Abstract: SA-PO446
Examining Ultrafiltration Variance across Two Peritoneal Dialysis Prescriptions of the Automated Wearable Artificial Kidney (AWAK) in a Porcine Model
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Jain, Arsh, London Health Sciences Centre, London, Ontario, Canada
- Huda, Siti Noor, AWAK Technologies Pte Ltd, Singapore, Singapore
- Chirumarry, Sridhar, AWAK Technologies Pte Ltd, Singapore, Singapore
- Lim, Jason Tze Chern, AWAK Technologies Pte Ltd, Singapore, Singapore
- Gow, Sheena, AWAK Technologies Pte Ltd, Singapore, Singapore
- Gori, Mandar, AWAK Technologies Pte Ltd, Singapore, Singapore
- Venkataraya, Suresha Belur, AWAK Technologies Pte Ltd, Singapore, Singapore
- Singh, Sanjay, AWAK Technologies Pte Ltd, Singapore, Singapore
Background
AWAK PD uses sorbent-based tidal therapy that regenerates spent dialysate into clean dialysate fluid that returns to the peritoneum. Our aim was to study the ultrafiltration (UF) generation per gram of glucose exposed and absorbed (UF efficiency – UFE) under 2 AWAK PD prescriptions.
Methods
This study was conducted in a 5/6 nephrectomised porcine (Sus Scrofa, male). The animal (Low transporter; D/Pcreatinine at 4 hour = 0.40) was maintained on automated PD therapy (5 exchanges of 2L fills of 1.5% Dianeal® over 10 hours) in between the test periods. During the test period, daily 9-hour AWAK PD therapy was conducted; it consists of a 7-hour tidal sorbent phase and a 2-hour non-sorbent dwell phase (initial fill 2L, 1.5% Dianeal®). Glucose was dosed using AWAK’s glucose management system Setting 3; 4 settings are available, ranging from 0.3 – 6.8mL of Glucose 70%, every 7.5 minutes in the first 7 hours of tidal dialysis and during the 2-hour non-sorbent dwell, glucose was dosed every 7.5 minutes (Test A) or 15 minutes (Test B). The animal also had daily last fills (1L, 2.5% Dianeal®) throughout the study period. Post-AWAK PD therapy dialysate data were collected for glucose analysis and UF calculation.
Results
The difference in UF between the 2 tests was statistically insignificant (p-value = 0.81). The UF ranges and UFE rates are shown in Table 1. Higher UFE (exposed and absorbed) were observed for Test B and would be a preferred treatment prescription as it was able to achieve similar UF with lowered glucose exposure. This experiment was performed on a porcine model with a low transport status and the results may vary for a high transport status peritoneal membrane.
Conclusion
With a reduced requirement of glucose, the device size can be improved. Further long-term studies in both animals and humans are needed to ascertain the efficacy of the glucose management system and prescription implications of AWAK PD therapies.
Table 1: Summary of UF results from 2 glucose prescriptions
| Glucose dosing in non-sorbent phase | Test A - every 7.5 minutes [n = 14 days] | Test B - every 15 minutes [n = 14 days] |
| Average UF volume (mL); min-max | 852 (413 – 1046) | 867 (448 – 1064) |
| UFE – exposed (mL/g) | 9.4 | 10.3 |
| UFE – absorbed (mL/g) | 18.0 | 19.2 |
Funding
- Commercial Support – AWAK Technologies Pte Ltd