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 Introduction: In maintenance hemodialysis (HD) patients, low central venous oxygen saturation (ScvO2 ) and small decline in relative blood volume (RBV) have been associated with adverse outcomes. Here we explore the joint association between ScvO2 and RBV change in relation to all-cause mortality. Methods: We conducted a retrospective study in maintenance HD patients with central venous catheters as...
Abstract Background: In maintenance hemodialysis patients, intradialytic hypotension (IDH) is a frequent complication that has been associated with poor clinical outcomes. Prediction of IDH may facilitate timely interventions and eventually reduce IDH rates. Methods: We developed a machine learning model to predict IDH in in-center hemodialysis patients 15-75 min in advance. IDH was defined as systolic blood...
Abstract Rationale & objective: People with end-stage kidney disease (ESKD) have very low physical activity, and the degree of inactivity is strongly associated with morbidity and mortality. We assessed the feasibility and effectiveness of a 12-week intervention coupling a wearable activity tracker (FitBit) and structured feedback coaching versus wearable activity tracker alone on changes in physical...
Abstract Background: We hypothesized that the association of ultrafiltration rate with mortality in hemodialysis patients was differentially affected by weight and sex and sought to derive a sex- and weight-indexed ultrafiltration rate measure that captures the differential effects of these parameters on the association of ultrafiltration rate with mortality. Methods: Data were analyzed from the US Fresenius...
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Abstract Background: Nonadherence to hemodialysis appointments could potentially result in health complications that can influence morbidity and mortality. We examined the association between different types of inclement weather and hemodialysis appointment adherence. Methods: We analyzed health records of 60,135 patients with kidney failure who received in-center hemodialysis treatment at Fresenius Kidney Care clinics across the Northeastern US...
Abstract Background: Attaining the optimal balance between achieving adequate volume removal while preserving organ perfusion is a challenge for patients receiving maintenance hemodialysis. Current strategies to guide ultrafiltration are inadequate. Methods: We developed an approach to calculate plasma refill rate throughout hemodialysis using hematocrit and ultrafiltration data in a retrospective cohort of patients receiving maintenance hemodialysis at...
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Abstract Introduction: Several factors affect the survival of End Stage Kidney Disease (ESKD) patients on dialysis. Machine learning (ML) models may help tackle multivariable and complex, often non-linear predictors of adverse clinical events in ESKD patients. In this study, we used advanced ML method as well as a traditional statistical method to develop and compare the...
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.