FOR many kidney patients afflicted with end stage renal disease (ESRD), having to sit through dialysis treatments for hours on end is an inconvenient but necessary part of life. But the development of a portable artificial kidney device by locally-based AWAK Technologies could change that.

The product, which weighs around one kg and is one-touch battery-operated, is expected to undergo clinical trials in the United States this year, and AWAK hopes to commercialise the medical device in 2015.

Said Neo Kok Beng, AWAK's president and chief executive: 'The best way for a kidney to function is for it to work 24/7. One way to return the lifestyle back to kidney patients is to make a device that works 24/7, and this is the philosophy that underlies our design.'

Unlike centre-based hemodialysis which filters waste products out of a patient's body by pumping blood through a machine, AWAK's artificial kidney device uses the peritoneal dialysis process which works in the abdomen. After the dialysate solution has absorbed the body's waste products, the fluid is drained from the abdomen and replaced with new fluid.

In the case of AWAK's device, the fluid need not even be continually replaced. One of the more innovative features of AWAK's device is that the dialysate solution is recycled through an automated system. This reduces the need for patients to keep topping up the device with new dialysate solution.

In fact with the system, which Mr Neo affectionately calls 'the NEWater of dialysis', users just need to change the disposable cartridge containing the dialysate solution once, or up to three times a day, depending on the therapy mode.

Beyond the convenience factor, AWAK's users could also stand to gain from the substantial cost savings involved.

Currently, centre-based hemodialysis treatment is still the most common method of dialysis among kidney patients in Singapore.

Highlighting the challenge for patients undergoing such dialysis sessions, Mr Neo said: 'For such patients, dialysis usually occurs on alternate days. This means that the toxins build up in the body for 48 hours and have to be cleared in a couple of hours. The treatment then causes a big 'swing' in the body due to the inconsistent levels of waste and chemicals in the body between treatments.'

First-mover advantage

This could result in the patient developing further medical complications such as hypertension and cardiac arrest. Using AWAK's system, which works 24/7, such 'swings' can be avoided and patients will no longer have to take further medication to treat the side effects, explained Mr Neo.

As a result, the company estimates that patients could save up to US$10,000 a year from reduced drug and hospitalisation costs when they make the switch to AWAK.

The benefits are not limited to the end users. AWAK also promises value propositions for dialysis centres through increases in revenue and decreases in cost.

At present, a dialysis machine, which costs between $15,000 and $20,000, can serve an average of six patients weekly, observed Mr Neo. 'With our product, dialysis centres can scale up their operations and serve as many patients as they can due to the lack of facilities constraints for patient recruitment,' he said.

The medical device company also hopes to assist dialysis centres in cost reduction efforts by lowering manpower needs and eliminating expensive in-centre dialysis treatments for dialysis centres which make the switch.

While some medical companies such as Fresenius Medical Care and NephCor are currently working on wearable dialysis treatments, none of them have been able to provide a marketable product yet. By pushing for its wearable artificial kidney to reach the market in 2015, AWAK hopes to be the first company to market such a product and thus gain a first-mover advantage.

Already, the company has received considerable attention from both local and foreign agencies.

In 2008, the company received a $500,000 grant from enterprise enabling agency Spring Singapore under its technology innovation programme. Fast forward two years later and the company achieved another milestone, this time by winning an innovation initiative award from the US Department of Veteran Affairs. The US$1 million award will allow AWAK to continue the study of its automated wearable artificial kidney system so as to test the safety and efficacy of the design, said Mr Neo.

According to the 2011 annual data report released by the US Renal Data System, in 2009, there were close to 600,000 kidney patients in the US with a total cost of US$23.3 billion. On average, a kidney patient will spend US$72,000 a year using Medicare (a form of health insurance coverage administered by the US government).

Great ambitions

With a target price tag of $20,000 per patient per year, AWAK hopes to offer its wearable artificial kidney system at a price that is lower than the current US reimbursement insurance scheme. The medical device company has $6 million from private funds and expects to acquire $30 million to commercialise its model.

In order to prepare for commercialisation of the wearable kidney system in 2015, the company is currently working with regulatory health bodies in Singapore, the US and Europe. Its plans include extending its technology platform to develop home-based peritoneal dialysis and hemodialysis machines.

The company has great ambitions when it comes to changing the future of renal care.

Said AWAK chairman Gordon Ku: 'The vision of AWAK is to change the paradigm in kidney dialysis. With AWAK, we aim to be the Microsoft or Apple of dialysis.'