Description

Kidney is the foundation of life. It plays a crucial role in excretion, regulation and endocrine functions in the body, making it one of the most important organs. The kidney consists of nephrons, which primarily include glomeruli and renal tubules.

In general situations, metabolic waste exists in the blood and is eliminated through the kidneys. The process is as follows: Firstly, blood is filtered through the glomerular capillaries. But because the glomerulus cannot pass through large molecules such as plasma proteins, the resulting ultrafiltration fluid (original urine) only contains small molecules such as water, creatinine and urea. Secondly, some components in the ultrafiltration fluid (such as water, glucose, Na+, Cl -, K+, etc.) are selectively reabsorbed into the blood by renal tubules and collecting ducts. Finally, the metabolic waste creatinine and urea continue to remain in the original urine, forming final urine that is excreted by the human body.

Kidney damage is not an immediate process but rather a chronic and hidden one. Chronic kidney damage is also known as chronic kidney disease. Chronic kidney disease (CKD) is a chronic progressive damage to the structure and function of the kidney caused by various reasons, with a course of more than 3 months. Its clinical manifestations include varying degrees of urinary protein, edema, hypertension, renal function damage, and a group of syndromes. The most common type is chronic renal insufficiency, with creatinine and urea nitrogen levels higher than normal, renal volume atrophy, and anemia or PTH levels higher than normal. The basic functional unit of the kidney is the nephron. When a small number of nephrons are damaged, other nephrons can compensate to exercise normal kidney function. However, when the kidney continues to be damaged, normal nephrons are unable to compensate for necessary functions such as blood filtration to maintain life, resulting in uraemia. It was already too late when we discovered kidney problems.

According to a report in The Lancet, in 2017, approximately 1.2 million people died from chronic kidney disease globally. From 1990 to 2017, the global mortality rate of chronic kidney disease increased by 41.5%, although age-standardized mortality rates did not show a significant change. Since 1990, the global prevalence of chronic kidney disease in all age groups has increased by 29.3%, while age-standardized prevalence has remained stable.

How big the affected people are! In this fast-paced world and with aging, our bodies gradually age and deteriorate, especially our kidney organs. In our daily lives, some of our behaviors also inadvertently harm our kidneys, such as consuming excessive salt, inadequate water intake, smoking, and misuse of medications. Most importantly, our nephrons are non-regenerative. After kidney function is impaired, metabolic waste, particularly creatinine and urea, cannot be properly eliminated through the kidneys. Instead, they seep into the gastrointestinal tract, causing damage to bodily functions and other organs. A large amount of these waste products remaining in the body can cause destructive harm. If measures are not taken to purify these wastes, the human body will continue to deteriorate and decline.

What treatment methods are currently available for chronic kidney disease?

Kidney disease syndrome is a common and difficult-to-treat glomerular disease, which is not only complex in terms of pathophysiology but also associated with multiple complications that are difficult to control. After conducting research, BUCT has identified several current treatment methods:

(1) Medication treatment

Advantages: There are numerous categories that can be used in conjunction. Such as diuretics, furosemide, etc.

Disadvantages: There are many restrictions on the use of drugs, such as those for allergies and pregnant women who cannot use them. What is more dangerous is that it can easily cause an imbalance between body fluids and electrolytes, leading to sudden hyperkalemia.

(2) Peritoneal dialysis

Peritoneal dialysis, also known as "PD," utilizes the patient's peritoneum as a dialysis membrane. It involves instilling dialysis fluid into the abdominal cavity, enabling solute exchange between the blood and the dialysis fluid to remove metabolic waste, maintain electrolyte and acid-base balance.

Advantages: Peritoneal dialysis does not require vascular preparation, carries a lower risk of bleeding, and does not require anticoagulation treatment. It is a simple and convenient procedure that can even be performed at home, making it suitable for children, patients with diabetes, and individuals with severe vascular disease.

Disadvantages: After treatment, complications such as peritonitis, pulmonary infections, and protein malnutrition may occur. Additionally, this treatment method can cause inconvenience in the patient's daily life and mobility, carries a high cost, and poses a significant risk of infection.

(3) Hemodialysis

Hemodialysis is an extracorporeal blood purification method. It typically involves creating an arteriovenous fistula in the patient's arm, connecting an artery and a vein, which allows sufficient blood flow for the dialysis process.

Applicable conditions: Chronic kidney failure, uremia, etc. However, it is not suitable for individuals with intracranial hemorrhage or increased intracranial pressure.

Advantages: Hemodialysis can remove metabolic waste from the patient's body, purify their blood, and maintain their electrolyte and acid-base balance at a relatively stable state.

Disadvantages:

1. After treatment, complications such as bleeding, air embolism, hypertension, and hypotension may occur. To prevent these complications, patients need anticoagulation therapy.
2. The equipment is sophisticated, the cost is high, and the treatment duration is long. The dialysis process requires patients to have a high tolerance of pain.

(4) Surgical treatment

Kidney transplantation surgery involves implanting the donor's kidney into the recipient's body to restore kidney function.

Advantages: Successful kidney transplantation can fully restore kidney function. Compared to dialysis treatment, patients have a better quality of life and a higher survival rate, making it the best treatment method for end-stage kidney disease patients.

Disadvantages: The surgical cost is high, the renal source is difficult to match, and rejection reactions are prone to occur after the surgery. Long term use of immunosuppressants is required after transplantation to prevent rejection reactions. In short, this method is almost impossible.

In summary, there is currently no cure for chronic kidney disease as the nephron is not renewable! Therefore, when the kidneys are damaged, the metabolic waste of the human body, especially creatinine and urea, will be left in large amounts in the blood. As creatinine and urea continue to accumulate in the blood, they first penetrate into the gastrointestinal tract through the blood vessels, further harming the body. To alleviate the suffering and burden of patients and improve their quality of life, BUCT aims to use synthetic biology methods to create a microorganism kidney that can colonize the gastrointestinal tract, replacing the kidney's function of purifying metabolic waste and simultaneously producing beneficial substances for the human body to promote recovery.

BUCT is committed to assisting the chronic kidney failure population in reducing the levels of creatinine and urea in the body, while also alleviating the other consequences of impaired kidney function, such as fluid and sodium retention and neurological damage caused by high urea levels. To achieve this, BUCT has designed a gastrointestinal probiotic that acts as a "kidney-like unit," continuously removing creatinine and urea that seep from the capillary walls in the gastrointestinal tract and using these waste products to synthesize polyglutamic acid and creatine. The converted polyglutamic acid has wide applications in the medical and healthcare fields, including maintaining normal gut microbiota growth, enhancing immunity, memory, lowering blood sugar, protecting the heart, and improving physical performance. It may also have the function of increasing intestinal motility, promoting the elimination of metabolic waste through the colon. Creatine is non-toxic and a nutritional substance, serving as a fatigue recovery agent, enhancing intelligence, preventing damage caused by brain injuries, and can be used to alleviate depression and schizophrenia.

BUCT sincerely hopes to reduce creatinine and urea levels in the bloodstream by assisting the kidneys in purifying metabolic waste, ultimately aiming to reduce the frequency of dialysis for patients and control the worsening of their condition to enhance their quality of life. Additionally, BUCT provides significant assistance in improving the patient's condition and disease prognosis by reducing symptoms and increasing the intake of beneficial substances for the human body.

• GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020 Feb 29;395(10225):709-733. doi: 10.1016/S0140-6736(20)30045-3. Epub 2020 Feb 13. PMID: 32061315; PMCID: PMC7049905.