In embodiments of the invention, there is provided a dialyzer or filter comprising hollow fibers, in which blood flows on the exterior of the hollow fibers, and dialysate or filtrate may flow on the inside. The external surfaces of the hollow fibers may have properties of smoothness and hemocompatibility. The fiber bundle may have appropriate packing fraction and may have wavy fibers. Optimum shear rates and blood velocities are identified. Geometric features of the cartridge, such as pertaining to flow distribution of the blood, may be different for different ends of the cartridge. Air bleed and emboli traps may be provided. Lengthened service life may be achieved by combinations of these features, which may permit additional therapies and applications or better economics.

An example peritoneal dialysis system is disclosed. The example peritoneal dialysis system includes at least one pump and a memory device configured to store therapy prescriptions including a low ultrafiltration (“UF”) therapy prescription, a first standard UF therapy prescription with a longer duration and a lower dextrose concentration, and a second standard UF therapy prescription with a shorter duration and a higher dextrose concentration. The memory device also stores a schedule indicative as to which of the therapy prescriptions are to be performed on specified dates. The system further includes a logic implementer configured to determine or identify a current date, use the schedule stored in the memory device to select the therapy prescription based on the current date, and control the at least one pump based on the selected therapy prescription to perform a peritoneal dialysis therapy.

The present invention relates to a method for regulating supply of substituate in an extracorporeal blood treatment with an extracorporeal blood treatment apparatus comprising a dialyzer divided by a semipermeable membrane into a blood chamber and a dialyzing fluid chamber and a device for supplying substituate. Moreover, the present invention relates to an extracorporeal blood treatment apparatus having a device for regulating supply of substituate. Regulation of supply of substituate in the extracorporeal blood treatment takes place as a function of the rheological loading of the dialyzer. To regulate supply of substituate during extracorporeal blood treatment, rheological loading of the dialyzer is determined from transmembrane pressure on the dialyzer and flow resistance of the dialyzer and substituate rate is increased or reduced according to the loading. The selection of dialyzer parameters or blood parameters is therefore no longer necessary and the distinction between pre-dilution and post-dilution is also made obsolete.

The disclosed subject matter relates to extracorporeal blood processing or other processing of fluids. Volumetric fluid balance, a required element of many such processes, may be achieved with multiple pumps or other proportioning or balancing devices which are to some extent independent of each other. This need may arise in treatments that involve multiple fluids. Safe and secure mechanisms to ensure fluid balance in such systems are described.

An extracorporeal blood treatment apparatus is provided comprising a filtration unit (2) connected to a blood circuit (17) and to a dialysate circuit (32), a preparation device (9) for preparing and regulating the composition of the dialysis fluid; a control unit (12) is configured for setting a sodium concentration value for the dialysis fluid in the dialysis supply line (8) at a set point; the setting of the sodium concentration includes the sub-step of calculating the sodium concentration value as an algebraic sum of a main contribution term based on the blood plasma conductivity and of an adjustment contribution term based on a concentration of at least a substance in the dialysis fluid chosen in the group including bicarbonate, potassium, acetate, lactate, citrate, magnesium, calcium, sulphate, and phosphate.

Embodiments of the disclosure provide a method for determining beginning blood volume of a patient during dialysis (e.g., hemodialysis). Ultrafiltration rates are determined at different time stamps during dialysis by obtaining a blood flowrate measurement and hematocrit measurements at input port and output port of a dialyzer connected to the patient. The flowrate and hematocrit measurements are used to determine fluid removed from the patient during dialysis. The ultrafiltration rates and fluid removed from the patient are used to determine the beginning blood volume of the patient.

The present invention relates to an apparatus for an extracorporeal blood treatment having an extracorporeal blood circuit in which a dialyzer is arranged and having a dialyzate circuit, wherein the blood circuit is in fluid communication with a first chamber and the dialyzate circuit is in fluid communication with a second chamber of the dialyzer, and wherein the two chambers are separated from one another by a semipermeable membrane, with a dialyzate pump for a conveying of the dialysis solution being present in the dialyzate circuit, wherein the apparatus has a control unit that is configured to operate the apparatus in a first phase and in a second phase following the first phase, wherein the dialyzate pump is operated with a smaller flow rate in the first phase than in the second phase and/or wherein the dialyzate pump conveys a dialysis solution in the first phase that is of a higher concentration with respect to at least one component than in the second phase.

Hemodialysis systems are described. A hemodialysis system may include a dialysate flow path through which dialysate is passed from a dialysate reservoir, which includes a valved vent to atmosphere, to an ultrafilter. The dialysate flow path includes a pneumatically actuated diaphragm-based dialysate pump for pumping fluid from the dialysate reservoir to the ultrafilter. The hemodialysis system may include a controller for controlling pneumatic actuation pressure delivered to the dialysate pump and at least one valve connecting the dialysate reservoir vent to the atmosphere. The hemodialysis system may be configured to actuate the dialysate pump and the at least one valve to introduce air into the dialysate flow path and expel liquid from the dialysate flow path to a drain.

A system and method for balancing flows of renal replacement fluid is disclosed. The method uses pressure controls and pressure sensing devices to more precisely meter and balance the flow of fresh dialysate and spent dialysate. The balancing system may use one or two balancing devices, such as a balance tube, a tortuous path, or a balance chamber.

Dialysis systems are disclosed comprising new fluid flow circuits. Systems may include blood and dialysate flow paths, where the dialysate flow path includes balancing, mixing, and/or directing circuits. Dialysate preparation may be decoupled from patient dialysis. Circuits may be defined within one or more cassettes. The fluid circuit fluid flow paths may be isolated from electrical components. A gas supply in fluid communication with the dialysate flow path and/or the dialyzer able to urge dialysate through the dialyzer and urge blood back to the patient may be included for certain emergency situations. Fluid handling devices, such as pumps, valves, and mixers that can be actuated using a control fluid may be included. Control fluid may be delivered by an external pump or other device, which may be detachable and/or generally rigid, optionally with a diaphragm dividing the device into first and second compartments.