News

World Kidney Day: Advancing Acute Kidney Failure Management

World Kidney Day takes place annually on the second Thursday of March. This global campaign aims to raise awareness about kidney health, prevention, risks and living with kidney failure. ADVITOS GmbH, one of the EIT Health Catapult MedTech finalists and since then a participant in our Catapult program, has launched a revolutionary new technology for the treatment of multiple organ failure with its ADVOS (Advanced Organ Support) procedure. We talked to ADVITOS’ Catherine Schreiber, Deputy Managing Director, about the importance of her new procedure for kidney health and the future use of her ADVOS multi machine.

 

  1. March 11th is World Kidney Day, a worldwide campaign that focuses on kidney health. To what extent does kidney health play a role in your work?

There are two fundamentally different types of kidney failure: acute and chronic. As soon as the chronic kidney failure falls below approx. 20% of the original function, a transplant or preparation for a dialysis procedure must be considered. Our therapy focus with the ADVOS multi device is on patients with multiple organ failure in the intensive care unit. Acute kidney failure is part of multiple organ failure and can trigger or significantly worsen it. In the context of COVID-19 reporting, the media informed the general public that the combination of lung and kidney failure significantly increases mortality.

Our ADVOS therapy system aims to support the kidney function in acute cases of illness and to treat the patient using the multi-organ therapy approach (combined kidney, liver and lung support) so that further organ damage is minimized and thus survival is increased as well as restoration of full kidney function after discharge from the hospital is guaranteed.

 

  1. ADVITOS is a scale-up, whose detoxification process ADVOS is used worldwide as the first procedure for extended and individualized support of the main detoxification organs liver, lungs and kidneys as well as the acid-base balance. Can you tell us a little more about the procedure?

Our body needs to be continuously detoxified in order to stay healthy. This means that harmful substances are steadily removed from the body via the detoxification organs. If just one of the three main organs of detoxification – liver, lungs or kidneys – fails, it can already cause problems for the patient and increase mortality. If all three organs fail (multiple organ failure), the mortality rate is over 75%1. So it’s a matter of life and death for the patient. Until now, each organ had to be treated with its own medical therapy and associated device. For some years now, the voices of medical professionals have been increasing that there is a great need for combined multi-organ support in order to be able to treat patients more holistically and to reduce costs and complexity.

We have developed the ADVOS method for this purpose, which is based on a single technology and in a single device simultaneously supports the liver, lungs and kidneys and offers blood pH management by correcting the acid-base balance and removing CO2. Our 4-in-1 procedure, which is unique in the world, can significantly improve the chances of survival of intensive care patients. Observational studies have shown that our technology dramatically improves expected patient survival, from a very low 10% in critically ill patients to up to 50%.

 1 Vincent et al. (1998). Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicentre, prospective study.

 

  1. Where is ADVOS already being used?

The ADVOS process is currently used in 20 leading (university) clinics in Germany. We are also talking with clinics in Austria in order to begin therapy there soon.

 

  1. You won the Innovation Prize Bavaria 2020 in November. What significance does this award have with regard to the implementation of your technology in the market?

The Bavarian Innovation Prize has increased interest in us and our ADVOS process. This has given us better visibility in the market – both with hospital staff and decision-makers as well as with potential investors.

Doctors are sometimes quite conservative about new procedures and technologies. Recognition by the innovation award can certainly help us a bit here and also open new doors to establish our ADVOS process in other clinics.

 

  1. To what extent is ADVOS an advance on conventional kidney replacement therapy?

Here we have to differentiate between the use of renal replacement therapy in chronically ill patients and in patients with acute kidney failure. In the chronically ill, kidney replacement therapy leads to a significant extension of the patient’s lifespan, which can be just as good as in patients after a kidney transplant. Studies on renal replacement therapy in critically ill patients in the intensive care unit have shown that the hospital mortality of these patients is still at least over 45%. Despite various studies aimed at reducing this high mortality rate, no improvement has been achieved in the last 30 years.

Renal dialysis patients with acute kidney failure all have multiple organ failure. As with Covid-19 patients, this is often accompanied by lung failure but also by liver failure. The ADVOS therapy was developed for this and has already been able to demonstrate initial successes in several published studies. By the way, almost all of the patients in these studies also had acute kidney failure requiring dialysis.

 

  1. The main theme of World Kidney Day this year is chronic kidney disease. Can this patient group also benefit from ADVOS?

ADVOS therapy was not primarily developed for chronic kidney patients. But the use of ADVOS therapy for multi-organ failure in critically ill patients can help to ensure that fewer patients develop chronic kidney failure as a result of acute kidney failure. A current study shows that up to 10-20% of patients who have been treated in intensive care and who have had acute kidney failure developed chronic kidney failure after discharge from the hospital.

In a few years, it is also conceivable that our therapy will also be used in patients with chronic kidney disease. Classic renal replacement therapy only removes water-soluble toxins and excess fluid. In addition to water-soluble toxins, the kidneys also remove other types of toxins: the focus here is on protein-bound toxins. Since the ADVOS therapy also removes these toxins, it is conceivable that in a few years people with chronic kidney disease will also benefit from our therapy and, hopefully, the quality of life and life expectancy will increase (patients with chronic dialysis currently have a shorter life expectancy than the normal population).

 

  1. Finally: What is your personal message on World Kidney Day?

I think the most important thing is that as few patients as possible need chronic dialysis. In my opinion, this can only be done through preventive measures or by reducing kidney failure in acute illnesses.