Chronic kidney disease affects more than 700,000,000 people worldwide. There are about 3,000,000 people worldwide with end stage kidney disease (ESKD) on maintenance hemodialysis, essential to sustaining their lives. As many as 7,000,000 people worldwide each year will die due to lack of access to this complex and expensive technology. When a patient starts hemodialysis, average lifetimes are 4-5 years. Dialysis therapies cost the world over $100B each year.  Dialysis is an environmental disaster with over 187,200,000,000 liters of high quality water used each year and over 1.8 million kilometers of PVC tubing consumed and tossed in the trash each year. There have been only incremental advances in the technology of chronic dialysis since it was introduced in Seattle in 1960. The University of Washington Center for Dialysis Innovation (CDI), some 15 lead investigators and 30 students and postdocs, is committed to developing wearable and portable forms of hemodialysis using 1 liter of water and more closely emulating the 24/7 toxin clearance provided by the heathy kidney. Chemistry and chemical engineering play a major role in this transformational medical device development. To meet this objective CDI uses TiO<sub>2</sub> photocatalysis, improved blood compatibility based upon zwitterionic and fluoropolymer surfaces, molecularly imprinted polymers and enhanced skin and blood vessel healing based upon precision porous polymers. These technological approaches and the CDI systems engineering for integrating these developments will be summarized in this talk.

Kidney dialysis: A multidisciplinary nexus for chemistry, physics, engineering, biology and medicine

ACS Fall 2021

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