When 74-year-old Vermonter Bob Burnett faced a serous complication with his home dialysis treatments, he and his wife, Edna, were running out of options. Blood clots kept blocking his dialysis filter, making treatments long, stressful and sometimes impossible to finish.

For patients like Burnett, dialysis is a lifeline — removing toxins and excess fluid from the blood when the kidneys are no longer able to do so. Normally, blood thinners like heparin can help prevent clots during treatment. But after surgery or in situations where blood thinners can’t be used, like with bleeding conditions, patients are left with few safe options. 

“The clots were not being resolved,” says Macaulay Onuigbo, MD, nephrologist and medical director for the Home Dialysis Program at University of Vermont Health-University of Vermont Medical Center. "We were facing a situation where the standard tools just didn’t take." 

Dr. Onuigbo had been working closely with Adam Locke, a senior dialysis technician with UVM Medical Center home dialysis training and support. Drawing on his hands-on experience, Locke noticed a pattern: The clots always began forming at the same spot inside the dialysis filter. He decided to try something simple — rotating the filter by hand every 15 minutes. To everyone’s surprise, the clots stopped forming.

After several months of proving that the method could keep treatments going safely. Dr. Onuigbo and Locke recognized they had discovered something entirely new. 

“We were going through two bags of saline a day just trying to keep the lines clear,” says Locke. “It wasn’t sustainable — for the patient, for the system or for anyone involved.” 

“There’s already so much to do with home dialysis… getting everything ready, cleaning up, fixing things when they go wrong,” says Edna. “When the clots kept happening, it was just too much. This made things manageable again. It gave us back confidence and peace.” 

Dr. Onuigbo has since partnered with the UVM College of Engineering and Mathematical Sciences to turn the idea into something lasting. The improvised hand-rotation has since grown into a fully prototyped device called the Hemodialysis Filter Rotator (HDFR), with a pending U.S. patent and growing international interest. The latest version includes smart features like Bluetooth connectivity, a companion smartphone app, and sensors that monitor rotation speed and angle. Dr. Onuigbo hopes to launch a pilot study at UVM Medial Center soon.

“This is exactly where academic medicine shines,” says Dr. Onuigbo, “when a committed and dedicated multidisciplinary team can combine clinical insight with engineering innovation to find a new solution for an old problem.”