Method and system for determining kidney failure

• US 6,695,790 B2
• Filed: 10/26/2001
• Issued: 02/24/2004
• Est. Priority Date: 10/26/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Van Hove, Jos W. J., Van Oort, Geeske
• Primary Examiner(s): Layno, Carl
• Application Number:
  US09/984,087
• Publication Number:
  US 20030083585A1
• Time in Patent Office: 851 Days
• Field of Search: 607/2, 607/3, 607/9, 600/508, 600/509
• US Class Current: 600/508
• CPC Class Codes: A61B 5/201 Assessing renal or kidney functions
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval

Abstract

A method of determining kidney failure in a patient using an implantable medical device is described. In one embodiment, a first magnitude of a first polarization signal is measured. An additional magnitude of an additional polarization signal is measured after a first interval. A deflection differential between the first magnitude and the additional magnitude is determined and kidney failure in the patient is determined when the deflection differential is greater than an established threshold.

Claims

1. A method for determining kidney failure in a patient using an implantable medical device, the method comprising:

measuring a first magnitude of a first polarization signal;

measuring an additional magnitude of an additional polarization signal after a first interval;

determining a deflection differential between the first magnitude and the additional magnitude; and

determining whether a patient is likely to be experiencing or to experience kidney failure when the deflection differential is greater than an established threshold.

2. The method of claim 1, further comprising measuring the first magnitude of the first polarization signal during a first visit of the patient for a dialysis treatment.

3. The method of claim 2, further comprising measuring the additional magnitude of the second polarization signal during an additional visit of the patient for the dialysis treatment.

4. The method of claim 1, further comprising pacing a cardiac tissue of the patient with the implantable medical device.

5. The method of claim 4, further comprising monitoring a heart rate.

6. The method of claim 1, further comprising determining the established threshold.

7. The method of claim 1, further comprising comparing the deflection differential to a plurality of differential values to determine the established threshold.

8. The method of claim 1, further comprising setting the established threshold at a predetermined value based on a patient history.

9. The method of claim 1, further comprising storing in a memory at least one established threshold value.

10. The method of claim 1, further comprising storing the first magnitude in a memory.

11. The method of claim 1, further comprising storing the additional magnitude in a memory.

12. A method of determining kidney failure using a pacing system, the pacing system comprising at least one medical electrical lead having at least one first electrode configured for positioning in a cardiac tissue of a patient, an implantable pulse generator operably connected to the at least one medical electrical lead, and means for measuring a magnitude of a polarization signal, the method comprising:

measuring a first magnitude of a first polarization signal;

measuring an additional magnitude of an additional polarization signal after a first interval;

determining a deflection differential between the first magnitude and the additional magnitude; and

determining a kidney failure in the patient when the deflection differential is greater than an established threshold.

13. The method of claim 12, further comprising measuring the first magnitude of the first polarization signal during a first visit of the patient for a dialysis treatment.

14. The method of claim 13, further comprising measuring the additional magnitude of the second polarization signal during an additional visit of the patient for the dialysis treatment.

15. The method of claim 12, further comprising pacing the cardiac tissue of the patient with the implantable medical device.

16. The method of claim 15, further comprising monitoring a heart rate.

17. The method of claim 12, further comprising determining the established threshold.

18. The method of claim 12, further comprising comparing the deflection differential to a plurality of differential values to determine the established threshold.

19. The method of claim 12, further comprising setting the established threshold at a predetermined value based on a patient history.

20. The method of claim 12, further comprising storing at least one established threshold value in a computer memory.

21. The method of claim 12, further comprising storing the first magnitude in a computer memory.

22. The method of claim 12, further comprising storing the additional magnitude in a computer memory.

23. An implantable medical device for determining kidney failure in a patient, said device comprising:

at least one sensor lead operable to sense at least one polarization signal;

a processor operatively coupled to said at least one sensor lead;

wherein said processor is operable to measure a first magnitude of a first polarization signal during a first visit of the patient for a dialysis treatment;

wherein said processor is further operable to measure a second magnitude of a second polarization signal during a second visit of the patient for a dialysis treatment;

wherein said processor is further operable to determine a deflection differential between the first magnitude and the second magnitude; and

wherein said processor is further operable to determine a kidney failure in the patient when the deflection differential is greater than an established threshold.

24. The device of claim 23, further comprising:

at least one pacing lead operable to pace the cardiac tissue of the patient.

25. The device of claim 24 wherein the processor is further operable to monitor a heart rate of the cardiac tissue.

26. The device of claim 24 wherein the processor is further operable to determine the established threshold.

27. The device of claim 24 further comprising a database comprising a plurality of differential values, wherein the processor is further operable to determine the established threshold by comparing the deflection differential to the differential values.

28. The device of claim 23 wherein the processor is further operable to set the established threshold at a predetermined value based on a patient history.

29. The device of claim 23, further comprising a storage location for storing at least one established threshold value.

30. The device of claim 23, further comprising a storage location for storing the first magnitude.

31. The device of claim 23, further comprising a storage location for storing the second magnitude.

32. An implantable medical device, comprising:

an implantable pulse generator;

at least one medical electrical lead operably connected to the implantable pulse generator, the medical electrical lead having at least one first electrode configured for positioning in a cardiac tissue of a patient; and

a processor operably adapted to measure a first magnitude of a first polarization signal in the cardiac tissue of the patient and to measure an additional magnitude of an additional polarization signal after a first interval;

the processor further operably adapted to determine a deflection differential between the first magnitude and the additional magnitude; and

to determine a kidney failure in the patient when the deflection differential is greater than an established threshold.

33. The device of claim 32, further comprising at least one pacing lead operably adapted to pace the cardiac tissue of the patient.

34. The device of claim 32, wherein the processor is further operably adapted to monitor a heart rate of the cardiac tissue.

35. The device of claim 32, wherein the processor is further operably adapted to determine the established threshold.

36. The device of claim 32, further comprising a database comprising a plurality of differential values, wherein the processor is further operably adapted to determine the established threshold by comparing the deflection differential to the differential values.

37. The device of claim 32, wherein the processor is further operably adapted to set the established threshold at a predetermined value based on a patient history.

38. The device of claim 32, further comprising a memory location operably connected to the processor for storing at least one established threshold value.

39. The device of claim 32, further comprising a memory location operably connected to the processor for storing the first magnitude.

40. The device of claim 32, further comprising a memory location operably connected to the processor for storing the second magnitude.

41. An implantable medical system for determining kidney failure in a patient, the system comprising:

at least one medical electrical lead having at least one first electrode configured for positioning in a cardiac tissue of the patient;

an implantable pulse generator operably connected to the at least one medical electrical lead;

means for measuring a first magnitude of a first polarization signal;

means for measuring an additional magnitude of an additional polarization signal after a first interval;

means for determining a deflection differential between the first magnitude and the additional magnitude; and

means for determining a kidney failure in the patient when the deflection differential is greater than an established threshold.

42. The system of claim 41, further comprising means for measuring the first magnitude of the first polarization signal during a first visit of the patient for a dialysis treatment.

43. The system of claim 41, further comprising means for measuring the additional magnitude of the second polarization signal during an additional visit of the patient for the dialysis treatment.

44. The system of claim 41, further comprising means for pacing the cardiac tissue of the patient.

45. The system of claim 41, further comprising means for monitoring a heart rate of the cardiac tissue.

46. The system of claim 41, further comprising means for determining the established threshold.

47. The system of claim 41, further comprising means for comparing the deflection differential to a plurality of differential values to determine the established threshold.

48. The system of claim 41, further comprising means for setting the established threshold at a predetermined value based on a patient history.

49. The system of claim 41, further comprising means for storing at least one established threshold value.

50. The system of claim 41, further comprising means for storing the first magnitude.

51. The system of claim 41, further comprising means for storing the additional magnitude.

52. System means for implementing a computer useable medium including a computer program for determining kidney failure in a patient using a pacing system, the pacing system comprising at least one medical electrical lead having at least one first electrode configured for positioning in a cardiac tissue of a patient, an implantable pulse generator operably connected to the at least one medical electrical lead, and means for measuring a magnitude of a polarization signal, the system implementing means comprising:

means for implementing computer program code that measures a first magnitude of a first polarization signal;

means for implementing computer program code that measures an additional magnitude of an additional polarization signal after a first interval;

means for implementing computer program code that determines a deflection differential between the first magnitude and the additional magnitude; and

means for implementing computer program code that determines a kidney failure in the patient when the deflection differential is greater than an established threshold.

53. The program of claim 52, further comprising means for implementing computer program code that measures the first magnitude of the first polarization signal during a first visit of the patient for a dialysis treatment.

54. The program of claim 52, further comprising means for implementing computer program code that measures the additional magnitude of the second polarization signal during an additional visit of the patient for the dialysis treatment.

55. The program of claim 52, further comprising means for implementing computer program code that paces the cardiac tissue of the patient.

56. The program of claim 52, further comprising means for implementing computer program code that monitors a heart rate of the cardiac tissue.

57. The program of claim 52, further comprising means for implementing computer program code that determines the established threshold.

58. The program of claim 52, further comprising means for implementing computer program code that compares the deflection differential to a plurality of differential values to determine the established threshold.

59. The program of claim 52, further comprising means for implementing computer program code that sets the established threshold at a predetermined value based on a patient history.

60. The program of claim 52, further comprising means for implementing computer program code that stores at least one established threshold value.

61. The program of claim 52, further comprising means for implementing computer program code that stores the first magnitude.

62. The program of claim 52, further comprising means for implementing computer program code that stores the additional magnitude.