Peritoneal equilibration test and dialysis system using same

• US 9,147,045 B2
• Filed: 07/09/2008
• Issued: 09/29/2015
• Est. Priority Date: 07/09/2008
• Status: Active Grant

• Current Assignee: Baxter Healthcare SA (Baxter International Inc.), Baxter International Inc.
• Original Assignee: Baxter Healthcare SA (Baxter International Inc.), Baxter International Inc.
• Inventors: Yu, Anping, Vonesh, Edward F., Kellam, Benjamin, Childers, Robert W., Cizman, Borut
• Primary Examiner(s): Mehta, Bhisma
• Assistant Examiner(s): LEE, BRANDY SCOTT
• Application Number:
  US12/170,193
• Publication Number:
  US 20100010425A1
• Time in Patent Office: 2,638 Days
• Field of Search: 604/29, 604/31, 604/67, 702/19, 210/739, 210/742, 210/175, 210/143
• US Class Current: 1/1
• CPC Class Codes: A61M 1/1524 the interface providing means for actuating on functional elements of the cassette, e.g. plungers
• CPC Class Codes: A61M 1/155 with treatment-fluid pumping means or components thereof
• CPC Class Codes: A61M 1/159 specially adapted for peritoneal dialysis
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 1/282 Operational modes
• CPC Class Codes: A61M 1/287 Dialysates therefor
• CPC Class Codes: A61M 2205/12 with interchangeable cassettes forming partially or totally the fluid circuit
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

An ultrafiltration (“UF”) evaluation method includes: (i) determining an amount of UF removed from a patient over a first dwell time; (ii) determine an amount of UF removed from the patient over a second, different dwell time; (iii) determining an amount of UF removed from the patient over a third, different dwell time; and (iv) fitting a curve to the UF removal amounts for the first, second and third dwell time. A peritoneal dialysis therapy generation method using the curve determined according to the “UF” evaluation method to generate at least one peritoneal dialysis therapy regimen.

Claims

1. A peritoneal dialysis system comprising:

a housing;

at least one pump carried by the housing and configured to fill a patient with fresh dialysate and drain spent dialysate from the patient; and

a logic implementer configured in an ultrafiltration evaluation sequence to;

(i) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a first dwell time;

(ii) determine, as a portion of the first spent dialysate, a first amount of ultrafiltrate (“

UF”

) removed from the patient for the first dwell time;

(iii) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a second and different dwell time;

(iv) determine, as a portion of the second spent dialysate, a second amount of UF removed from the patient for the second, different dwell time;

(v) fit a curve to at least the first UF removal amount and the second UF removal amount; and

(vi) use the curve to determine an optimal dwell time or dwell time range for the patient.

2. The peritoneal dialysis system of claim 1, the logic implementer further configured to cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a third, different dwell time, and determine, as a portion of the third spent dialysate, a third amount of UF removed from the patient for the third, different dwell time.

3. The peritoneal dialysis system of claim 2, the logic implementer still further configured to cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a fourth, different dwell time, and determine, as a portion of the fourth spent dialysate, a fourth amount of UF removed from the patient for the fourth, different dwell time.

4. The peritoneal dialysis system of claim 1, wherein the first and second dwell times are different ones of:

a nominal 30 minute dwell, a nominal 60 minute dwell, a nominal 120 minute dwell, and a nominal 240 minute dwell.

5. The peritoneal dialysis system of claim 1, wherein the first and second dwell times are taken to be one of:

(i) a time from an end of the pumping to the patient to a beginning of the draining of the patient; and

(ii) a time from an end of the pumping to the patient to an end of the draining of the patient.

6. The peritoneal dialysis system of claim 1, which includes a data transfer device configured to operate with the logic implementer to transfer the first and second amounts of UF removed for the first and second dwell times to a remote location.

7. The peritoneal dialysis system of claim 6, the data transfer device of a type selected from the group consisting of:

(i) a data card; and

(ii) a data network.

8. The peritoneal dialysis system of claim 1, the logic implementer further configured to record actual times for the first and second dwell times and match the first and second actual times with the respective first and second UF amounts.

9. The peritoneal dialysis system of claim 1, wherein the logic implementer is a first logic implementer, and which includes a second logic implementer, the first logic implementer configured to calculate a sufficient number of UF amounts for different dwell times sufficient for the second logic implementer to fit the curve to the UF amounts.

10. The peritoneal dialysis system of claim 9, the second logic implementer configured to (i) determine at least one of a hydraulic permeability coefficient (“

LPA”

) and a fluid absorption coefficient using the curve and (ii) use the at least one coefficient to develop at least one therapy regimen for the patient.

11. The peritoneal dialysis system of claim 10, the at least one therapy regimen developed additionally using at least one of:

(i) a chemical analysis of the patient'"'"'s blood;

(ii) a chemical analysis of the patient'"'"'s spent dialysate; and

(iii) a kinetic model.

12. The peritoneal dialysis system of claim 1, wherein the logic implementer is configured to cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after the first dwell time such that no residual volume remains in the patient, and cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after the second and different dwell time such that no residual volume remains in the patient.

13. A peritoneal dialysis system comprising:

a housing;

at least one pump carried by the housing and configured to fill a patient with fresh dialysate and drain spent dialysate from the patient; and

a logic implementer configured in an ultrafiltration evaluation sequence to;

(i) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a first dwell time such that no residual volume remains in the patient;

(ii) determine, as a portion of the first spent dialysate, a first amount of ultrafiltrate (“

UF”

) removed from the patient for the first dwell time;

(iii) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a second and different dwell time such that no residual volume remains in the patient;

(iv) determine, as a portion of the second spent dialysate, a second amount of UF removed from the patient for the second, different dwell time;

(v) fit a curve to at least the first UF removal amount and the second UF removal amount; and

(vi) use the curve to determine an optimal dwell time or dwell time range for the patient.

14. The peritoneal dialysis system of claim 13, wherein the first and second dwell times are at least one of:

(i) a time from an end of the pumping to the patient to a beginning of the draining of the patient;

or (ii) a time from an end of the pumping to the patient to an end of the draining of the patient.

15. The peritoneal dialysis system of claim 13, which includes a data transfer device configured to operate with the logic implementer to transfer the first and second amounts of UF removed for the first and second dwell times to a remote location.

16. The peritoneal dialysis system of claim 13, the logic implementer further configured to record times for the first and second dwell times and match the first and second times with the respective first and second UF amounts.

17. The peritoneal dialysis system of claim 13, wherein the logic implementer is a first logic implementer, and which includes a second logic implementer, the first logic implementer configured to calculate a sufficient number of UF amounts for different dwell times sufficient for the second logic implementer to fit the curve to the UF amounts.

18. A peritoneal dialysis system comprising:

a housing;

at least one pump carried by the housing and configured to fill a patient with fresh dialysate and drain spent dialysate from the patient; and

a logic implementer configured in an ultrafiltration evaluation sequence to;

(i) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a first dwell time to remove all of the fresh dialysate pumped to the patient plus an expected first amount of ultrafiltrate (“

UF”

);

(ii) determine, as a portion of the first spent dialysate, a first actual amount of UF removed from the patient for the first dwell time;

(iii) cause the at least one pump to pump fresh dialysate to the patient and drain spent dialysate from the patient after a second and different dwell time to remove all of the fresh dialysate pumped to the patient plus an expected second amount of UF;

(iv) determine, as a portion of the second spent dialysate, a second actual amount of UF removed from the patient for the second, different dwell time;

(v) fit a curve to at least the first UF removal amount and the second UF removal amount; and

(vi) use the curve to determine an optimal dwell time or dwell time range for the patient.

19. The peritoneal dialysis system of claim 18, wherein the first and second dwell times are at least one of:

(i) a time from an end of the pumping to the patient to a beginning of the draining of the patient;

or (ii) a time from an end of the pumping to the patient to an end of the draining of the patient.

20. The peritoneal dialysis system of claim 18, the logic implementer further configured to record times for the first and second dwell times and match the first and second times with the respective first and second actual UF amounts.