Fresenius Medical Care

Fresenius Medical Care focuses its research and development strategy on three essential objectives:

  • to continuously enhance the quality of life of patients with chronic kidney disease using innovative products and treatment concepts
  • to offer our customers high-quality services while keeping our prices as low as possible, and,
  • on this basis, to continue to expand our global leadership in the dialysis market.

In 2009, Fresenius Medical Care expanded its activities in its key areas of strategic development – for example in the field of online-hemodiafiltration (Online-HDF) and the 5008 therapy system based on it. In May 2009, we presented another innovation built on this development platform at the industry congress ERA-EDTA (European Renal Association / European Dialysis and Transplant Association): MIXED HDF. This treatment method, which is probably the most advanced dialysis treatment available in the world, is a new form of Online-HDF and can be tailored even more precisely to the medical needs of individual patients thanks to a complex new control technology. Fresenius Medical Care was the first company to get MIXED HDF ready for market launch. We are convinced that this innovation will further contribute to establishing Online-HDF as the treatment of choice for dialysis patients, and expect to achieve a clear market edge with this trend-setting technology. Just like the 5008 therapy system, MIXED HDF also saves on resources: the device uses up to 30 % less energy, water and concentrate than traditional hemodialysis methods during treatment. Due to its considerable potential for the medical world, Fresenius Medical Care uses Online-HDF as a long-term innovation platform.

We also continued to develop our portfolio in the area of home dialysis in 2009 – another of our strategic development platforms. In 2008, we introduced the Liberty Cycler, our therapy system for peritoneal dialysis (PD), in the US. It was a resounding success: over 2,500 patients are now being treated with the device. We will have a stronger focus on this product in North America in the future. We have continued to improve the Liberty Cycler ever since we introduced it – for instance with an expanded alarm system to help users avoid application errors. With the further development of the device’s software, patients’ individual treatment settings and results can now be processed even more comprehensively and transmitted to the attending clinic. There, the data is regularly checked to adapt the treatment to individual patients in the best possible way.

As a home dialysis treatment method – i. e., a treatment that is performed in the patient’s home environment –, PD requires a high level of individual responsibility from patients as they usually carry it out themselves. It is therefore crucial that these patients receive intensive training on hygiene and safety matters. With its intuitive user interface and easy-to-understand instructions, which guide patients through the device settings step-by-step via a screen, the Liberty Cycler is one of the simplest and safest devices in this respect. To further increase the user-friendliness of the cycler, we are currently working on new help software, which uses short instructional videos and text information to demonstrate how the device should be used. It will also allow patients to receive prompt answers to their questions via a help menu, even during treatment. We plan to make this new feature standard for the device in 2011.

Another development focus at Fresenius Medical Care is the Body Composition Monitor (BCM) diagnosis machine, which we successfully launched in additional markets in 2009. The BCM can determine the exact make-up of the human body and its fluids (body water, fat, and fat-free body mass). This provides doctors with information on the patients’ general health – for instance on the constitution of their blood vessels – and helps them to determine to what extent a patient may be suffering from overhydration. Such information can substantially improve the treatment quality of dialysis, as both heart and vascular diseases and overhydration are common side effects of chronic kidney disease. We are currently working on making the advantages of BCM technology, which to this point have only been documented in the treatment of hemodialysis patients, available to other patient groups. Initial studies have shown, that peritoneal dialysis patients can also benefit from professional fluid management, a regular check of their fluid status with the treatment adjusted accordingly. Another group of patients whose treatment could be improved with the use of BCM technology are people who suffer from acute kidney failure.

Besides the activities in our strategic focal areas, Fresenius Medical Care has also improved and continued to develop our traditional hemodialysis products. The 4008S classic, for instance, is a new addition to our range of hemodialysis machines. This device offers exceptional treatment quality along with high reliability and safety at an affordable price thanks to its high-quality basic configuration. Thanks to its cost effectiveness and simple operability, it should provide access to high-quality dialysis treatment for even more dialysis patients, especially in areas with a poor infrastructure.

In the United States, we have also tailored our range of products to the needs of our patients and customers. This puts us in an excellent position to cope with the planned introduction of a new quality-oriented lump-sum reimbursement system for dialysis. A good example is the 2008T, a new product generation of the 2008 hemodialysis series, which gained approval from the FDA (U.S. Food and Drug Administration) in the United States in 2009. In addition to further improving the machine’s usability and safety, and thus its treatment performance, the 2008T is the first hemodialysis machine on the US market to use an integrated computer system, which automatically compiles clinical treatment data. The reimbursement reform, which will come into effect in 2011, requires dialysis treatment to fulfill certain quality criteria, among other things. This means that the 2008T, which automatically compiles data, offers a distinct advantage as it can measure the success of the treatment and improve it even more effectively. We presented the new 2008T at the American Society of Nephrology Conference in 2009, and are aiming to launch the device in 2010.

An important partner for Fresenius Medical Care in clinical research is the Renal Research Institute (RRI). The RRI was founded in 1997 as a joint venture between Fresenius Medical Care North America and the Beth Israel Medical Center, a hospital in New York, and is widely recognized as a leading research facility in the field of nephrology. In 2009, the RRI continued research in the field of SORB technology, among others. This project focuses on so-called sorbents – particular substances that bind toxins in liquids so that they can be removed. These sorbents can be used, for example, to recycle dialysis solution, which absorbs toxins during PD or HD treatment that have been filtered out of the patients’ blood. By cleansing and then recycling the dialysate with the help of sorbents, the amount of water typically needed during dialysis treatment can be reduced from 120 to 200 liters to approximately six to ten liters. This innovative sorbent technology is particularly important for our “wearable kidney” project, as a device of this kind must be able to function with a substantially smaller amount of liquid to be light and small enough to be worn on the body. This is an objective we are also working on. Other research projects pursued by the RRI are centered on the lifespan of red blood cells in connection with inflammatory processes in the body, and on citrate anticoagulation, a method which can be used as an alternative to or together with the substance heparin for hemodilution. A more in-depth knowledge of the characteristics of red blood cells can be advantageous for treating dialysis patients more effectively with the erythropoiesis stimulating agent EPO or with iron compounds.

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