[HN Gopher] Can an artificial kidney finally free patients from ...
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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.
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(page generated 2023-09-02 23:00 UTC)