人工腎臓の最近の進歩

Since 1967 when dialysis therapy has become indication for healthcare, Japan’s dialysis medicine and medical care has made remarkable progress in the last 50 years, and its treatment outcome is internationally the highest level. As of the end of December 2016, the number of dialysis patients in Japan is 329,609 and the number of peritoneal dialysis patients is reported to be 9,021. In recent years, in response to the needs of patients for hemodialysis, various treatment variations exist. Hemodialysis (HD) is excellent in removal efficiency of small molecular weight substances, and hemofiltration (HF) is excellent in removal efficiency of large molecular weight substances. A combination of HD and HF is HDF, which is enable balanced solute removal from small molecular weight substances to large molecular weight substances. HDF was performed in 72,959 (24.4％) of 329,609 nationwide dialysis patients in the statistical survey of the end of 2016 by the Japanese Society of Dialysis Therapy, and is considered to an effective method for many problems of long-term dialysis patients. Dialysis related technologies, including dialyzer and hemodiafilter, are progressing steadily. Today the usefulness of dialysis membranes with broad fractionation characteristics is important for some patients because of the idea that the improvement of disease condition by removing uremic toxins binding to albumin or uremic toxins near albumin. Although an artificial kidney had great clinical results, the artificial kidney has only a filtration function, but has no hormone secretion ability or reabsorption function like a human kidney.
Bioartificial kidneys using renal tubular cells and regenerative medicine have also been attempted, but human kidneys are complex organs, and it is considered that it will take more time to put them into practical use.