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.
Chronic hemodialysis is a life-sustaining therapy, delivered mostly thrice weekly in dialysis clinics. For patients on dialysis who appear to have a heightened likelihood of severe infection or death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), travel to these facilities and proximity to fellow patients and health care providers during hemodialysis may pose an...
Patients treated with hemodialysis (HD) repeatedly undergo intradialytic low arterial oxygen saturation and low central venous oxygen saturation, reflecting an imbalance between upper body systemic oxygen supply and demand, which are associated with increased mortality. Abnormalities along the entire oxygen cascade, with impaired diffusive and convective oxygen transport, contribute to the reduced tissue oxygen supply....
Intradialytic hypotension (IDH) is a common complication of hemodialysis, but there is no data about the time of onset during treatment. Here we describe the incidence of IDH throughout hemodialysis and associations of time of hypotension with clinical parameters and survival by analyzing data from 21 dialysis clinics in the United States to include 785682...
Broad adoption of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is key to successfully fighting the spread of coronavirus disease 2019 (COVID-19). When fallen ill with COVID-19, in-center hemodialysis patients are at particularly high risk for morbidity and mortality.1 , 2 Therefore, attaining high vaccination rates in both dialysis patients and staff is of utmost importance....
Background/aims: Hepatitis B (HB) vaccination in hemodialysis patients is important as they are at a higher risk of contracting HB. However, hemodialysis patients have a lower HB seroconversion rate than their healthy counterparts. As better sleep has been associated with better seroconversion in healthy populations and early hemodialysis start has been linked to significant sleep-wake disturbances...
Artificial intelligence (AI) is considered as the next natural progression of traditional statistical techniques. Advances in analytical methods and infrastructure enable AI to be applied in health care. While AI applications are relatively common in fields like ophthalmology and cardiology, its use is scarcely reported in nephrology. We present the current status of AI in...
Red blood cells (RBC) are the most abundant cells in the blood. Despite powerful defense systems against chemical and mechanical stressors, their life span is limited to about 120 days in healthy humans and further shortened in patients with kidney failure. Changes in the cell membrane potential and cation permeability trigger a cascade of events...
Background Dialysis recovery time (DRT) surveys capture the perceived time after HD to return to performing regular activities. Prior studies suggest the majority of HD patients report a DRT > 2 h. However, the profiles of and modifiable dialysis practices associated with changes in DRT relative to the start of dialysis are unknown. We hypothesized hemodialysis (HD)...
Hemodialysis has saved many lives, albeit with significant residual mortality. Although poor outcomes may reflect advanced age and comorbid conditions, hemodialysis per se may harm patients, contributing to morbidity and perhaps mortality. Systemic circulatory “stress” resulting from hemodialysis treatment schedule may act as a disease modifier, resulting in a multiorgan injury superimposed on preexistent comorbidities. New functional...
Precise maintenance of acid-base homeostasis is fundamental for optimal functioning of physiological and cellular processes. The presence of an acid-base disturbance can affect clinical outcomes and is usually caused by an underlying disease. It is, therefore, important to assess the acid-base status of patients, and the extent to which various therapeutic treatments are effective in...
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.