Chapter category: Tissue Engineering
Percutaneous Access for Peritoneal Dialysis: A Tissue Engineering Approach
The Artificial Kidney: Physiological Modeling and Tissue Engineering
Edited by: John K. LeypoldtISBN: 1-57059-602-6
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Chapter authors:
Jennifer A. LaIuppa and Clifford J. Holmes
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The newly emerging field of tissue engineering, which combines recent advances in the fields of molecular and cell biology with developments in material science, chemical engineering and biotechnology, promises to address clinical needs in many areas of medicine. The ability to fabricate or reconstruct tissues and organs either in vitro or in vivo using engineering principles would allow a wide variety of disease states to be better treated than by conventional therapy. Examples include bone and cartilage reconstruction, periodontal regeneration, liver, pancreas and renal replacement devices, and cardiac prostheses. For a comprehensive overview, a recent book by Lanza et al is recommended.1 Tissue engineering may also play a useful role in the treatment of end stage renal disease with peritoneal dialysis (PD).
PD is currently a widely accepted form of renal replacement therapy, with over 110,000 patients being treated worldwide by the end of 1997. PD therapy is based on the ability of the peritoneum to exchange fluid and metabolic products from the blood and surrounding tissue with the dialysis solution. There are many regimens of therapy delivery today, such as continuous ambulatory PD, which uses four to five exchanges of 2–3 liters of dialysis solution per day, or automated PD, which employs a hardware device to automatically exchange even larger volumes of dialysis solution during the night. An extensive review of this therapy can be found by Gokal and Nolph.2 The successful delivery of this therapy, however, requires the use of a permanent indwelling percutaneous catheter which is used daily to infuse and drain dialysis solution into and out of the patient. The most frequent complication associated with these long term devices is infection of the exit site and subcutaneous tunnel, an outcome resulting from the inability of current designs to permit tissue–device integration.
Additional chapters from this book:
Tissue Engineering in the Peritoneal Cavity: Genetic Modification of the Peritoneal Membrane
Catherine M. Hoff and Ty R. Shockley
Peritoneal dialysis (PD) is a simple, cost effective form of renal replacement therapy for the management of patients with end stage renal disease (ESRD).1 In PD, hypertonic dial...
Percutaneous Access for Peritoneal Dialysis: A Tissue Engineering Approach
Jennifer A. LaIuppa and Clifford J. Holmes
The newly emerging field of tissue engineering, which combines recent advances in the fields of molecular and cell biology with developments in material science, chemical engineering and bi...
The Bioartificial Renal Tubule
H. David Humes, Sherrill MacKay and Janeta Nikolovski
The kidney was the first solid organ whose function was approximated by a machine and a synthetic device. In fact, renal substitution therapy with hemodialysis or chronic ambulatory peritoneal...
Transport Kinetics During Peritoneal Dialysis
Michael F. Flessner
While hemodialysis is the principal renal replacement therapy in the world, an alternative therapy for patients with kidney failure is peritoneal dialysis. Under normal conditions, the periton...
Urea Removal During Hemodialysis
Daniel Schneditz
Urea evolved as the carrier for the excretion of nitrogen in most mammals, including man, probably because it is relatively inert, highly soluble in water, and highly perm...
Fluid Removal During Hemodialysis
John K. Leypoldt and Alfred K. Cheung
The total volume and distribution of body fluids are highly regulated in normal individuals because of precise excretion of water and ions by the kidney.1,2 In end stage...
