Biosensors Transform Kidney Disease Management
Jan 09, 2023
Have you ever wondered if there is a non-invasive, fast, and convenient renal function monitoring system? It is small and compact, like a smartwatch, and can be worn 24 hours a day. At the same time, it can be connected to the Internet, allowing you to remotely understand kidney function, and use big data, machine learning, and other methods to predict the risk of future renal function decline. If you have ever dreamed, congratulations, your dream is about to come true!
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On November 6, 2022, at the awards ceremony of the 2022 Kidney Week (Kidney Week) academic conference held by the American Society of Nephrology (ASN), new in vivo and in vitro biosensing systems and their applications in changing the management of kidney diseases were introduced.
1. Introduction of new biosensors
In the past 15 years, the breakthrough development of basic science has made it possible for humans to detect physical changes in professional medical institutions such as hospitals. Monitoring methods such as electrocardiograms and brain waves are widely used in clinical practice.
However, the bioelectricity detection equipment currently used in clinical practice is directly covered on the skin, and it is difficult to accurately detect the internal conditions of the body.
In addition, the current detection equipment is relatively bulky and cannot be carried around.
Given this, through the continuous efforts of scientists, finally, in 2019, scientists from the United States integrated electrocardiogram, blood pressure, blood oxygen monitoring, and other equipment into a portable new biosensor the size of a thumb.
What indicators can this new biosensor monitor?
It can be customized to monitor body temperature, and microbial potential (such as electrocardiogram), monitor sweat, blood flow, blood pressure, blood oxygen, vein mapping, and cardiac auscultation. In addition, there are specially modified devices to monitor wound healing.
Scholars believe that this new type of biosensor can be applied to people with limited mobility or lack of language skills, such as newborns. The baby's biosensor can monitor the baby's ECG and core body temperature, while the red dot on the foot is an optical monitoring device that can monitor the blood oxygen level.
At present, more than 20 countries, including the United States, have approved the marketing of this new type of biosensor (this type of new type of biosensor is not listed in China). Such devices have served more than 12,000 patients and collected more than 150,000 hours of data. The above data suggest that this new biosensor is safe and reliable, and has wider application prospects, such as for kidney disease management.
2. New biosensors and kidney disease management
In addition to attaching to the surface of the human body, the new biosensor can also be implanted in the brain and heart to monitor blood flow inside the organ and customize the corresponding biomarkers.
For the current nephropathy examination method, although estimating the glomerular filtration rate (eGFR) is simple and easy, the test results may be false positive or false negative, and the accuracy is low in some populations.
The "gold standard" of kidney disease inspection: kidney biopsy is an invasive method that cannot be detected frequently, and it is difficult to use for kidney disease monitoring. The new biosensor in the body can combine the advantages of the two to non-invasively, accurately, and long-term monitor the kidney status. For example, implanting novel biosensors under the capsule of a transplanted kidney can continuously track the health of the graft, such as the temperature and perfusion status of the transplanted kidney.
Currently, a prototype biosensor in the kidney has been used to monitor renal function in animal models.
A new biosensor that is soft and non-rejecting is implanted in the kidney of mice, and its main purpose is to evaluate the safety and effectiveness of the biosensor in vivo.
The most important component of the device is an encapsulated thin-film gold sensor (100nm scale), which can monitor the surface temperature of the mouse kidney. The study found that if the mouse kidney surface temperature is higher, the kidney perfusion state is better; if the mouse kidney surface temperature is lower, the kidney perfusion state is poor.
The human body also has similar laws. The new biosensor in the body can transmit the above data to the computer through wifi or Bluetooth to help understand the condition of the kidneys. More importantly, procedures could be developed in the future to estimate the risk of renal hypoperfusion to avoid the risk of acute kidney injury in kidney transplant recipients or patients with chronic kidney disease.
It is worth mentioning that a preclinical study on a pig model kidney monitor has been prepared, and relevant results are expected to be released in the next year or two.
Sweat levels of some biomarkers correlate with blood levels. So new biomonitors (called microfluidic devices) can also attach to human skin and monitor sweat to infer lactose, chloride, pH, and glucose levels in the blood.
Such devices are already widely used in clinical and sports medicine. Whereas creatinine, urea, and pH in sweat may correlate with creatinine, urea, and pH in plasma or blood. Therefore, a team developed a prototype microfluidic device that monitors creatinine, urea, and pH in sweat. The prototype can non-invasively, in real-time, and portable monitor the creatinine, urea levels, and pH values in human sweat, to estimate the creatinine, urea, and pH values in human blood. When enough clinical data is collected through the new in vivo and in vitro biomonitors, machine learning can be used to understand the risk of renal function decline in patients, and the prescription can be adjusted in time based on these data.
To sum up, the new biosensors have achieved certain results in preclinical and clinical research, and have been launched in some countries.
Shortly, 7×24h monitoring and management of the kidneys of patients will be possible, which will reduce the risk of acute kidney injury in some patients with chronic kidney disease and kidney transplant recipients, and help improve the final prognosis of patients.
for more information:ali.ma@wecistanche.com
