A method of performing dialysis includes: recirculating a dialysis fluid from a patient or a dialyzer for at least two cycles, each cycle contacting the dialysis fluid first with a zirconium phosphate layer followed by at least one of a urease layer, a zirconium oxide layer, or a carbon layer; storing the recirculated dialysis fluid in a storage container; and transferring the dialysis fluid from the storage container to the patient or the dialyzer. In one example, the zirconium phosphate layer and the at least one of the urease layer, the zirconium oxide layer, or the carbon layer is provided by a sorbent cartridge.

Methods, systems, and kits are provided for performing hemodialysis, hemodiafiltration, and peritoneal dialysis on a portable machine suitable for both clinical and home use. Peritoneal dialysate can be flowed into and out of the peritoneal cavity, and can also be regenerated within the system, without the need for introducing fresh dialysate. Common hardware and software can be utilized for both peritoneal dialysis and other forms of dialysis such as hemodialysis, hemofiltration, and hemodiafiltration, allowing for facile transition between different dialysis modes using the same dialysis machine.

Peritoneal dialysis, such as automated peritoneal dialysis (APD) is provided with any one or more or all of the following sensing or feedback features: impedance sensing to detect peritonitis, temperature sensing to detect peritonitis, bio-MEMS sensing to detect peritonitis, and glucose control for diabetes patients, wherein each sensing or feedback feature analyzes patient effluent fluid or fluid dwelling within a patient's peritoneal cavity.

A sorbent based monitoring system for measuring the solute concentration of at least one component of a fluid. The system has a sorbent regeneration system for regeneration of the fluid and has a sorbent cartridge that has at least one material layer. The fluid is conveyed through the sorbent cartridge and contacts at least one sensor after having contacted at least one material layer.

A dialysis system includes a disposable cassette including a flexible sheet and a plurality of dialysis fluid pathways, a plurality of actuators operable with the flexible sheet to direct dialysis fluid through the plurality of dialysis fluid pathways, and a controller configured to (i) determine at least one limitation of the plurality of dialysis fluid pathways, (ii) generate a flow schedule indicating how dialysis fluid should be directed through the plurality of dialysis fluid pathways in accordance with the at least one limitation, and (iii) control the plurality of actuators so that dialysis fluid is pumped through the plurality of dialysis fluid pathways according to the flow schedule.

A peritoneal dialysis system includes a cycler including a pump actuator, a heater and a heating pan operable with the heater, and a disposable set operable with the cycler. The heating pan includes a sidewall forming a slot. The disposable set includes a pumping cassette and a heater/mixing container. The pumping cassette includes a pump chamber configured to be actuated by the pump actuator. Additionally, the heater/mixing container is in fluid communication with the pumping cassette and is sized to be received at the heating pan. The heater/mixing container includes a port configured such that when the port is slid into the slot of the heater pan sidewall, the port is prevented from rotating about an axis transverse to a direction of flow through the port.

A peritoneal dialysis system includes first and second concentrate sources in selective fluid communication with a medical fluid pumping cassette, the first and second concentrate sources holding first and second peritoneal dialysis concentrates, respectively; a pump actuator configured to cause the medical fluid pumping cassette to pump the first and second concentrates; and a processor and memory configured to (i) determine a cumulative volume of at least one of the first or second peritoneal dialysis concentrates pumped from the medical fluid pumping cassette by the pump actuator, (ii) compare the cumulative volume to a threshold, and (iii) if the cumulative volume is outside of the threshold, modify a subsequent stroke volume of at least one of the first or second pump chambers actuated by the pump actuator in an attempt to cause an updated cumulative volume for the at least one peritoneal dialysis concentrate to be within the threshold.

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.

Compositions for regeneration of spent dialysis fluid are disclosed. The compositions include a sorbent comprising a titanium-glyoxal complex. Sorbent cartridges comprising the sorbents, and methods and systems for using the cartridges in dialysis also are disclosed.

A method of performing dialysis includes: recirculating a dialysis fluid from a patient or a dialyzer for at least two cycles, each cycle contacting the dialysis fluid first with a zirconium phosphate layer followed by at least one of a urease layer, a zirconium oxide layer, or a carbon layer; storing the recirculated dialysis fluid in a storage container; and transferring the dialysis fluid from the storage container to the patient or the dialyzer. In one example, the zirconium phosphate layer and the at least one of the urease layer, the zirconium oxide layer, or the carbon layer is provided by a sorbent cartridge.