Pioneering Leadership in Computational Biomedicine and Data Analytics
Much of the work at RRI involves the development of advanced mathematical models aimed at improving the care of dialysis patients and creating value for Fresenius Medical Care. Mathematicians at RRI, in collaboration with Fresenius Medical Care's Global Research and Development (GRD) division, have spearheaded the concept of virtual clinical trials (VCTs).
Treatment algorithms are developed and tested in large-scale VCTs using mathematical simulations of patient's physiology. In collaboration with the Fresenius Medical Care Global Medical Office, VCT-derived algorithms have been implemented at Fresenius Kidney Care (FKC) clinics throughout North America, potentially benefiting over 160,000 FKC patients.
The computational biomedicine group works with other branches of RRI, including the clinical and laboratory research groups, data analytics team, and Fresenius Medical Care GRD. A substantial proportion of the work undertaken by the RRI teams is specifically designed to validate concepts and insights derived from the computational biomedical research and to generate data used to inform mathematical models.
RRI's data analytics team includes highly specialized research design statisticians and epidemiologists, who can further our understanding of patient and population outcomes. The team has mastered a broad range of statistical methods, including descriptive analysis, longitudinal multidimensional models, predictive analytics, machine learning, and deep-learning neural networks. While the team's research portfolio involves a wide range of chronic kidney disease research initiatives, its primary focus is on improving kidney care through quantitative analysis. For several years, the team has been integral in the analysis of Crit-Line® data. Insights gleaned from the team’s work resulted in novel, ground-breaking research into the dynamics of intradialytic arterial and venous oxygen saturation, fluid overload, inflammation, sodium, blood pressure, and lipids.
Abstract Objectives: Despite the possibility of concurrent infection with COVID-19 and malaria, little is known about the clinical course of coinfected patients. We analysed the clinical outcomes of patients with concurrent COVID-19 and malaria infection. Methods: We conducted a retrospective cohort study that assessed prospectively collected data of all patients who were admitted between May and December...
Abstract The aim of the paper is to summarize the current understanding of the molecular biology of arteriovenous fistula (AVF). It intends to encourage vascular access teams, care providers, and scientists, to explore new molecular tools for assessing the suitability of patients for AVF as vascular access for maintenance hemodialysis (HD). This review also highlights...
Abstract Diagnosis of fluid overload (FO) in early stage is essential to manage fluid balance of patients with chronic kidney disease (CKD) and to prevent cardiovascular disease (CVD). However, the identification of fluid status in patients with CKD is largely dependent on the physician's clinical acumen. The ratio of fluid overload to extracellular volume (FO/ECV)...
Abstract Background: We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods: We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included...
Abstract Introduction: Segmental eight-point bioimpedance has been increasingly used in practice. However, whether changes in bioimpedance analysis components before and after hemodialysis (HD) using this technique in a standing position is comparable to traditional whole-body wrist-to-ankle method is still unclear. We aimed to investigate the differences between two eight-point devices (InBody 770 and Seca mBCA 514)...
Abstract Erythropoietin deficiency is an extensively researched cause of renal anemia. The etiology and consequences of shortened red blood cell (RBC) life span in chronic kidney disease (CKD) are less well understood. Traversing capillaries requires RBC geometry changes, a process enabled by adaptions of the cytoskeleton. These changes are mediated by transient activation of the...
Abstract Introduction: One proposed threshold ultrafiltration rate (UFR) of concern in hemodialysis patients is 13 ml/h per kg. We evaluated associations among UFR, postdialysis weight, and mortality to determine whether exceeding such a threshold would result in similar levels of risk for patients of different body weights. Methods: Data were analyzed in this retrospective cohort study for...
Abstract Herbal medicine, a form of complementary and alternative medicine (CAM), is used throughout the world, in both developing and developed countries. The ingredients in herbal medicines are not standardized by any regulatory agency. Variability exists in the ingredients as well as in their concentrations. Plant products may become contaminated with bacteria and fungi during...
Abstract The development of maintenance hemodialysis (HD) for end stage kidney disease patients is a success story that continues to save many lives. Nevertheless, intermittent renal replacement therapy is also a source of recurrent stress for patients. Conventional thrice weekly short HD is an imperfect treatment that only partially corrects uremic abnormalities, increases cardiovascular risk,...
Our Research Lab
The RRI laboratory is at the center of our clinical trials and advanced data analytics. The lab employs sophisticated tools and methodologies to dig deeper, looking at questions and factors critical to the development of cutting-edge technologies, new medical devices, and innovative therapeutic methods.
RRI has a long history in creating intellectual property. Since its inception, over 140 patents have been issued to RRI inventors. Here are a few recent examples:
Virtual kidney donation (U.S. Patent 10,391,220):
This invention describes allo-hemodialysis, a method where a patient's blood is dialyzed against the blood of a healthy subject (“buddy”). Allo-HD drastically reduces the complexity and cost of hemodialysis and may thus help to address the global shortfall in dialysis therapy
Method of removing protein-bound deleterious substances during extracorporeal renal replacement treatment (U.S. Patent 8,419,943):
This invention describes a novel concept to remove protein-bound solutes by means of a displacer molecule that competes with the solute at its binding site. The effectiveness of that approach has been shown in a clinical study by Madero et al.
System and method of modeling erythropoiesis and its management (U.S. 10,319,478):
This invention describes a method of attaining a target hemoglobin level using an erythropoiesis stimulating agent regimen. It is central to virtual trials as conceived by Fuertinger et al.