Pertioneal Membrane Function Test Method, Peritoneal Membrane Function Test Apparatus and Peritoneal Membrane Function Test Program

• US 20090271119A1
• Filed: 08/22/2006
• Published: 10/29/2009
• Est. Priority Date: 10/18/2005
• Status: Active Grant

• Current Assignee: JMS Company Limited
• Original Assignee: JMS Company Limited
• Inventors: Okamoto, Masahiro, Namoto, Shinji, Karino, Tomokazu, Hamada, Hiroyuki
• Granted Patent: US 8,303,532 B2
• Time in Patent Office: Days
• US Class Current: 702/19
• CPC Class Codes: A61M 1/1613 Profiling or modelling of patient or predicted treatment evolution or outcome
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation

Abstract

It is intended to provide a method whereby the peritoneal function of a dialysis patient can be tested by a relatively easy procedure and yet a high accuracy can be achieved compared with the existing methods, and an apparatus for the peritoneal function test by using the same. Standards of four kinetic parameters (CCr, Kt/V, MTACu, and MTACc) available in a definite dialysis guideline are computed in accordance with the relational expression (formula (7)). The curve showing the relation between MTACu/c thus obtained and the drained fluid volume is indicated in a graph together with the PET data of the patient which has been prepared separately. Thus, the peritoneal function can be evaluated based on the relative position of the patient'"'"'s data and the curve showing the standard values in the graph.

Claims

1. A peritoneal function testing method comprising steps of:

(i) plotting MTACu/c and a drained fluid volume, which are included in results of a peritoneal function test of a patient, in a coordinate system presenting an MTACu/c-drained-fluid-volume curve as a baseline; and

(ii) evaluating the results based on positions of (a) the plotted MTACu/c and drained fluid volume and (b) the curve,

the MTACu/c being a ratio between MTACu, which is an overall mass transfer-area coefficient for urea nitrogen, and MTACc, which is an overall mass transfer-area coefficient for creatinine.

2. A peritoneal function testing method comprising:

a substitution step of performing, in a formula using four parameters of MTACu, MTACc, CCr, and Kt/V, a reference-value substitution for at least one of the four parameters, the MTACu being an overall mass transfer—

area coefficient for urea nitrogen, the MTACc being an overall mass transfer—

area coefficient for creatinine, the CCr being a clearance for creatinine, and the Kt/V being a clearance for urea;

a computation step of computing the formula after the substitution step; and

an evaluation step of evaluating a relationship between a peritoneal permeability and a drained fluid volume based on results of a peritoneal function test by comparing computation results obtained in the computation step with MTACu/c and the drained fluid volume included in the results of the peritoneal function test.

3. The peritoneal function testing method of claim 2, wherein

in the substitution step, (i) the reference-value substitution is performed for the CCr and the Kt/V, and (ii) the formula includes the MTACu/c as a term therein, which is a ratio between the MTACu and the MTACc.

4. The peritoneal function testing method of claim 2, wherein

in the substitution step, the formula is a formula (7),

$\begin{array}{c}\mathrm{Kt}=V_D\end{array}$

{ 1 - ( 1 - CCr V D ) MTACu / c } ( 7 )

or a modified formula of the formula (7),

where V_D is a drained fluid volume for a solution with a medium osmotic pressure after a predetermined retention period.

5. The peritoneal function testing method of claim 2, wherein

in the substitution step, the formula is a formula (8),

$\begin{array}{c}\mathrm{Kt}=V_D\end{array}$

{ 1 - { V D V D 

( 0 ) } - n 

{ { V D V D 

( 0 ) } n 

( 1 - CCr V D ) } MTACu / c } ( 8 )

or a modified formula of the formula (8),

where n is 0.5 or 1, V_D is a drained fluid volume for a solution with a medium osmotic pressure after a predetermined retention period, and V_D(0) is an injected fluid volume.

6. The peritoneal function testing method of claim 3, wherein

in the evaluation step, the computation results and the results of the peritoneal function test are plotted in a coordinate system with the MTACu/c and the drained fluid volume as each axis, and a deterioration of peritoneal function based on the results of the peritoneal function test is predicted in accordance with positions of the plotted results of the peritoneal function test and information obtained from the computation results.

7. The peritoneal function testing method of claim 3, wherein

further in the evaluation step, when the results of the peritoneal function test are in such a numerical range that the MTACu/c is 1.44 or lower, a switching point from peritoneal dialysis to hemodialysis or from peritoneal dialysis to a combination of the peritoneal dialysis and the hemodialysis is evaluated by taking into account a scope of the drained fluid volume in the numerical range.

8. A peritoneal function testing apparatus

(i) performing, in a formula using four parameters of MTACu, MTACc, CCr, and Kt/V, a reference-value substitution for at least one of the four parameters, the MTACu being an overall mass transfer-area coefficient for urea nitrogen, the MTACc being an overall mass transfer-area coefficient for creatinine, the CCr being a clearance for creatinine, and the Kt/V being a clearance for urea;

(ii) computing the formula after the substitution step; and

(iii) evaluating a relationship between a peritoneal permeability and the drained fluid volume based on results of a peritoneal function test by comparing computation results obtained in the computation step with MTACu/c and the drained fluid volume included in the results of the peritoneal function test.

9. A peritoneal function testing program causing a computer to execute:

a substitution step of performing, in a formula using four parameters of MTACu, MTACc, CCr, and Kt/V, a reference-value substitution for at least one of the four parameters, the MTACu being an overall mass transfer-area coefficient for urea nitrogen, the MTACc being an overall mass transfer-area coefficient for creatinine, the CCr being a clearance for creatinine, and the Kt/V being a clearance for urea;

a computation step of computing the formula after the substitution step; and

an evaluation step of evaluating a relationship between a peritoneal permeability and the drained fluid volume based on results of a peritoneal function test by comparing computation results obtained in the computation step with MTACu/c and the drained fluid volume included in the results of the peritoneal function test.