New Kirpa Kit: A Manual Dialysis Device for Low- and Middle-Income Countries in Catastrophic Environments

Background: Alarming data about the increased incidence of acute kidney injury (AKI) in low- and middle-income countries around the globe is a trigger to research. While much is being done to prevent AKI, we must also investigate easy and economic options for renal replacement therapy (RRT)in resource-limited environments. After in vitro experiments showed promising results, we decided to join forces with Dialysis Without Borders to find a way to help these vulnerable populations. Methods: Last year we witnessed in our hospital increased incidence of AKI from heatwave. We commonly treat patients who present late to care because they live in low-resource, rural settings or even un urban Mexico. To improve treatment options, we look forward to using a manual dialysis equipment for acute ultrafiltration, and if necessary, hemodialysis to treat life threatening conditions, as a temporary treatment or bridge to the treatment needed. Results: We introduce the KIRPA Kit, a manual dialysis device without the need for electricity, at very low cost. We can draw out blood (60 ml) from the patient via the bypass line into Syringe 1. Then the blood will be pushed out of the syringe through the filter and be returned to the patient. While the blood passes through the filter, the dialysate (for purposes of HD) will come from the syringe 3 through the filter. While for the ultrafiltration, this will get to the effluent bag through the syringe 2. There is a syringe that acts as a deaeration chamber located proximal to the patient that may serve to pull off any air bubbles visualized in the circuit (syringe 4). Conclusion: It is quite important the learning and training before the use of KIRPA in humans. Although it is simple and quickly. The manual dialysis may serve as a future tool for patients without timely access to necessary RRT. It is a new and innovative therapy for clinical scenarios where deficiencies, sometimes even of light, wreak havoc on patients with fluid overload or require RRT.