Device and method for modulating renal function

• US 7,744,618 B2
• Filed: 12/07/2006
• Issued: 06/29/2010
• Est. Priority Date: 12/07/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Shuros, Allan C., Brooke, M. Jason, Poonawala, Tasneem
• Primary Examiner(s): Lucchesi; Nicholas D
• Assistant Examiner(s): Yeh; Jenner
• Application Number:
  US11/567,907
• Publication Number:
  US 20080140000A1
• Time in Patent Office: 1,300 Days
• Field of Search: 606/112, 606/194, 606/192, 606/191, 604/96.01, 604/67, 604 65- 66, 604 8- 9, 607/60, 600/16
• US Class Current: 606/191
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/3606 adapted for a particular treatment
• CPC Class Codes: A61N 1/3614 based on impedance measurement

Abstract

Renal function may be modulated by an implantable device having one or more leads or catheters disposed near the kidney via the lymphatic system. In one embodiment, lymphatic drainage from the kidney is modulated to increase or decrease tubular reabsorption of salt and water. The renal function modulation therapy may be delivered in an open-loop or closed-loop fashion, with the latter dependent upon a physiological variable such as blood pressure or cardiac output.

Claims

1. A method, comprising:

implanting an implantable device having a controller and a means operable by the controller for delivering a renal function modulation therapy wherein the renal function modulation therapy delivery includes obstructing renal lymphatic flow;

configuring the controller to receive a blood pressure measurement from a blood pressure sensor; and

,

configuring the controller to obstruct renal lymphatic flow in response to the blood pressure measurement exceeding a specified limit value.

2. The method of claim 1 further comprising introducing a catheter or lead connected to the therapy delivery means into the patient'"'"'s lymphatic system and routing the catheter or lead to an appropriate site for affecting renal function.

3. The method of claim 1 wherein the renal function modulation therapy comprises augmenting renal lymphatic flow.

4. The method of claim 1 wherein the renal function modulation therapy comprises delivery of a drug directly to the kidney by retrograde infusion through a lymphatic vessel.

5. The method of claim 1 wherein the renal function modulation therapy comprises inhibition or stimulation of a renal nerve or other site affecting renal sympathetic stimulation.

6. The method of claim 1 further comprising programming the controller to deliver renal function modulation therapy upon receipt of a command to do so via telemetry.

7. The method of claim 1 wherein the implantable device includes a sensor for measuring a physiological variable and further comprising programming the device controller to deliver renal function modulation therapy in closed-loop fashion in dependence upon the measured physiological variable.

8. The method of claim 7 wherein the renal function modulation therapy further comprises augmenting renal lymphatic flow and wherein the physiological variable is blood pressure.

9. The method of claim 7 wherein the renal function modulation therapy comprises blocking renal lymphatic flow and wherein the physiological variable is cardiac output.

10. The method of claim 7 wherein the renal function modulation therapy comprises blocking renal lymphatic flow and wherein the physiological variable is a cardiac function index that reflects the adequacy of cardiac output for a particular exertion level.

11. The method of claim 7 wherein the physiological variable is selected from a group that includes blood pressure, cardiac output, transthoracic impedance, exertion level, blood pH, blood osmolarity, and blood electrolyte concentration.