Operations and Business Environment - Fresenius Medical Care

02. 1
Our Fiscal year
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offers various types of high-quality, high-performance
machines for automated peritoneal dialysis (APD) –
so-called cyclers.
As a result, another focus of our worldwide development
activities in 2006 was the “Global Cycler” project.
The aim is to offer high-quality APD at optimized
costs. The use of a common technological platform
for this project is an important step in this direction.
Membrane Technology
Whether hemodialysis is successful depends not only
on the dialysis machine, but also on the dialyzers and
membrane types used. With its different variants of the
Fresenius Polysulfone membrane, Fresenius Medical
Care has been the market leader in membrane technology
for many years. Today’s hollow fiber dialyzers
are highly effective and technologically sound. Still, we
are constantly working to further improve the efficacy
of membranes and dialyzers.
Conventional dialyzers and filters are characterized by
their non-specific removal of substances dissolved in
the patients‘ blood – all substances up to a defined
molecular weight pass through the membrane. In 2006,
we intensified our research on dialysis membranes that
work more selectively. For example, we are conducting
research on membranes with specific properties which
can remove targeted substances from patients’ blood.
In addition, we are working on membranes which
can release pharmaceutical agents into the blood of
patients – the so called “pharma tech” approach. Moreover,
special membrane properties can be achieved by
attaching appropriate ligands – special molecules –
to the membrane surface. All of these activities are still
in early development stages; the general medical
approach has to be tested first. But we are convinced
that future membranes will have functional qualities
of this type. In the search for promising possibilities,
we benefit from our experience as a leading membrane
developer and membrane manufacturer.
Acute Dialysis and Support Systems for Liver Functions
Another focal point of our R & D activities is the development
of machines and methods for the treatment
for acute kidney failure and addressing multi-organ
failure. In 2006, we intensified our activities in this area,
concentrating on classical acute dialysis. The high incidence
of this life-threatening illness in hospitals and the
inadequate treatment possibilities justify the concerted
efforts being made. As is the case with chronic renal
replacement therapy, treatment of acute renal failure
is limited by an incomplete pathophysiological understanding
of the processes involved. Where understood,
these processes have proved difficult to influence
successfully.
We are currently researching therapy concepts which
differ from the above-mentioned classical methods in
that the aim is targeted intervention in the disease process,
for example, in cases of multiorgan failure. The
procedures being investigated include apheresis techniques
and the use of certain adsorbers.
Acute liver failure has a special status among acute
illnesses due to the highly complex function of the
liver as the main detoxification organ. While “artificial
kidneys” can sustain life for many years even in cases
of complete kidney failure, there is no such therapy
available for liver failure. At the same time, there are
more and more cases of acute liver failure on account
of the increasing incidence of chronic viral liver
diseases (Hepatitis B and C), as well as due to poisoning
from drug and alcohol abuse.
Due to the complexity of the liver functions, extracorporeal
treatments are currently limited to a small part
of the organ’s detoxification spectrum. At present, such
therapies are only effective in cases where the liver has
not suffered irreversible damage, providing relief while
the liver regenerates itself, or serving as a stopgap
until a liver transplantation can be performed. Fresenius
Medical Care has an excellent track record in this area
for several years thanks to the Prometheus system we
developed. The system is constantly being improved
Fresenius Medical Care 2006