Dialysis system having adaptive prescription generation

Patent metadata

Field	Value
Publication number	US-11311658-B2
Application number	US-202016871558-A
Country	US
Kind code	B2
Filing date	May 11, 2020
Priority date	Jul 9, 2008
Publication date	Apr 26, 2022
Grant date	Apr 26, 2022

Abstract

An example peritoneal dialysis system is disclosed. The example peritoneal dialysis system includes an automated peritoneal dialysis (“APD”) machine configured to remove ultrafiltrate (“UF”) from a patient and record how much UF has been removed. The APD machine operates according to a prescription to remove the UF. The system also includes a server in communication with the APD machine. The server analyzes the UF data to determine if the prescription is to be modified to compensate for changes to the patient's renal function or renal transport characteristics.

First claim

The invention is claimed as follows:

1. A peritoneal dialysis system comprising:
an automated peritoneal dialysis (“APD”) machine including a pumping mechanism, a memory device, and a logic implementer configured to control the pumping mechanism according to a prescription specifying a desired amount of ultrafiltrate (“UF”) to be removed from a patient during a treatment, the APD machine configured to track an amount of the UF removed from the patient for each treatment performed, the memory device storing a plurality of approved prescriptions for selection by the patient; and
a server communicatively coupled to the APD machine, the server configured to:
receive UF data for detecting at least one of the patient's renal function or transport characteristics,
determine that one prescription, of the plurality of approved prescriptions, should be removed from possible selection by the patient to satisfy a criteria for removing a desired amount of UF from the patient,
receive a confirmation from a clinician computer indicative that the one prescription of the plurality of approved prescriptions should be removed, and
transmit a message to the APD machine indicative that the one prescription of the plurality of approved prescriptions should be removed,

wherein the APD machine is configured to prevent the patient from selecting the one prescription of the plurality of approved prescriptions.

2. The peritoneal dialysis system of claim 1 , wherein the server is further configured to use the UF data to (i) update a first moving average UF removed trend, (ii) determine a trending range around the first moving average UF removed trend, and (iii) determine at least one of an upper and lower UF removed limit from the trending range.

3. The peritoneal dialysis system of claim 2 , wherein the server is further configured to (iv) form a second moving average UF removed trend, (v) provide a notification if the second moving average UF removed trend moves outside of the at least one UF removed limit, and (vi) determine whether the removal of the one prescription of the plurality of approved prescriptions is due to at least (a) a lack of patient compliance or (b) a therapy prescription issue.

4. The peritoneal dialysis system of claim 3 , wherein the first moving average UF removed trend is of a longer duration than the second moving average UF removed trend.

5. The peritoneal dialysis system of claim 3 , wherein the upper limit is formed by adding a factor multiplied by the trending range to the first moving average UF removed trend, and the lower limit is formed by subtracting the factor multiplied by the trending range from the first moving average UF removed trend.

6. The peritoneal dialysis system of claim 3 , wherein the server is further configured to provide the notification if the second moving average UF removed trend moves outside the at least one UF removed limit for a certain number of consecutive days or the second moving average UF removed trend moves outside the at least one UF removed limit.

7. The peritoneal dialysis system of claim 1 , wherein each of the plurality of approved prescriptions specifies at least one of a dialysate type, a dialysate dextrose level, a therapy time, a fill volume, a number of night fill exchanges, or an indication as to whether or not a day exchange is to be performed.

8. The peritoneal dialysis system of claim 1 , wherein the logic implementer is configured to remove the one prescription of the plurality of approved prescriptions from the memory device.

9. The peritoneal dialysis system of claim 1 , wherein the plurality of approved prescriptions includes a first prescription for removing a greater amount of UF, a second prescription for removing a lesser amount of UF, and a third prescription for removing a standard amount of UF that is between the greater amount of UF and the lesser amount of UF.

10. The peritoneal dialysis system of claim 9 , wherein the one prescription of the plurality of approved prescriptions to be removed is the second prescription.

11. The peritoneal dialysis system of claim 1 , wherein the APD machine is further configured to track which of the plurality approved prescriptions are selected for each treatment performed, and
wherein the server receives an indication of which prescription was selected for each treatment performed in conjunction with the UF data.

12. The peritoneal dialysis system of claim 11 , wherein the server is further configured to use the indication of which prescription was selected for each treatment performed in conjunction with the UF data to determine that the one prescription, of the plurality of approved prescriptions, should be removed.

13. A peritoneal dialysis method comprising:
performing treatments using an automated peritoneal dialysis (“APD”) machine, the APD machine including a pumping mechanism, a memory device, and a logic implementer configured to control the pumping mechanism according to a prescription specifying an amount of ultrafiltrate (“UF”) to be removed from a patient during a treatment, the memory device storing a plurality of prescriptions for selection by the patient;
tracking, via the APD machine, an amount of the UF removed from the patient for each treatment performed;
receiving, in a server communicatively coupled to the APD machine, UF data that is indicative of the amount of the UF removed from the patient;
determining, via the server, that one prescription of the plurality of prescriptions should be removed from possible selection by the patient to satisfy a criteria for removing a desired amount of UF from the patient;
receiving, in the server, a confirmation from a clinician computer indicative that the one prescription of the plurality of prescriptions should be removed;
transmitting, from the server, a message to the APD machine indicative that the one prescription of the plurality of prescriptions should be removed; and
preventing, via the APD machine, the patient from selecting the one prescription of the plurality of prescriptions.

14. The peritoneal dialysis method of claim 13 , further comprising:
tracking, via the APD machine, which of the plurality of prescriptions are selected for each treatment performed;
receiving, in the server, an indication of which prescription was selected for each treatment performed in conjunction with the UF data; and
using, via the server, the indication of which prescription was selected for each treatment performed in conjunction with the UF data to determine the one prescription of the plurality of prescriptions should be removed.

15. The peritoneal dialysis method of claim 13 , wherein the plurality of prescriptions includes a first prescription for removing a greater amount of UF, a second prescription for removing a lesser amount of UF, and a third prescription for removing a standard amount of UF that is between the greater amount of UF and the lesser amount of UF.

16. The peritoneal dialysis method of claim 15 , wherein the one prescription of the plurality of prescriptions to be removed is the second prescription.

17. The peritoneal dialysis method of claim 13 , further comprising removing, via the logic implementer, the one prescription of the plurality of prescriptions from the memory device.

18. The peritoneal dialysis method of claim 13 , wherein each of the plurality of prescriptions specifies at least one of a dialysate type, a dialysate dextrose level, a therapy time, a fill volume, a number of night fill exchanges, or an indication as to whether or not a day exchange is to be per

Assignees

• Baxter Int
• Baxter Healthcare Sa

Inventors

• Yu Alex A
• Grayson James
• Childers Robert W

Classifications

• A61M2205/3553

  remote, e.g. between patient's home and doctor's office · CPC title

• A61M2230/005

  Parameter used as control input for the apparatus · CPC title

• A61M2205/3303

  Using a biosensor · CPC title

• B01D61/30

  Accessories; Auxiliary operation · CPC title

• A61M2205/3331

  Pressure; Flow · CPC title