The disclosure relates to a method including determining a treatment time of a dialysis treatment for a patient, receiving, from at least a sensor of a dialysis machine, a dialysate flow rate, the dialysate comprising bicarbonate pumped out of a bicarbonate source, wherein the bicarbonate source has an initial amount of bicarbonate, and predicting that by end of the dialysis treatment no more than a threshold amount of bicarbonate will be left in the bicarbonate source, and in response, determining that a clearance value during the treatment is or will be higher than the threshold clearance value, and sending, to a balancing system, an instruction to reduce the dialysate flow rate to a reduced rate, wherein the reduced rate results in reducing a rate of bicarbonate pumped out of the bicarbonate source while maintaining a clearance value of the treatment at no less than the threshold clearance value.

The present invention generally relates to hemodialysis and similar dialysis systems, including a variety of systems and methods that would make hemodialysis more efficient, easier, and/or more affordable. One aspect of the invention is generally directed to new fluid circuits for fluid flow. In one set of embodiments, a hemodialysis system may include a blood flow path and a dialysate flow path, where the dialysate flow path includes one or more of a balancing circuit, a mixing circuit, and/or a directing circuit. Preparation of dialysate by the preparation circuit, in some instances, may be decoupled from patient dialysis. In some cases, the circuits are defined, at least partially, within one or more cassettes, optionally interconnected with conduits, pumps, or the like. In one embodiment, the fluid circuit and/or the various fluid flow paths may be at least partially isolated, spatially and/or thermally, from electrical components of the hemodialysis system. In some cases, a gas supply may be provided in fluid communication with the dialysate flow path and/or the dialyzer that, when activated, is able to urge dialysate to pass through the dialyzer and urge blood in the blood flow path back to the patient. Such a system may be useful, for example, in certain emergency situations (e.g., a power failure) where it is desirable to return as much blood to the patient as possible. The hemodialysis system may also include, in another aspect of the invention, one or more fluid handling devices, such as pumps, valves, mixers, or the like, which can be actuated using a control fluid, such as air. In some cases, the control fluid may be delivered to the fluid handling devices using an external pump or other device, which may be detachable in certain instances. In one embodiment, one or more of the fluid handling devices may be generally rigid (e.g., having a spheroid shape), optionally with a diaphragm contained within the device, dividing it into first and second compartments.

A processor of a medical device configured to communicate with a remote server can be programmed to protect the medical device from exposure to unauthorized or malicious software. A system or method to implement this form of protection can include, for example, at least one processor on the medical device, a control software module that controls the operation of the medical device and is executable on the processor, a data management module that manages data flow to and from the control software module from sources external to the medical device, and an agent module that has access to a limited number of designated memory locations in the medical device. In addition, a hemodialysis apparatus can be configured to operate in conjunction with an apparatus for providing purified water from a source such as a municipal water supply or a well. A system for controlling delivery of purified water to the hemodialysis apparatus can comprise a therapy controller of the hemodialysis apparatus configured to communicate with a controller of a water purification device, and a user interface controller of the hemodialysis apparatus configured to communicate with the therapy controller, and to send data to and receive data from a user interface.

The disclosure relates to systems and methods for generating a brine solution using a salt cartridge for recharging zirconium phosphate in a reusable sorbent module. The salt cartridge can include an inlet and an outlet on opposite sides. Water can be pumped through the salt cartridge to dissolve the salts in the salt cartridge and the resulting solution can be collected as a brine solution for use in recharging the zirconium phosphate.

Disclosed herein is a material for use in sorbent-based dialysis, the material comprising: acidic and/or neutral cation exchange particles; alkaline anion exchange particles; and one or more of an alkali metal carbonate, a water insoluble alkaline earth metal carbonate, and a water insoluble polymeric ammonium carbonate. Also disclosed herein are uses of said material and its preparation.

The invention provides a first concentrate comprising lactate and calcium ions, said first concentrate having increased stability against precipitation at temperatures around +4 C., said first concentrate being useful for preparing a ready-to-use dialysis fluid by mixing said first concentrate with water and optionally a second concentrate comprising glucose, wherein that the lactate concentration L.sub.conc (expressed in moles per litre, M) of the concentrate fulfills the conditions:

[00001]$a)L_{\mathrm{conc}}>0.8M;\mathrm{and}$$b)L_{\mathrm{conc}}<\left(1.9-0.4{\mathrm{Ca}}_{\mathrm{ready}}\right)M;$

and wherein Ca.sub.ready is the calcium concentration of the ready-to-use dialysis fluid expressed in millimoles per litre (mM).

A regeneration system that has a first regeneration module containing a first chosen regenerative substance; a second regeneration module containing the first chosen regenerative substance; and a first mixing chamber. A first outlet stream of a fluid sequentially exits the first mixing chamber, flows through the first regeneration module in fluid communication with the first chosen regenerative substance and returns to the first mixing chamber, and a second outlet stream of the fluid sequentially exits the first mixing chamber and flows through the second regeneration module in fluid communication with the first chosen regenerative substance.

A dialysis acid precursor assembly including: a dry dialysis acid precursor composition including sodium chloride, a dry acid and a magnesium chloride 4.5-hydrate (MgCl2.4.5H2O), a calcium salt and at least one of a potassium salt, calcium salt and an anhydrous glucose, and a moisture-resistant container having a water vapor transmission rate less than 0.2 g/m2/d at 38 C./90% RH, wherein the dry dialysis acid precursor composition is sealed in the container.

A portable hemodialysis system is provided including a disposable cartridge and a reused dialysis machine. The disposable cartridge includes a dialysate flow path and a blood flow path which flow in opposite directions through a dialyzer. The disposable cartridge further includes a filter for removing waste products from the dialysate as well as one or more flow sensors for measuring the flow of dialysate in the dialysate flow path. The preferred flow sensor includes a rotatable spoked wheel in the dialysate flow path which is rotated by the flow of dialysate. The spoked wheel includes one or more magnets which are rotated with the rotation of the spoked wheel. The flow sensor further includes a magnetic field sensor in the reused dialysis machine which is connected to a processor for monitoring the rotation of the spoked wheel to determine flow of fluid in the dialysate flow path.

A combination kidney and liver dialysis system and method provides a portable, lightweight hemodialysis device that removes uremic toxins, hepatic toxins, water, and impurities from the blood. The method comprises separating the blood into a plasma portion and a cellular portion, immediately returning the cellular portion to the body, providing large volumes of replacement fluids, diluting the plasma portion with replacement fluids, and then manipulating the plasma portion of the blood to pass through hemoperfusion membranes, hemodiafiltration membranes, and extracorporeal membrane oxygenation membranes. Dialysis is performed on the plasma portion of the blood with an albumin dialyzer against an albumin dialysate and a high molecular weight cut off membrane. Dialysis is performed on the plasma portion of blood with a lipid dialysate comprising 10-30% lipid composition, and a high flux dialyzer. The system can also use any form of dialysis technology including hollow fiber, flat plate and microfluidic technology.