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Why kidney failure led me to found an Health Tech Startup
87 points by LeslieDewhurst 14 days ago | hide | past | favorite | 34 comments
Not everyone gets a second chance at life.

For me it came when I was diagnosed with Chronic Kidney Disease (CKD), put on dialysis and told that I’d need to wait three to five years for a new kidney. Depressed at the thought of five year wait, thrice weekly dialysis and the likelihood that I might die, I’d revised my will, walked into my local coffee and asked in an embarrassingly loud voice if anyone had a spare kidney. Fortunately, Lucy the manager volunteered and praise be, we were a kidney compatible match. My ordeal was over in less than two years and I’d gotten my second chance.

That’s when I’d started to learn about the humongous cost of CKD patient support. About 20% of the US Medicare budget of $776 Bln is used in supporting patients with kidney disease. A similar percentage is taken by the UK’s NHS. The reason’s straightforward: once diagnosed, CKD is for the rest of a patient’s life. For us post-transplanters a lifetime of support, mostly quarterly physician meetings and twice daily meds, is still required and that’s a lot of time for both patients and physicians.

What if we could reduce at least some of that cost by putting most of that post transplant support into an App that patients can use daily and physicians can remotely monitor? That’s how Health-AI and TrackMyTac, our first App, came into being after I’d spent too many months on the interminable treadmill of blood works, followed by physician meetings and more meds. In my ideal world, that App would coach me into taking my meds on-time twice a day and also reassure me and my physician that my med levels at my next bloods would be on-track. Most important of all: if this would be possible with one App, then that App should be available globally because kidney failure is a global challenge and needs a global solution.

By early 2020, we had a demonstrable version of TrackMyTac and I showed it around. There was interest, but by far the most common comment was: interesting, come and see us in 3- 5 year’s time and change it now, cos docs won’t like self-monitoring. Then Covid-19 blew-in like a baltic blizzard. Rather than down keyboards and wait out the pandemic we pushed-on and developed an additional entry level App along with a totally automated one with voice control. Then, almost overnight, Doctors worldwide began to search for ways to manage and monitor patients remotely and that 3 - 5 years dissolved into 3 - 5 months.

We’re almost two years old now and we have product, users and a developing, worldwide, market. Now, we’re looking to our next funding round. None of this would have happened if I hadn’t suffered that personal crisis, Lucy hadn’t agreed to help and remote patient monitoring hadn’t become a pressing global reality.

With serendipity like that, how could I not have founded an Heath Tech start-up?

@DewhurstLeslie




Folks, I would strongly suggest getting a DNA test. There are mutations that are highly suggestive of susceptibility to kidney disease. Know your status and eat a kidney friendly diet and make sure you get frequent blood checks if you’re on drugs that may impact your kidneys (e.g. lithium, amphetamines, etc).


Any DNA test providers you recommend? Preferably one that deletes your data / DNA after you're done with it.



Do they store the dna in a database that law enforcement could, perhaps with a subpoena, have access to?

Here's a video how law enforcement can get a match on a dna database through any of your relatives that did a dna test there. https://www.youtube.com/watch?v=KT18KJouHWg

This kind of thing creates a chilling effect in which people avoid getting the medical help they need just to not contribute with a permanent genetic database. This kind of stuff is exactly why HIPAA exists.

Also: why did they give you a summary, but gave the doctors a full report? Could you get the full report if you asked them?


> why did they give you a summary, but gave the doctors a full report? Could you get the full report if you asked them?

If the tests aren’t FDA approved they probably don’t want to risk the regulatory ire that 23&Me encountered.


But then why the doctors have access to it?

I used 23&Me. They’re simple and cheap. And I’m not concerned about protection from legal searches here. We shed DNA everywhere we go. Law enforcement can go as far as picking up things like discarded cigarette butts a suspect tosses out their car to get a DNA match.

I don't think that's a fair comparison. Your DNA in a database is much different than your DNA needing to be individually targeted to be sampled.

> getting a DNA test

still a hard pass from me, I dont trust the 23 and me's of this world with my genetic code.

> get frequent blood checks

Do this either way, prevention is better than any cure, and monitoring is the first step to prevention. Elizabeth Holmes vision was not entriely stupid, when combined with batting her eyelashes, was what lured so many people in.


No, you do NOT need to do frequent blood checks. Find yourself a doctor that you feel comfortable with, do yearly physicals and consult with them for anything in-between. Excessive testing will needlessly lead you into a spiral of health anxiety.

Every 3-6 months tested and annual physical. Every physical I have ever had has included bloods - so it seems we agree on that frequency.

Done it for 10 years and 0 spirals of health anxiety, reduced medications and improved health. Annecdotal perhaps, but every person I know that undertakes a similar regime suffers far far less from health anxiety than those that dont. However, the health anxious tend to be sure they have cancer/diabetes/brain tumors based on their google searches but refuse to go to a doctor and get a checkup.


> About 20% of the US Medicare budget of $776 Bln is used in supporting patients with kidney disease

Wow, seems the government could save a ton of money long-term by shoveling money into a moonshot to bring these artificial kidneys to viability: https://news.ycombinator.com/item?id=28679840


I always knew that the US had universal health care for that one organ, but 81 billion dollars? [0] I am astonished that solving that isn't considered a high level financial emergency. There should be an X-Prize for that.

[0] https://www.cdc.gov/kidneydisease/basics.html#:~:text=Top%20....


Seems there is? https://www.kidneyx.org/

But given the scale of spending, I wonder if the prize is big enough



> and asked in an embarrassingly loud voice if anyone had a spare kidney. Fortunately, Lucy the manager volunteered

"It never hurts to ask." Indeed.


What made you set out to solve this problem yourself, rather than leverage or collaborate with one of the existing solutions to this problem? Offhand, I know of two companies with this exact focus and they've been around for a few years. What sets you apart from the existing solutions (e.g. Cricket Health) ?


Show instead of Ask?


I agree. This should probably be a Show HN.

Show HN rules:

https://news.ycombinator.com/showhn.html


Seems more like an application?

https://www.ycombinator.com/apply/


This looks really great Leslie! My dad is on dialysis and I'm going through the process to see if I'm eligible to donate to him— so far so good (I'm 36 and my dad is 65).

I signed up on your site to be an early adopter.


Thanks, Sean. I did notice. We'll be in touch to put you on the list when your dad is post transplant. Best,

Leslie


I am a founder in Acute Kidney Disease start-up and similarly amazed how undeserved the market is.

How are you dealing with the regulatory burden? Are you pursuing registration in US or EU?

How to get in contact about your funding round?


leslie.dewhurst@h-ai.co.uk

The regulatory burden varies. We're pursuing both UK and US but US is more important to us.


Wow Lucy!


My idea for a health tech start up: make a (relatively) cheap MRI machine using high-temperature superconductor tape


Happy to help out www.diapason.consulting


Wow. That’s really awesome. Go get it!


Is it available to Download?


Note that donating a kidney is not free of long-term complications for the donor. This was not emphasized in the pioneering days of donations, but is considered now.

Essentially you're halving your kidney capacity, which is not noticeable in your 20s, but will creep up on you later as you age.

It also means that any toxin or infection that attacks the remaining kidney will be an emergency. Women are especially prone to UTI that cause kidney infections.

(My father was missing part of one kidney, and it was on his mind throughout his life whenever he became ill.)

So make sure you really like the person you're donating to, since there are consequences to yourself.

Also, I hate to mention this, but the CCP has halal kidneys for sale, with a replacement guarantee even. I think you know where they're harvested from.


> Essentially you're halving your kidney capacity, which is not noticeable in your 20s, but will creep up on you later as you age.

Yes, kidney capacity is routinely tested in 60+ old people (at least in my country) as well in pets (my two 12 yo cats are tested every year).


You are absolutely correct! That fact is often overlooked, and it is vital to be properly informed about the consequences of donation.

I'm wondering why anyone would disagree with you...


Despite HN being a tech-oriented forum, most members are completely ignorant of science.

I understand that kidney donation risks are not well-understood, but ignorance permeates virtually every topic here.

Off the top of my head, I'd say that salmonella from lettuce or eating out would be one of the greatest risks to a kidney donor, though for women pregnancy might be high-risk with one kidney. An MRI might also be a concern, because of the risk of allergies to dyes affecting kidneys and the liver.

(The reason I'm shadowbanned is because dang is also ignorant about what science is. My posts are nearly 100% factual, but that doesn't fit the Marxist narrative here.)


You lost me with the "marxist narrative". YCombinator is the apex of liberalism/capitalism.



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