# Beyond Urea Kinetics: Balancing Tradeoffs in Dialyzer Design for the Next 50 Years

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $518,661

## Abstract

The 548,000 Americans who rely on dialysis to stave off death from kidney failure suffer from
malnutrition, inflammation, immune defects, and vastly increased incidence of coronary
thromboses and pulmonary embolisms. Conventional hemodialysis cartridges are designed to
remove urea, because urea removal is fundamental to dialysis quality metrics. However, urea is
a largely non-toxic stand-in for other waste products, and urea-focused efforts fail to capture the
complexity of dialysis in renal failure.
One class of uremic wastes that are thought to contribute to the illness of dialysis patients is
called "protein-bound uremic toxins" (PBUTs), such as indoxyl sulfate, kynurenic acid, and p-
cresyl. Because dialyzers do not allow albumin to pass from blood to dialysate, the toxins
bound to albumin do not pass in appreciable quantities either. Dialyzer design has focused on
urea removal. We hypothesize that increasing the residence time of blood in the dialyzer will
allow for increased PBUT removal and eventually, better health for patients who depend on
dialysis.
Hemodialysis treatment is associated with an increased risk of clotting despite anemia, uremia,
and chronic heparin use. The superphysiological shear stresses that platelets experience in
hemodialysis appear to prime them to form clots inappropriately. We designed a parallel-plate
dialyzer with tightly controlled shear forces. We will test whether platelet activation with this
novel design reduces platelet activation, compared to conventional dialyzers.

## Key facts

- **NIH application ID:** 10856289
- **Project number:** 1R01DK139048-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** WILLIAM H FISSELL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $518,661
- **Award type:** 1
- **Project period:** 2024-08-16 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10856289

## Citation

> US National Institutes of Health, RePORTER application 10856289, Beyond Urea Kinetics: Balancing Tradeoffs in Dialyzer Design for the Next 50 Years (1R01DK139048-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10856289. Licensed CC0.

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