patients from those who don't. | srameshc wrote: | I truly hope this is could be the solution. Dialysis is live | saving , yet very difficult. I always hoped there was an easier | solution to hemodialysis and peritoneal dialysis. | thr0waway001 wrote: | That would be cool as a kidney disease patient. | piyushpr134 wrote: | hope as much money & marketing is poured in cure, is also poured | into prevention as it is better to prevent than to cure. | | I believe that many types of kidney diseases are linked to | metabolic syndrome. Hope media and doctors highlight this to all | and sundry that eating less, moving more, keeping weight and | blood sugar in control can stop disease progression. | porkbeer wrote: | I respect what you are saying, but both people I know suffering | through it are type 1, and are just struggling to stay alive in | a way where they want to continue living. | RetroTechie wrote: | Kidney problems can also be acute. Resulting from some kind of | poisoning, out-of-control infection, or some situation where | immune system attacks the body itself. | | Husband of an friend of mine (~75y old at the time) got unwell | during a heatwave. Kidneys gave up, resulting in blood | poisoning & that was the end. | | I hope for the grow-spare-from-own-body-cells method to become | a practical option. That would do away with donor shortages & | immune system rejection problems. Kidneys & liver would | probably rank high as desired replacement organs. | DennisP wrote: | There's also polycystic kidney disease, which is a fairly | common genetic condition. | tomcam wrote: | Five years away, I'm sure! | | The really good stuff is perpetually five years away... | ma55ypi3 wrote: | Will this be abused whereby peoples are coerced into trading | their kidney for an artificial one for a price? | code_duck wrote: | I doubt it as the artificial one will probably be very | expensive. | bmicraft wrote: | If this doesn't get rejected by the patient, how would that | even make economic sense? | gjm11 wrote: | What does that scenario look like in practice? | | Suppose I'm the evil coercing person. I have an artificial | kidney and $X, you have (still in your body) a real kidney, and | you're short of money so you prefer (artificial kidney + $X) to | (real kidney). We make the trade. | | Why would I do that? Presumably so that I can (evilly) treat | someone with kidney disease by giving them a real kidney, which | they prefer to an artificial one. In fact, to make it worth my | while they must also be paying me at least $X more for the real | kidney than they would have for the artificial one. | | So the incentives work out provided my patient prefers (real | kidney) to (artificial kidney + $X), and my victim prefers | (artificial kidney + $X) to (real kidney), and what I'm doing | is (evilly, coercively) enabling them both to get what they | prefer. | | It's hard to see how I can be doing anyone _very much_ harm | here. Presumably the idea is that the victim is worse off, | having been persuaded to give up their precious real kidney for | an inferior artificial kidney in exchange for mere money, but | also-presumably they are poor enough not to have the luxury to | use phrases like "mere money" and $X is a life-changing amount | for them. Which probably means their situation at the outset is | very bad, but that isn't _my_ fault. | | I expect there _are_ possible situations where the existence of | artificial kidneys enables some things to happen that look good | to all participants but end up being bad ideas in the long run. | But it seems super-implausible to me that these could outweigh | the benefits of being able to make functioning artificial | kidneys. | n3storm wrote: | I saw that movie too. I think is based on a book though. | esotericsean wrote: | This probably isn't a viable solution for my father who has been | on dialysis for 2 years and is in ESRD. I am a candidate for a | kidney transplant for him (I went through the whole process), but | he has other issues that have been preventing him from having | another surgery. I'm pretty scared to do the procedure, too. | | But really glad to see progress being made here. Hopefully, also, | the world works toward improving diet and starts eliminating | metabolic diseases like Type-2 Diabetes and Heart Disease. | DennisP wrote: | Also they say it'll be available by 2030 at the earliest: | https://pharm.ucsf.edu/kidney/device/faq | rocky1138 wrote: | As a living kidney donor, I can tell you that it's not all that | scary. It's much scarier to be ESRD and suffering the hellish | purgatory of dialysis. | | The operation is quick and recovery isn't too bad. As long as | you have support at home from friends and family it's not | terrible. | | What struck me, though, was how weak it made me. Walking for | the first time in a week was very slow, very sweaty, and put me | into a state of extreme exhaustion. | idontunder wrote: | are you feeling okay now? have you had other consequences | from donating your kidney? | munchler wrote: | [flagged] | phibz wrote: | As someone on dialysis, this would be amazing to see. I wonder if | the same immunoresponse issues would happen with this like with a | transplant. | | The holy grail of transplant medicine for years has been acquired | immunity, where you convince the immunesystem not to attack the | transplant. Still hoping we see progress there, but this looks | like a viable alternative to a donor transplant. | cardy31 wrote: | There is a lot of research going into making kidneys without | the markers that cause rejection. They hope to make pig kidneys | compatible with human transplantation this way. | mdhen wrote: | They have one in a brain dead patient right now, been over a | month with no issues. | civilitty wrote: | Did the patient donate his body to science or something? | What's the legality and ethics of operating on a | neurologically dead person? | tialaramex wrote: | "This important research, which study leaders say could | save many lives in the future, was made possible by the | family of a 57-year-old male who elected to donate his | body after a brain death declaration and a circumstance | in which his organs or tissues were not suitable for | transplant." | bobmaxup wrote: | https://nyulangone.org/news/pig-kidney- | xenotransplantation-p... | DennisP wrote: | The article says it "does not trigger the recipient's immune | system to go on the attack." I've read elsewhere that the | biological stuff inside is sealed off from the immune system. | quasarj wrote: | Wish this was coming sooner. Maybe one day I'll have one! | candiddevmike wrote: | Would teaching the immune system to "forget" cover this | situation (along with other autoimmune diseases) too? | f6v wrote: | I think Treg therapies is something that could potentially be | used in both autoimmunity and transplantation. But the again, | the idea isn't new and has been around for 20 or more years. | As they say, "lost in translation". | blorenz wrote: | As someone totally unqualified to make an assessment about | this, I feel selectively forgetting is much harder than | generalized forgetting. This would make the person vulnerable | to multitudes of vectors. | robbiep wrote: | You're basically right, we have no idea how to do this - we | can help the immune system remember new things (ie we've | started teaching it how to attack cancers that it has been | ignoring) but when the body wants to go at something, the | only way we've been able to get it to sort it's shit out is | to wipe out all the agents of the adaptive immune system | and implant a new one (give someone a bone marrow | transplant). | | This has resulted in cures for patients with MS, but is | really risky and doesn't scale. | ck2 wrote: | American health insurance is allowed to refuse to pay for any | treatment considered experimental so the correct question is | "will anyone be able to afford it" and the answer is "not the | masses not anytime this decade". | porkbeer wrote: | I bet its cheaper than the alternative, expensive treatment for | life... | hnbad wrote: | Yes, and most people can't afford neither. | DennisP wrote: | Medicare pays for dialysis, regardless of age. So it'll | probably also pay for this, to save itself money. | f6v wrote: | I see this argument very often in relation to various medical | interventions. First off, insurance anywhere isn't going to | just pay for experimental treatment. Second, a great deal of | inventions were not available to the masses at first. So should | we stop inventing things? Or wait for a new worldwide socialist | revolution first? | [deleted] | zaitsev1393 wrote: | No idea why i can't access this website from Ukraine. | [deleted] | oneshtein wrote: | Site owner blocked the site for Ukrainians. :-/ | | Error 1009 Ray ID: 80075b57bf1f2301 * 2023-09-02 17:08:45 UTC | | Access denied | | What happened? | | The owner of this website (www.ucsf.edu) has banned the country | or region your IP address is in (UA) from accessing this | website. | | Use this link: | | https://web.archive.org/web/20230829172126/https://www.ucsf.... | [deleted] | tptacek wrote: | https://archive.ph/ba9Cw | | Presumably it's just an overbroad filter responding to some | random attack in the past. Either way: best not to pick it | apart on this thread, which isn't about web filtering, but | rather artificial kidneys. | Tagbert wrote: | Oddly, I'm getting a server not found for archive.ph. | AnnikaL wrote: | Cloudflare DNS does not work for archive.ph and its other | domains. ___________________________________________________________________ (page generated 2023-09-02 23:00 UTC)