Unmet need: About 50,000 people in the UK are receiving treatment for incurable kidney failure. Of these, about 44% are treated with haemodialysis which is usually provided in hospital or free-standing 'satellite' units. Patients have to attend the dialysis unit three times a week. It takes the dialysis machine about 4 hours to remove the toxins and fluid that has built up in the patient's body. But with the time taken for the staff to connect and disconnect the patient, and for the patient to travel to and from the unit, attending for dialysis can take over 7 hours. Patients who are able to undertake haemodialysis at home not only avoid the travel time and the risk of developing hospital-acquired infections, but also have the opportunity to try alternative dialysis schedules. Home haemodialysis patients are increasingly moving to short treatment sessions 5 or 6 times a week and to dialysis overnight while they sleep. These schedules are associated with improved well-being and survivalcompared to the traditional thrice weekly treatment. Even though patients require their own machine, dialysis at home costs the NHS much less than the labour-intensive centre based treatments. But, despite NICE guidance  strongly encouraging renal units to promote home haemodialysis, fewer than 3% of dialysis patients choose this modality.

Solution: In collaboration with D4D, Quanta Fluid Solutions are developing a 'patient-centred' haemodialysis machine, the SelfCare+. This small, user-friendly machine will provide treatment that is just as efficient as a centre-based dialysis. Quanta's first innovative step was to replace the bulky, high maintenance hydraulic systems that prepare the fluid required for dialysis with small plastic components moulded into a disposable cartridge. This means the Selfcare+ can be made light enough to be portable and that it has no internal fluid pathways that require disinfection between treatments. With D4D support, Quanta has obtained an NHS i4i (Invention for Innovation) grant to ensure that the Selfcare+ can meet the needs of potential home haemodialysis patients as fully as possible. Feedback from patients to date is very promising. The SelfCare+ is expected to be approved for sale in Europe in mid-2012. It is hoped that, with more flexible installation requirements, short user training period, rapid set-up and strip-down times and the option of use while travelling, will encourage more haemodialysis patients to opt for, and get the benefits of, self-care in their home.

A cutting-edge technology with the objective of allowing the self-administration of haemodialysis and carrying out the procedure in the person's own home with simplicity has been spearheaded by Devices for Dignity. The machine is easily transported, requires no cleaning and needs only minimal clinical support.

Traditionally people who rely on haemodialysis as a treatment for kidney failure have to visit a hospital three times a week to undergo their treatment. With each treatment lasting approximately four hours, with additional time needed to set up dialysis machines - this is an incredibly disruptive process for patients, and is labour-intensive and costly for the NHS.

When Martin Johnson, of Quanta Fluid Solutions (the commercial partner collaborating with D4D), wanted to develop a unique haemodialysis machine, he looked to D4D for greater knowledge on patient and clinical needs; working with D4D renal specialist Dr Elizabeth Lindley.

"What D4D has done has enabled us to develop a relationship with Dr Lindley and her team. It has also provided us with access to patients to discuss their needs and requirements from a home dialysis unit. Without D4D I don't think we'd have had the same quality of advice and support from clinical staff." said Mr Johnson.

Through D4D, Mr Johnson attended an NHS Innovation Conference in London, where the haemodialysis unit attracted the attention of NHS Chief Executive Sir David Nicholson. "Meeting Sir David Nicholson, and hearing him endorsing what we're doing is fantastic."

The Quanta machine SelfCare+ uses a sophisticated cartridge to mix the water and salt solutions required to generate the fluid required for dialysis. Although it produces the fluid in small aliquots, it is able to match the flow rates of a standard machine so that patients receive exactly the same high quality treatment they would receive in a hospital haemodialysis unit. As the cartridge is disposable, the need for disinfecting the fluid pathways of the machine after each dialysis is eliminated.

Having the machine at home allows patients to adapt their treatment schedule, enabling them to dialyse at times which fit into their daily lives. They can also chose to have short sessions each day, reducing the build up of excess fluid and toxins between treatments, or to have slow, gentle dialysis overnight.

In addition, according to latest medical research, more frequent and longer dialysis will have a beneficial impact on patient survival and long-term overall wellbeing. Current hospital dialysis capacity is unlikely to be able to expand to cope with the increased treatment delivery required, so the new haemodialysis machine aims to provide a cost effective solution for increased dialysis frequency for a significant proportion of kidney patients.

Professor Albert Ong, Head of the Academic of Nephrology at the University of Sheffield, said: "This new device could revolutionise the treatment of patients with kidney failure by making dialysis more available and flexible. It will also shift the emphasis of treatment away from the hospital into the home."

The new machine is currently undergoing regulatory tests. If all goes well, staff and patients at the Sheffield Kidney Institute, the University of Sheffield´s Nephrology Unit, and at Leeds Teaching Hospitals will be starting the clinical evaluation early next year. It is anticipated that the launch of the system in the UK market will be 2012 and it will be made available to dialysis patients via their local renal units in the NHS Trusts that have progressive home programs.

Quanta is developing SelfCare+ with input from patients, clinicians, nurses from the UK, Germany, France, the USA and other countries.

Link to Quanta website