Determining dialysis treatment effectiveness

• US 9,155,823 B2
• Filed: 08/22/2011
• Issued: 10/13/2015
• Est. Priority Date: 08/22/2011
• Status: Expired due to Fees

• Current Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Holdings Incorporated (Fresenius Medical Care AG)
• Inventors: Tarn, Jeffrey, Wang, Fei, Wang, Aiyuan
• Primary Examiner(s): DRODGE, JOSEPH W
• Application Number:
  US13/214,519
• Publication Number:
  US 20130053651A1
• Time in Patent Office: 1,513 Days
• Field of Search: 210/85, 210/86, 210/94, 210/96.2, 210/138, 210/143, 210645-647, 210/739, 604/4.01, 604/5.01, 604/6.01, 604/6.09, 604/29, 604 65- 67, 600/301
• US Class Current: 1/1
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/1601 Control or regulation
• CPC Class Codes: A61M 1/1603 Regulation parameters
• CPC Class Codes: A61M 1/1611 Weight of the patient
• CPC Class Codes: A61M 1/28 Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
• CPC Class Codes: A61M 2202/0498 Urea
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/505 Touch-screens; Virtual keyboard or keypads; Virtual buttons; Soft keys; Mouse touches
• 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

Abstract

A method performed on a dialysis machine includes receiving a first value that represents a pre-dialysis body weight of a patient and receiving a second value that represents a volume of liquid (V) inside a body of the patient. The method also includes administering dialysis to the patient, calculating an instantaneous body weight (W) of the patient based at least in part on the first value, determining a length of time (t) for which the dialysis was administered to the patient, determining a dialyzer clearance (K) associated with the dialysis, and calculating, based at least in part on the length of time, the instantaneous body weight, the volume, and the dialyzer clearance, a urea reduction ratio (URR) associated with the dialysis.

Claims

1. A method comprising:

providing a hemodialysis machine comprising tubes to transfer blood between a patient and the machine, a display screen, and one or more controllers operable for;

receiving a first value that represents a pre-dialysis body weight of a patient;

receiving a second value that represents a volume of liquid (V) inside a body of the patient;

administering a dialysis treatment to the patient;

while the dialysis treatment is being administered to the patient;

calculating an instantaneous body weight (W) of the patient based at least in part on the first value;

determining a length of time (t) for which the dialysis treatment was administered to the patient;

determining a dialyzer clearance (K) associated with the dialysis treatment;

calculating, based at least in part on the length of time, the instantaneous body weight, the volume of liquid, and the dialyzer clearance, a urea reduction ratio (URR) associated with the dialysis treatment;

providing a user interface for display on the display screen of the hemodialysis machine comprising;

a set of controls that enable a user to control whether or not either of a URR value and a Kt/V value are presented on the display, and enabling the user to toggle between presentation of a Kt/V value and presentation of a URR value on the display, comprising a toggle control to enable toggling between a display of a URR value and a Kt/V value, and radio controls specifying whether the user interface displays one or both of Kt/V values and URR values,

providing, for display on the display screen of the hemodialysis machine, a visual representation of the progress of the dialysis treatment that includes at least one graph having an x-axis and a y-axis,

wherein the x-axis represents a time value, and the y-axis represents at least one of the Kt/V value and the URR value,

wherein the y-axis represents the Kt/V value if a Kt/V option is chosen on the controls, and the y-axis represents URR if the URR option is chosen on the controls, and

wherein the graph includes at least one component representing either of the correlation of time to Kt/V and the correlation of time to URR; and

continuing administration of dialysis until a delivered URR value tracked by the user interface meets or exceeds a target URR value.

2. The method of claim 1, wherein the one or more controllers are further operable for presenting a graphical representation of the urea reduction ratio on the display associated with the dialysis machine.

3. The method of claim 1, wherein the one or more controllers are further operable for determining an ultrafiltrate value (UF) associated with the dialysis treatment.

4. The method of claim 3, wherein calculating an instantaneous body weight of the patient comprises subtracting the ultrafiltrate value from the first value.

5. The method of claim 1, wherein calculating the urea reduction ratio comprises iteratively evaluating an algorithm.

6. The method of claim 5, wherein calculating the urea reduction ratio further comprises providing an estimated value for the urea reduction ratio.

7. The method of claim 5, wherein the algorithm is represented by the expression:

URR=URR−

f(URR)/f′

(URR)

wherein f(URR) is a function for determining URR, and f(URR) is a function for determining the derivative of URR.

8. The method of claim 7, wherein the one or more controllers are further operable for evaluating f(URR) according to the expression:

K*t/V+ln((1−

URR)−

0.008*t)−

(0.5+3.5*URR)*0.55*UF/W.

9. The method of claim 7, wherein calculating the urea reduction ratio further comprises iteratively evaluating the expression URR=URR−

f(URR)/ f′

(URR) until a predetermined condition is satisfied, wherein f(URR) is a function for determining URR, and f′

(URR) is a function for determining the derivative of URR.

10. The method of claim 9, wherein the predetermined condition is represented by the expression:

|f(URR)/f′

(URR)|<

0.01.

11. The method of claim 1, wherein the one or more controllers are further operable for evaluating Kt/V to provide a Kt/V value.

12. The method of claim 1, wherein the component of the graph comprises a line.

13. The method of claim 1, wherein the graph includes a first component that corresponds to the level of treatment provided to the patient during the dialysis treatment, and a second component that corresponds to an expected level of treatment over a future period of time.

14. The method of claim 1, wherein the graph indicates a critical point that represents a point in time at which either or both of a delivered Kt/V value will meet a target Kt/V value and a delivered URR will meet a target URR value.

15. A hemodialysis machine comprising:

tubes to transfer blood between a patient and the machine;

a display screen;

one or more processing devices; and

one or more memory devices comprising instructions that, when executed by the one or more processing devices, cause the one or more processing devices to perform operations comprising;

receiving a first value that represents a pre-dialysis body weight of a patient;

receiving a second value that represents a volume of liquid (V) inside a body of the patient;

causing a dialysis treatment to be administered to the patient;

while the dialysis treatment is being administered to the patient;

calculating an instantaneous body weight (W) of the patient based at least in part on the first value;

determining a length of time (t) for which the dialysis treatment was administered to the patient;

determining a dialyzer clearance (K) associated with the dialysis treatment;

calculating, based at least in part on the length of time, the instantaneous body weight, the volume of liquid, and the dialyzer clearance, a urea reduction ratio (URR) associated with the dialysis treatment;

providing a user interface for display on the display screen of the hemodialysis machine comprising;

a set of controls that enable a user to control whether or not either of a URR value and a Kt/V value are presented on the display and enabling the user to toggle between presentation of a Kt/V value and presentation of a URR value on the display, the set of controls comprising a toggle control to enable toggling between a display of a URR value and a Kt/V value, and radio controls specifying whether the user interface displays one or both of Kt/V values and URR values,

providing, for display on the display screen of the hemodialysis machine, a visual representation of the progress of the dialysis treatment that includes at least one graph having an x-axis and a y-axis,

wherein the x-axis represents a time value, and the y-axis represents at least one of the Kt/V value and the URR value,

wherein the y-axis represents the Kt/V value if a Kt/V option is chosen on the controls, and the y-axis represents URR if the URR option is chosen on the controls, and

wherein the graph includes at least one component representing either of the correlation of time to Kt/V and the correlation of time to URR; and

continuing administration of dialysis until a delivered URR value tracked by the user interface meets or exceeds a target URR value.

16. The hemodialysis machine of claim 15, wherein calculating the urea reduction ratio comprises iteratively evaluating an algorithm.

17. The hemodialysis machine of claim 15, wherein calculating the urea reduction ratio further comprises providing an estimated value for the urea reduction ratio.

18. The hemodialysis machine of claim 15, wherein the component of the graph comprises a line.

19. The hemodialysis machine of claim 15, wherein the graph includes a first component that corresponds to the level of treatment provided to the patient during the dialysis treatment, and a second component that corresponds to an expected level of treatment over a future period of time.

20. The hemodialysis machine of claim 15, wherein the graph indicates a critical point that represents a point in time at which either or both of a delivered Kt/V value will meet a target Kt/V value and a delivered URR will meet a target URR value.