The invention provides a method and an apparatus or system for dialysis. The method and apparatus or system are useful for removing an undesirable protein-binding substance such as a toxin from a biological fluid such as blood or blood plasma. As such, the method and apparatus or system are useful for treating a subject in need of dialysis such as a subject suffering from hepatic disease. The methods feature a) dialyzing a biological fluid against a dialysis fluid containing an adsorber for a protein-binding substance to be removed through a semipermeable membrane, b) adjusting the dialysis fluid so that the binding affinity of the adsorber for the protein-bound substance to be removed is lowered and the substance to be removed passes into solution, and c) balancing the volume or flow of one or more fluids in the apparatus or system suitable for dialyzing a biological fluid containing a protein-binding substance to be removed. The apparatus or system features a) a biological fluid circuit (3); b) a dialysis fluid circuit (2); c) a means (4; 6; 7; 8; 9) for solubilizing the protein-binding substance to be removed; d) a dialysis, filtration or diafiltration device (5); e) a balancing system or apparatus suitable for balancing the volume or flow of one or more fluids in the apparatus or system suitable for dialyzing a biological fluid containing a protein-binding substance to be removed; and f) a dialysate regeneration unit.

Systems and methods suitable for extracorporeal lung support are provided that expose blood, across a semipermeable membrane, to a dialysis liquid. The dialysis liquid features a buffering agent and has a high buffering capacity for H.sup.+ ions. Carbon dioxide, bicarbonate and hydrogen cations are transported across a semipermeable membrane into the dialysis liquid. The dialysis fluid may be recycled and repeatedly used, and its pH may be adjusted, and other fluids added to it. Certain substances may be removed from the blood, and the amount of these substances removed from the blood may be substantially automatically or substantially continuously monitored or quantified. The systems and methods are suitable for treating or preventing respiratory acidosis, metabolic acidosis, and diseases featuring lung malfunction, kidney malfunction, or liver malfunction.

Systems, methods, and/or apparatuses may be operative to perform a dialysis process that includes a displacer infusion process. In one embodiment, a method for determining a displacer compound may include constructing a plurality of target protein quantitative structure-activity relationship (QSAR) models, one for each of the plurality of binding sites, analyzing a set of candidate compounds using the plurality of QSAR models to determine a set of at least one potential compound with an affinity for binding to each of the plurality of binding sites, and selecting at least one displacer compound from the set of at least one potential compound. Other embodiments are described.

A system includes an implantable device including a pump to pump the fluid from the peritoneum to the bladder via respective catheters, control circuitry, battery and transceiver; a charging and communication system configured to periodically charge the battery and communicate with the implantable device to retrieve data reflective of the patient's health; and monitoring and control software, suitable for use with conventional personal computers, for configuring and controlling operation of the implantable device and charging and communication system. The monitoring and control software allows a treating physician to remotely adjust the volume, time, and frequency with which fluid is pumped from the peritoneal cavity to the bladder based on the data reflective of the patient's health.

Described herein is a process suitable for extracorporeal lung support that relies on exposing blood, separated by a semipermeable membrane from the dialysis liquid. The dialysis liquid comprises a buffering agent and has a high buffering capacity for H+ ions. Carbon dioxide, bicarbonate and hydrogen cations can be efficiently transported across a semipermeable membrane to the dialysis liquid. This also allows for the regeneration and recycling of the dialysis liquid, and thus for its repeated use. The versatility of the dialysis liquid allows adjusting the pill of the dialysis liquid, add fluids to the dialysis liquid and/or to the blood in the extracorporeal circuit and to remove substances from the blood in the extracorporeal circuit, depending on the conditions and needs. Thus, the process is versatile, and suitable for treating or preventing respiratory acidosis, metabolic acidosis, diseases associated with lung malfunction and/or kidney malfunction and/or liver malfunction.

Described herein is a process suitable for extracorporeal lung support that relies on exposing blood, separated by a semipermeable membrane from the dialysis liquid. The dialysis liquid comprises a buffering agent and has a high buffering capacity for H+ ions. Carbon dioxide, bicarbonate and hydrogen cations can be efficiently transported across a semipermeable membrane to the dialysis liquid. This also allows for the regeneration and recycling of the dialysis liquid, and thus for its repeated use. The versatility of the dialysis liquid allows adjusting the pH of the dialysis liquid, add fluids to the dialysis liquid and/or to the blood in the extracorporeal circuit and to remove substances from the blood in the extracorporeal circuit, depending on the conditions and needs. Thus, the process is versatile, and suitable for treating or preventing respiratory acidosis, metabolic acidosis, diseases associated with lung malfunction and/or kidney malfunction and/or liver malfunction.

According to some embodiments, a system may treat blood outside the body of a patient. The system may include one or more pumps configured to pump blood in a fluid flow path at a collective rate over 4 liters per minute. The system may include one or more heat exchangers operable to heat at least a portion of the blood to a temperature of at least 42 degrees Celsius and to allow the blood to cool one or more degrees following heating. The system may include one or more albumin dialysis modules configured to perform albumin dialysis on at least a portion of the blood at least after the one or more heat exchangers allow the blood to cool one or more degrees.

Systems, methods, and/or apparatuses may be operative to perform a dialysis process that includes a displacer infusion process. In one embodiment, a method for determining a displacer compound may include constructing a plurality of target protein quantitative structure-activity relationship (QSAR) models, one for each of the plurality of binding sites, analyzing a set of candidate compounds using the plurality of QSAR models to determine a set of at least one potential compound with an affinity for binding to each of the plurality of binding sites, and selecting at least one displacer compound from the set of at least one potential compound. Other embodiments are described.

A device and methods for treating renal failure are disclosed. One embodiment of the device is an implantable peritoneal dialysis device. When in use, the device can have a semi-permeable reservoir implanted in the peritoneal cavity. The reservoir can receive blood waste and drain through one or more conduits, via a pump, to the biological bladder. Solids and/or a solution benefiting dialysis can be pumped to the reservoir and/or implanted in the peritoneal cavity.

The present invention provides compositions which can be used to treat a carrier protein-containing multiple pass dialysis fluid in particular in order to ensure regeneration of a carrier protein such as albumin in the dialysis fluid. The invention further relates to kits comprising such compositions and uses thereof as well as to methods for providing and regenerating a carrier protein-containing multiple pass dialysis fluid.