Jacob Upperco on Creating Novel Devices and Delivering Insight and Treatment Inside the Kidney: Signals KOLs

In this episode of Signals KOLs, Jacob Upperco shares his path from biomedical engineering to building a first-of-its-kind kidney function support device. Jake walks us through his early fascination with human physiology, his hands-on prototyping work, and how he's translating ideas into real-world solutions for patients facing acute kidney distress. As it turns out, the heart and kidneys are more tightly linked than most people realize.

Jake also breaks down how 3ive Labs’ catheter-based therapy sustains or enhances kidney function by precisely recreating native negative pressure and flow profiles.¹ We get a preview of what's ahead with “Pump 2.0”, and a glimpse at the longer-term product vision. Along the way, we explore the art of iteration in medtech, the power of real-time urine output data, and why a deeper understanding of kidney physiology could unlock more personalized care.

Signals KOLs is the series that highlights key opinion leaders whose work is shaping the future of kidney health across industry, academia, policy, research, advocacy, and beyond.²

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Guest Bio

Jacob Upperco is the Vice President of Technology & Innovation at 3ive Labs, where he leads R&D of their novel kidney support technologies that combine human-centered design with clinical precision. With over a decade of experience in medical device design and development, Jacob has worked across a range of applications— always with a focus on turning complex clinical needs into actionable solutions. Prior to joining 3ive, he conceptualized, built and tested medical devices for use by physicians and scientists across various clinical research applications, including biomechanical diagnostics, medical image processing and interventional cardiology. He holds an MBID from the Georgia Institute of Technology and a BS in biomedical engineering from Tulane University. He has co-authored dozens of issued patents and several peer reviewed articles.

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Chapters

• 00:20 — Introduction to Jacob Upperco and His Background

• 02:01 — Journey into MedTech and Thrive Labs

• 03:39 — The Development Process of Medical Devices

• 05:00 — Innovations in Kidney Health Technology

• 06:55 — Gathering Inputs and Iterating on Medical Devices

• 08:31 — The Role of Team Dynamics in Device Development

• 10:10 — Understanding the Device and Its Functionality

• 11:41 — Future Directions and Innovations in Kidney Therapy

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Takeaways

Pump 2.0 (left), Jake's Prototype (right)

• From passion to purpose: Jake's early fascination with anatomy and hands-on problem-solving led him to a career building devices that bridge engineering and clinical care.

• Prototyping to product: The first version of 3ive Labs' system started in a basic lab with analog tools (above, right). Today, it's a finely tuned device supporting clinical trials and headed toward FDA submission (above, left).

• Pump 2.0: The next generation includes significant upgrades in usability, human factors design, and data delivery— all while maintaining precise therapeutic control.

• Therapy meets monitoring: By integrating therapy delivery with real-time urine output measurement, the system enables a more dynamic and responsive approach to kidney care.

• Kidney-first design: 3ive’s approach targets the intra-renal space, restoring natural pressure gradients to reestablish kidney function in acute settings (see illustration below).

• Workflow-ready: Their small, specialized ureteral catheters fit seamlessly into existing hospital protocols — making it easier for clinicians to adopt the technology without disrupting care.

• Vision beyond acute care: Jake shares long-term ambitions for wearable and implantable devices, opening the door for chronic therapy applications down the line. (Like Roivios CEO John Erbey said, “imagine having a pacemaker for the kidneys.”)
  

Roivios.com

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Milestones

• Jun-2025: Roivios celebrates 10 years working to advance kidney care since Jake’s first prototype and the path to Pump 2.0 (LinkedIn)

• Mar-2025: CEO John Erbey Presents First Negative Pressure Renal Assist Device at LSI USA ‘25 (LSI, YouTube)

• Jan-2025: Roivios and Caresyntax Partner to Revolutionize Renal Care Through Data-Driven Insights (Press release)

• Dec-2024: FDA Grants IDE Approval for the Pivotal Trial of the JuxtaFlow® Renal Assist Device (RAD) (BioSpace)

• Nov-2024: Roivios Shares Promising Data on JuxtaFlow Renal Assist Device From BIPASS-AKI Feasibility Study (Press release, Study research poster)

• Apr-2024: Roivios Secures FDA Breakthrough Device Designation for JuxtaFlow® RAD, Showcases Pioneering Data at Society of Cardiovascular Anesthesiologists Annual Meeting (Press release)

Data presented at STS 2024 in Philadelphia, PA

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Discussion

• How might real-time urine data shift how we diagnose, monitor, and respond to kidney injury in acute settings?

• How should we be thinking about these types of “kidney attacks” — and what needs to change in order to catch and treat them earlier?

• What barriers have you seen in bringing novel catheter-based or device-enabled therapies to market in kidney care?

• What have you learned through designing, developing, or adopting novel medical devices in the kidney space you think others should know about?

• What questions do you have for Jake and the 3ive Labs R&D team?

  
  

1. https://roivios.com/product/

2. Disclosure: 3ive Labs is a division of Roivios, a sponsor of Signals. We believe in transparency—and we only partner with organizations that are advancing evidence-based approaches to transforming kidney care. All editorial direction for Signals is developed independently, and our conversations are grounded in candid, informed dialogue with leaders across the field. All reference materials are included in the show notes.

Disclaimer: This podcast and platform are for educational purposes only. The views expressed are those of the guests and do not constitute medical or financial advice. Please consult a qualified professional for guidance specific to your situation.