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Dialysis that isn't tethered to a clinic

editorial

Devices & Hardware · nothing open · hardest part: engineering, regulatory, manufacturing, reimbursement

Treatment is lifelong, three times weekly, and consumes a large share of some health systems' budgets. Machine and consumable design is closed and the recurring cost is structural.

This is editorial, not a record. Registry entries are cited facts about things that exist; an opportunity is our argument about something that does not. The links to existing work are checked against the catalog — the judgment around them is ours, and you should disagree with it where you know better.

why it stays closed

Haemodialysis is delivered as a service built around fixed clinics, proprietary machines, and single-use dialyser and tubing sets. The recurring consumable and the clinic visit are the cost, and both are locked to the machine. Portable and regenerative approaches would break that model, which is precisely why the incumbent design does not pursue them hard.

what is missing

A sorbent-based or otherwise water-frugal design that does not need a treated water supply, with an open dialyser specification and a safety architecture that a regulator will accept. The safety case is the hard part and should be treated as such: this is a device that can kill a patient quickly through fluid or electrolyte error.

who this is for

Patients whose treatment is rationed or who travel hours to a clinic, and health systems where the dialysis line item crowds out primary care.

what already exists

Nothing in the registry addresses this. That may mean the gap is real, or that our catalog has a hole — tell us if it is the second.

sources

None cited. Everything above is either reasoning about market structure or a claim you should check yourself. Where we could not source a number, we left it out rather than estimating one.

Last revised 2026-08-05.