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Figure 2: ESRD: End-stage renal disease; QoL: Quality of life; Panel A – Traditional pathway in the management of ESRD where the patient is on hemodialysis or peritoneal dialysis awaiting transplantation. Panel B – Future pathway in the management of ESRD. Patient QoL and choices drive management. Options include parallel and inter-related future “artificial kidneys”. The likely sequence of availability and use would be enhanced dialysis, portable/wearable kidney, and bio-hybrid/implantable kidney and regenerated kidney. However, developments overlap; for example, wearable/portable kidneys enhance dialysis by increasing the opportunity for home dialysis and increasing frequency and autonomy. Similarly, regenerative medicine may provide specialized cells for bio-hybrid/implantable kidneys and membranes for enhanced dialysis. Artificial intelligence/machine learning helps patients make an individualized decision; gives inputs to bioengineering technology, and can even provide specific data points regarding the performance of each of the “artificial kidneys”

Figure 2: ESRD: End-stage renal disease; QoL: Quality of life;  Panel A – Traditional pathway in the management of ESRD where the patient is on hemodialysis or peritoneal dialysis awaiting transplantation.  Panel B – Future pathway in the management of ESRD. Patient QoL and choices drive management. Options include parallel and inter-related future “artificial kidneys”. The likely sequence of availability and use would be enhanced dialysis, portable/wearable kidney, and bio-hybrid/implantable kidney and regenerated kidney. However, developments overlap; for example, wearable/portable kidneys enhance dialysis by increasing the opportunity for home dialysis and increasing frequency and autonomy. Similarly, regenerative medicine may provide specialized cells for bio-hybrid/implantable kidneys and membranes for enhanced dialysis. Artificial intelligence/machine learning helps patients make an individualized decision; gives inputs to bioengineering technology, and can even provide specific data points regarding the performance of each of the “artificial kidneys”