A Novel Anticoagulation-Free Hemodialysis Paradigm: A Second-Generation Hemodialysis Filter Rotator Prototype Using the NxStage Machine Is Ready for Clinical Trials

Background: There is a critically unmet need for a new method of anticoagulation-free hemodialysis (AFHD). Current alternatives are often ineffective, expensive, technically challenging and/or with potential serious adverse effects. In the 2021 Mayo Clinic Proceedings Innovations Quality Outcomes journal, we described the ‘Locke-Onuigbo maneuver’, a new original hemodialysis filter rotational approach to achieve AFHD using the NxStage HD machine. We completed the design and development of an advanced second-generation HD filter rotator (HDFR) prototype in 2023. Methods: This was a Capstone Project from “bedside to manufacture” translational research utilizing the ‘Locke-Onuigbo maneuver’. Results: In 2023, we completed the design and development of an advanced second-generation HDFR prototype that is now ready for clinical testing (Figures). These Youtube links show some of the demonstrations: https://www.youtube.com/watch?v=nCDraOlZZF8 and https://youtube.com/shorts/ncR3VieJkEY?feature=share. Conclusion: There is a long overdue imperative for a robust, safe, and sustainable modality for AFHD. Our second-generation HDFR prototype with its enhanced new features of increased resilience, longer running times, enhanced angle and speed consistency, improved ergonomics, solid state sensors for temperature and angle fidelity verifications, and an accompanying user-friendly versatile smartphone App with Bluetooth Connectivity to facilitate ease and convenience of monitoring and control of the HDFR, is the solution for this long overdue imperative for anticoagulation-free hemodialysis. It is ready for clinical testing.Excerpt - 2021 Mayo Clin Proc Innov Qual Outcomes articleThe second HDFR prototype from 2023