Hemodialysis monitoring system for hemodialysis machines
First Claim
1. A method of monitoring a hemodialysis treatment in real time for utilization with a hemodialysis machine including a dialyzer and with dialysate waste effluent removed from the dialyzer, comprising:
- providing a dialysate effluent constituent sensor and separately coupling a plurality of separate fluid portions of the dialysate effluent to said constituent sensor during a dialysis treatment;
detecting and measuring concentrations of said constituent in each of said dialysate effluent portions;
determining a dialysate constituent concentration-time profile from said dialysate constituent concentration measurements;
forming at least a two pool analysis to account for the differences in the constituent concentration in the extracellular and the intracellular spaces in a patient during the dialysis treatment; and
directly determining an indication of adequacy of said dialysis treatment from said dialysate constituent concentration-time profile.
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Abstract
An improved on-line real time hemodialysis monitoring system for hemodialysis treatment. The hemodialysis monitoring system quantitates the rate and amount of a constituent, such as urea, removed during the hemodialysis treatment by measuring the constituent concentrations as a function of time in the spent dialysate effluent from a hemodialysis machine. A quantity of the spent dialysate effluent is removed from the dialysate effluent waste line periodically for testing. A urea concentration time profile can be analyzed to determined the urea removal, KT/V, URR, SRI and normalized protein catabolic rate (nPCR) indices. The hemodialysis monitoring system preferably can obtain a dialysate sample equilibrated with the blood prior to the start of a hemodialysis treatment. The hemodialysis monitoring system includes a two pool analysis for taking into account the constituent concentration differences in the extracellular and intracellular spaces in the hemodialysis patient during the hemodialysis treatment.
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Citations
48 Claims
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1. A method of monitoring a hemodialysis treatment in real time for utilization with a hemodialysis machine including a dialyzer and with dialysate waste effluent removed from the dialyzer, comprising:
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providing a dialysate effluent constituent sensor and separately coupling a plurality of separate fluid portions of the dialysate effluent to said constituent sensor during a dialysis treatment; detecting and measuring concentrations of said constituent in each of said dialysate effluent portions; determining a dialysate constituent concentration-time profile from said dialysate constituent concentration measurements; forming at least a two pool analysis to account for the differences in the constituent concentration in the extracellular and the intracellular spaces in a patient during the dialysis treatment; and directly determining an indication of adequacy of said dialysis treatment from said dialysate constituent concentration-time profile. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An apparatus adapted for monitoring a hemodialysis treatment in real time for utilization with a hemodialysis machine including a dialyzer and with dialysate waste effluent removed from the dialyzer, comprising:
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a dialysate effluent constituent sensor and means for separately coupling a plurality of separate fluid portions of the dialysate effluent to said constituent sensor during a dialysis treatment; means for detecting and measuring concentrations of said constituent in each of said dialysate effluent portions; means for determining a constituent concentration-time profile from said dialysate constituent concentration measurements; means for forming at least a two pool analysis to account for the differences in the constituent concentration in the extracellular and the intracellular spaces in a patient during the dialysis treatment; and means for directly determining an indication of adequacy of said dialysis treatment from said dialysate constituent concentration-time profile. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. A method of monitoring a hemodialysis treatment in real time for utilization with a hemodialysis machine including a dialyzer and with dialysate waste effluent removed from the dialyzer, comprising:
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providing a dialysate effluent urea sensor and separately coupling a plurality of separate fluid portions of the dialysate effluent to said urea sensor during a dialysis treatment; detecting and measuring concentrations of said urea in each of said dialysate effluent portions; determining a dialysate urea concentration-time profile from said dialysate urea concentration measurements; forming at least a two pool analysis to account for the differences in the urea concentration in the extracellular and the intracellular spaces in a patient during the dialysis treatment; and directly determining an indication of adequacy of said dialysis treatment from said dialysate urea concentration-time profile. - View Dependent Claims (26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 42, 43, 44, 45, 46, 47)
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37. An apparatus adapted for monitoring a hemodialysis treatment in real time for utilization with a hemodialysis machine including a dialyzer and with dialysate waste effluent removed from the dialyzer, comprising:
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a dialysate effluent urea sensor and means for separately coupling a plurality of separate fluid portions of the dialysate effluent to said urea sensor during a dialysis treatment; means for detecting and measuring concentrations of said urea in each of said dialysate effluent portions; means for determining a urea concentration-time profile from said dialysate urea concentration measurements; means for forming at least a two pool analysis to account for the differences in the urea concentration in the extracellular and the intracellular spaces in a patient during the dialysis treatment; and means for directly determining an indication of adequacy of said dialysis treatment from said urea dialysate concentration-time profile. - View Dependent Claims (38, 39, 40, 41, 48)
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Specification