Direct Sodium Removal (DSR) therapy is Sequana Medical’s novel and proprietary approach under development for the management of volume overload due to heart failure.
The sodium concentration in patients with volume overload is in balance but there is too much sodium and too much fluid in the body.
Sequana Medical’s approach is to remove excess sodium in patients with residual renal function.
As a result, the body acts to restore the sodium concentration in the body by eliminating fluid through urination and osmotic ultrafiltration, resulting in a sustained level of fluid loss.
Sequana Medical’s DSR therapy involves the use of the peritoneal cavity for the removal of sodium via diffusion. To do this, a “sodium-free” solution known as “infusate” is administered to the abdomen and allowed to dwell for a pre-defined period.
During this time, sodium diffuses from the body down a steep diffusion gradient into the infusate. Circulation keeps the effective blood sodium concentration high. The infusate and the extracted sodium are then removed, resulting in a removal of sodium from the body. The body responds by eliminating the associated fluid via osmotic ultrafiltration (the movement of water, together with sodium, from the bloodstream to the peritoneal cavity) and/or urination.
The impact of administering a sodium-free solution to the peritoneal cavity, and the resulting sodium and fluid removal, was evaluated in a preclinical study with 15 pigs (of which five had experimentally induced heart failure) and in a first-in-human single dose DSR proof-of-concept study. These studies demonstrated that DSR can result in the removal of large quantities of sodium and fluid in a safe and tolerable manner.
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