Malaysia – Statistically, it is estimated that one in twelve Malaysians has kidney failure and millions more are at risk. Commonly, these patients need dialysis treatment when they reach the final stage of kidney failure or typically known as the end-stage renal failure (ESRF), where they lose 85% to 90% of their kidney function.
In Malaysia, the number of dialysis patients keeps increasing with the estimation of 5,000 new cases of ESRF being reported each year. The statistics from the National Kidney Foundation Malaysia reveals worrying figures where the total number of haemodialysis patients had increased from 12,182 patients in 2005 to 38,157 patients at the end of 2016. In fact, with he right projection there will be 43,000 haemodialysis patients altogether by the end of 2017.
Every year, the government allocates RM50 million to cater to the cost of treatment of around 38,000 ESRF patients. However, only 35,580 patients from that number undergo haemodialysis treatment. Out of the 35,580 patients, government hospitals are able to cover the expenses for only 8,000 patients. The remaining patients have to solely rely on the subsidy from the Government and NGOs. According to local sources, the amount paid by each patient for every session is RM162 (around USD$38 with government subsidy), and part of the amount comes from the cost of the haemodialyser. It is known that the market price for an imported haemodialyser can be as high as RM125 (US$30) per dialyser depending on the brand and packing size. Therefore, immediate action is needed to compensate and reduce at least the cost of haemodialyser.
To that end, UTM made it a mission to establish its own brand for renal products, starting with the production of a haemodialyser. In order to do that, Prof Dr Ahmad Fauzi Ismail and his team from the Advanced Membrane Technology Research Centre (AMTEC), Universiti Teknologi Malaysia (UTM), began their research into creating a home-grown haemodialysis system for blood purification using membrane technology that would greatly reduce the cost of treatment for Malaysian ESRF patients, and the government and NGOs who are subsidising treatment. This is because at present, hospitals and haemodialysis centres in Malaysia solely depend on imported renal products from modern countries like Japan and Germany.
The project started with the development of a high performance haemodialysis membrane, where prior to membrane fabrication process, a polymer solution was prepared by mixing 18 wt.% polysulfone and 8 wt.% polyvinylpyrrolidone in N-methyl-2-pyrrolidone as the solvent. Both membrane and haemodialyser were produced using in-house equipment and instruments producing a well-optimised membrane specifically designed to remove critical uremic toxins while retaining essential proteins like albumin in blood, resulting in an optimised blood purification process. Further, along with the low production cost and high flux achievement, this home-grown haemodialyser is capable of removing sufficient amounts of uremic toxins from a patient’s blood including a large fraction of recalcitrant middle molecular weight molecules.
It is anticipated that the reduced price of this home-grown haemodialyser, in addition to the product’s trusted performance, will heighten the chances of market penetration in Malaysia, with the potential to greatly reduce costs borne by patients, the government, and NGOs, freeing up valuable resources to be used in other high impact projects that cater to the nation’s needs. With such an impact to Malaysian society as a whole, it is little wonder that UTM’s long-term goals include making Malaysia a regional base for renal products in Southeast Asia, and perhaps one day, the world.