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Dialysis buddy

No more machines.
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Kidney hemodialysis requires being hooked up to a machine several times a week, sitting in a chair staring at other sick people sitting in similar chairs. Mechanical dialysis is never the same as purification from a real kidney. Some people with failed kidneys get transplants donated by loved ones. This is not always possible. However, it may be possible for a spouse or parent to help their ailing loved one without having to donate a kidney.

I propose that a willing spouse/parent be rigged with an arteriovenous fistula, the same as the ones that people on dialysis use to get hooked up to their machine. Then the patient and parent are hooked together with a semipermeable dialysis filter. Toxins from the blood of the child would pass on to the parent and be purified by the parents kidney. Since one transplanted kidney can sustain a person, two functioning kidneys can easily do the job for two people.

The dialysis buddy system provides blood purification by a real kidney. The patient does not have to sit in a dialysis suite for hours each week. Instead, this would be bonding time at home with a loved one. It may even be possible to hook up both the mother and the father in one of these dialysis buddy session - providing even more efficient blood purification.

bungston, Aug 14 2004

<link from Around TUIT> http://www.kidneyca...alysis/history.html
History of dialysis [Around TUIT, Oct 05 2004, last modified Oct 17 2004]

<link from Around TUIT> http://www.stanford...t/html/history.html
History of kidney research [Around TUIT, Oct 05 2004, last modified Oct 17 2004]

<link from Around TUIT> http://www.stanford...ant/html/kolff.html
expert trying solve some of the same problems [Around TUIT, Oct 05 2004, last modified Oct 17 2004]

Short fiction based on this idea http://medgadget.co...dgadget_sci_fi.html
Halfway down the page. "Cord". [bungston, Jul 04 2007]

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       nice thinking outside the boundries of the problem! This idea seems good in extreme emergancies (if there is no other options). But using it in the scenario you described it would be easier just to come up with cheap,easy to use dialysis machines for home use. Having someone else's toxin ridden blood go through your body can't be good and most probably dangerous. I like the premise, but not the application. Go fish.
Around TUIT, Aug 15 2004
  

       Gosh... I wonder if this would work? What an interesting idea.
veryvermilion, Aug 15 2004
  

       Wow. Maybe it's just late, but this totally blows my mind. Visions of weird, Terry Gilliam kind of tubing and stuff winding all around a couple's middles. I'd say there's probably not much better way to bond than blood swapping (presuming compatible type, of course). You're nuts, [bung], and it's awe-inspiring.
absterge, Aug 15 2004
  

       there are a lot of reasons that this is bad science. i do commend the intent, but (maybe mfd?) bad science.   

       to name a few, first there is the matter of the a.v. fistula necessary for both persons to hook them together, fraught with possible complications including clotting and sepsis. second is ABO compatibility (which i assume you infer). third are the accumulation of antibodies transferred from buddy to dialysis patient which will significantly impair the likelihood of a crossmatch negative kidney donor in the future if needed.   

       fourth is the possibility of passing disease back and forth between the circuit (cmv, hsv etc.) fifth, dialysis does a lot of other things besides "clear toxins", most significantly is restoring normovolemia through careful addition or removal of fluid. the "rigged kidneys" have no way to do this as they will be responding to the volemic status of their owner's vascular system. sixth is the issue of the toxins themselves, lactic acid, potassium etc. introduction of exesses of these into a healthy system could produce life threatening side effects. seven, there are many causes for renal failure and some would end up destroying the buddy kidneys after enough time.   

       these are just the most obvious that come to mind, i'm sure i could continue (on and on) with some more thought.   

       again i admire the intention.
xclamp, Aug 15 2004
  

       Well, I'm happy you stopped with only the "most obvious" reasons against the dialysis buddy...
veryvermilion, Aug 15 2004
  

       i didn't mean to imply there was no "good science" here either, just more bad than good. obviously there are some analogues to this idea (mother/fetus, siamese twins etc.) i didn't do a lit review but it wouldn't surprise me if this hadn't been tried in some form in the past.   

       this idea, somewhere in history, is probably the kind of thinking that resulted in dialysis and kidney transplant (and bio-artificial liver, pancreas devices) as it's done now. i didn't fishbone it, for that reason.
xclamp, Aug 15 2004
  

       some links if you want them
Around TUIT, Aug 15 2004
  

       [xclamp] pointed out several problems. All of those issues, though (I believe), could be dealt with in due time and with lots of research. Science is great.   

       Our immune systems, however, are greater. Immune cells from person A will know that cells in person B are NOT supposed to be a part of person A. They will attack and destroy those cells. Ditto for the immune cells of person B - they will attack and destroy every cell in the body of person A.   

       Experiments have been done with grafting the heads of animals onto the bodies of other animals - two-headed dogs have been created this way. The grafts, initially, were very successful - though the dogs (both heads) seemed very confused. Such creatures always died from immune reactions, though, usually within 2 to 6 days (one lasted 29 days). [Source - the book "Stiff" by Mary Roach]   

       If you mix two people's blood (and the many thousands of immune cells in blood), the blood will still be mixed even when the people are no longer connected. And both people will, in all likelyhood, be dead within six days, killed by the other person's immune system.   

       Change the donor person from "spouse/parent" to "identical twin" or "clone" and you might have a shot.
lyrl, Aug 15 2004
  

       Thank you for the thoughtful commentary, all. I can answer some of these objections. A dialysis membrane is impermeable to cells and large proteins (antibodies), so ideally there would be no ABO / rejection issues. Although leakage would be a real risk. As for drawbacks from the fistulas, [xclamp] is right that they have risks - but lots of folks have them anyway because there is no better way. Toxins etc - given that the concentration in the child is not yet lethal, introducing them into the parent would likely not be dangerous.   

       Transmissible causes for kidney failure - folks with these problems shouldn't do buddy dialysis.   

       It is great to get some thoughtful feedback!
bungston, Aug 15 2004
  

       buddy dialysis — an interesting concept, but not without repurcussions. For all the problems listed here: this should only be used as an extreme last resort.
dm01, Aug 22 2004
  

       So... if these fistulas do not transfer blood, won't you need some sort of active pumping equippment to get the bad fluid out, and the "good" fluid in?
ye_river_xiv, Oct 19 2006
  

       The pumping equipment is built into the partners. The gradient between arterial and venous maintains the high flow necessary.
bungston, Oct 19 2006
  

       I would put the effort into a home use machine. I loved spending time with my father but not from two feet away. And if mom dad and I are all hooked together and the phone rings....
Chefboyrbored, Oct 19 2006
  

       Thanks, [bungston], some interesting tales in that link.
normzone, Jul 04 2007
  


 

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