Dialysis system having filtering method for determining therapy prescriptions

• US 9,149,570 B2
• Filed: 04/03/2012
• Issued: 10/06/2015
• 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, Childers, Robert W., Vonesh, Edward F., Cizman, Borut, Niemann, Michael
• Primary Examiner(s): DRODGE, JOSEPH W
• Application Number:
  US13/438,551
• Publication Number:
  US 20120197183A1
• Time in Patent Office: 1,281 Days
• Field of Search: 210 85- 87, 210/96.1, 210/96.2, 210/103, 210/138, 210/141, 210/143, 210/321.6, 210/321.65, 210645-647, 604/4.01, 604/5.01, 604/6.01, 604/6.09, 604/29, 604 65- 67, 700 28- 33, 702/19, 705/2, 705/3, 706 45- 48, 706/61, 706/924, 703/6, 703/9, 703/11, 703/12
• US Class Current: 1/1
• CPC Class Codes: A61M 1/1522 the interface being evacuated interfaces to enhance contact
• CPC Class Codes: A61M 1/155 with treatment-fluid pumping means or components thereof
• CPC Class Codes: A61M 1/1565 Details of valves
• CPC Class Codes: A61M 1/159 specially adapted for peritoneal dialysis
• CPC Class Codes: A61M 1/1601 Control or regulation
• 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
• CPC Class Codes: A61M 1/281 Instillation other than by gravity
• CPC Class Codes: A61M 1/282 Operational modes
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: B01D 61/30 Accessories; Auxiliary operation
• CPC Class Codes: B01D 61/32 Controlling or regulating
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture

Abstract

A peritoneal dialysis system includes a logic implementer configured to: (i) generate a number of peritoneal dialysis therapy regimens that meet at least one therapy target input; (ii) accept a filter input; and (iii) filter the generated therapy regimens according to the filter input to refine the number of therapy regimens available for selection.

Claims

1. A peritoneal dialysis system comprising:

equipment configured to perform peritoneal dialysis by performing one or more exchange cycle with one or more solution; and

a logic implementer comprising;

a regimen implementer module configured to

(i) accept at least one therapy target input,

(ii) accept at least one solution input,

(iii) accept at least one fluid volume input,

(iv) accept at least one therapy time input, at least one of the inputs of (ii),

(iii) and (iv) including a plurality of possible values, and

(v) generate a plurality of peritoneal dialysis therapy regimens for the equipment that satisfy the at least one therapy target input by applying a predictive model that accepts the accepted inputs of (ii), (iii) and (iv), the model based on (a) dwell time versus ultrafiltration data for the at least one accepted solution input, and (b) a result of at least one peritoneal equilibrium test,

a prescription filtering module configured to

(vi) accept a filter input, and

(vii) filter the generated plurality of therapy regimens according to the accepted filter input to refine the number of therapy regimens available for selection, and

a communications module configured to

(viii) accept at least one filtered and selected therapy regimen and load the at least one filtered and selected therapy regimen onto the equipment.

2. The peritoneal dialysis system of claim 1, wherein the equipment includes an automated peritoneal dialysis (“

APD”

) machine configured to run one of the refined number of therapy regimens, the APD machine located remotely from the logic implementer.

3. The peritoneal dialysis system of claim 1, wherein the at least one therapy target input is a threshold value above or below which the input is satisfied.

4. The peritoneal dialysis system of claim 1, wherein the logic implementer is further configured to accept at least one patient transport characteristic input that is additionally used to generate the number of peritoneal dialysis therapy regimens that satisfy the at least one therapy target input.

5. The peritoneal dialysis system of claim 1, wherein the at least one solution input includes a selection of one solution from a plurality of different types of solutions.

6. The peritoneal dialysis system of claim 1, wherein the at least one solution input is a solution dextrose level input including a selection of one solution dextrose level from a plurality of predefined solution dextrose levels.

7. The peritoneal dialysis system of claim 1, wherein the at least one therapy time input includes a setting of a minimum and maximum total time for therapy.

8. The peritoneal dialysis system of claim 1, wherein the at least one fluid volume input includes at least one of:

(i) a setting of a minimum and maximum total fill volume, and (ii) a setting of a minimum and a maximum cycle fill volume.

9. The peritoneal dialysis system of claim 1, wherein the accepted filter input is at least one of:

(i) a non-clinical input, and (ii) based on a patient preference.

10. The peritoneal dialysis system of claim 1, wherein the accepted filter input is based upon at least one of:

(i) a solution cost, (ii) a solution bag weight, (iii) a glucose level, (iv) a night therapy time, (v) a day fill volume, (vi) a night fill volume, (vii) a night therapy time, (viii) a urea Kt/V range, (ix) a creatinine clearances range, (x) a 24 hour ultrafiltration range, (xi) a glucose absorbed range, (xii) a yes/no election for dry day input, (xiii) a yes/no election for last fill input, (xiv) a yes/no election for allowing last fill plus one day exchange input, (xv) a yes/no election for allowing last fill plus two day exchange input, and (xvi) a yes/no election for allowing last fill plus three day exchanges.

11. The peritoneal dialysis system of claim 1, wherein the logic implementer is configured to use the predictive model to simulate a therapy outcome using a parameter from the at least one peritoneal equilibrium test.

12. A peritoneal dialysis system comprising:

equipment configured to perform peritoneal dialysis by performing one or more exchange cycle with one or more solution; and

a logic implementer comprising;

a regimen generation module configured to

(i) accept at least one therapy target input,

(ii) accept at least one solution input and at least one other of;

(a) a patient transport characteristic input, (b) at least one fluid volume input, and (c) at least one therapy time input, and

(iii) generate a plurality of peritoneal dialysis therapy regimens for the equipment that satisfy the at least one therapy target input by applying a predictive model that accepts the accepted inputs of (i) and (ii), the model based on dwell time versus ultrafiltration data for the at least one accepted solution input and a result of at least one peritoneal equilibrium test,

a prescription filtering module configured to

(iv) accept a filter input, and

(v) filter the generated plurality of peritoneal dialysis therapy regimens according to the accepted filter input to refine the number of therapy regimens available for selection, and

a communications module configured to

(vi) accept at least one filtered and selected therapy regimen and load the at least one filtered and selected therapy regimen onto the equipment.

13. The peritoneal dialysis system of claim 12, wherein the at least one solution input includes at least one of a solution type selection or a solution dextrose level selection.

14. The peritoneal dialysis system of claim 12, wherein the at least one fluid volume input includes at least one of a total volume selection or an individual fill volume selection.

15. The peritoneal dialysis system of claim 12, wherein the logic implementer is further configured to accept at least one additional filter input to further reduce the refined number of therapy regimens resulting from (v).

16. The peritoneal dialysis system of claim 12, wherein the at least one therapy target input includes at least one therapy target threshold.

17. The peritoneal dialysis system of claim 12, wherein the logic implementer is configured to use the predictive model to simulate a therapy outcome using a parameter from the at least one peritoneal equilibrium test.

18. A peritoneal dialysis system comprising:

equipment configured to perform peritoneal dialysis by performing one or more exchange cycle with one or more solution; and

a logic implementer comprising;

a regimen generation module configured to

(i) accept one of a solution input, fluid volume input or therapy time input and at least one therapy target input selected from the group consisting of

(a) minimum urea clearance, (b) minimum urea Kt/V, (c) minimum creatinine clearance, (d) minimum glucose absorption, or (e) ultrafiltration removed, and

(ii) generate a number of peritoneal dialysis therapy regimens for the equipment that meet the at least one therapy target input by applying a predictive model that accepts one of the solution input, fluid volume input or therapy time input, the model based on a result of at least one peritoneal equilibrium test,

a prescription filtering module configured to

(iii) filter the generated peritoneal dialysis therapy regimens using at least one inputted patient preference to refine the number of therapy regimens available for selection, and

a communications module configured to

(iv) accept at least one filtered and selected therapy regimen and load the at least one filtered and selected therapy regimen onto the equipment.

19. The peritoneal dialysis system of claim 18, wherein each of the generated number of peritoneal dialysis therapy regimens includes at least (a) a therapy time, (b) a fill volume, (c) a number of cycles or (d) a total therapy volume.

20. The peritoneal dialysis system of claim 19, wherein the therapy time is selected from the group consisting of:

a total therapy time and a dwell time.

21. The peritoneal dialysis system of claim 18, wherein the logic implementer is further configured to generate the number of peritoneal dialysis therapy regimens using (i) at least one patient transport characteristic input;

(ii) at least one solution input;

(iii) at least one fluid volume input; and

(iv) at least one therapy time input.

22. The peritoneal dialysis system of claim 21, which includes an input range for at least one of (i) the at least one patient transport characteristic input, (ii) the at least one solution input, (iii) the at least one fluid volume input, and (iv) the at least one therapy time input.

23. The peritoneal dialysis system of claim 18, wherein the logic implementer is configured to use the predictive model to simulate a therapy outcome using a parameter from the at least one peritoneal equilibrium test.