Patent Grant
9168332
The present invention relates to a hemodialysis apparatus which dialyzes blood, a method of operating a hemodialysis apparatus, and a water content removal system for removing the water content from blood.
For instance, a hemodialysis apparatus includes a dialysis circuit which supplies and discharges a dialysate to and from a dialyzer. This dialysis circuit is provided with a quantitative vessel which houses a dialysate of a fixed quantity to be supplied to the dialyzer, and houses a waste dialysate of a fixed quantity that was discharged from the dialyzer. With a dialysis circuit, in a state where blood is caused to flow to a primary side of a dialysis membrane of the dialyzer, by discharging the dialysate from a secondary side of the dialyzer to the quantitative vessel while supplying the dialysate from the quantitative vessel to the secondary side of the dialysis membrane of the dialyzer, the dialysate is passed through the dialyzer, waste products contained in the blood are introduced into the dialysate, and the patient's blood is thereby subject to dialytic treatment (refer to Patent Document 1).
Moreover, in order to remove the excess water content contained in the patient's body, ultrafiltration treatment is performed in the foregoing dialytic treatment. In order to perform this ultrafiltration treatment, normally, an ultrafiltration line for removing the water content from the blood is connected to the waste fluid line that is more downstream than the dialyzer of the dialysis circuit. The ultrafiltration line is provided with, for instance, a pump, and the water content is sucked and removed from the blood inside the dialyzer by operating the pump (refer to Patent Document 1). Moreover, as another means for removing the water content from the blood, proposed is a method of providing a constant-pressure valve to a waste fluid line, maintaining a branch point of the waste fluid line and an ultrafiltration line to a positive pressure by the constant-pressure valve, and removing the water content of the blood in the dialysate through the ultrafiltration line (refer to Patent Document 2).
Meanwhile, in order to strictly management the amount of fluid contained in the patient's body, for instance, it is necessary to strictly control the fluid removal that is discharged from the ultrafiltration line. Thus, a quantitative pump is used as the pump of the ultrafiltration pump of foregoing Patent Document 1, and strictly controlled. Consequently, the control and the like of the hemodialysis apparatus become complicated and, for example, this causes the hemodialysis apparatus to become expensive. Moreover, with the constant-pressure valve of the dialysis circuit of foregoing Patent Document 2, not only does the control of the apparatus become difficult due to the control of the constant-pressure valve and the like, but also there is a possibility that the positive pressure at the branch point cannot be sufficiently maintained since the branch point of the waste fluid line and the ultrafiltration line is downstream of the dialyzer, and there may be cases where the fluid removal cannot be controlled with high precision.
The present invention was devised in view of the foregoing points, and its object is to provide a hemodialysis apparatus, a method of operating such a hemodialysis apparatus, and a water content removal system which enable the fluid removal from blood to be controlled with high prevision based on easier control and mechanism.
In order to achieve the foregoing object, the present invention provides a hemodialysis apparatus comprising a dialyzer, a vessel including a displaceable partition wall which partitions the inside of the vessel into a first chamber and a second chamber, a storage vessel which stores a dialysate, a dialysate exchange circuit which supplies the dialysate to the first chamber and discharges a waste dialysate in the second chamber to the outside by the consequent displacement of the partition wall to the second chamber side, a dialysate supply circuit which supplies the dialysate in the first chamber to the dialyzer and discharges the waste dialysate from the dialyzer to the second chamber by the displacement of the partition wall to the first chamber side, and a dialysate storage circuit which supplies the dialysate in the first chamber to the storage vessel by the displacement of the partition wall to the first chamber side. Note that the expression “displacement” of the partition wall not only refers to the movement of the overall partition wall, and also includes cases where the partition wall itself becomes deformed and displaced.
According to the present invention, since a part of the dialysate in the first chamber can be supplied to the storage vessel by the displacement of the partition wall of the vessel, the water content of the blood corresponding to the amount of such dialysate can be discharged to the second chamber by utilizing the negative pressure of the second chamber that is consequently generated. Thus, fluid removal from blood can be controlled with high precision based on easier control and mechanism.
The vessel may also include a resilience application device which applies resilience to the partition wall for returning to the first chamber side when the partition wall is displaced to the second chamber side. In the foregoing case, since the displacement of the partition wall of the vessel can be performed based on resilience, for instance, a drive source that is needed for power feeding is not required, and the configuration and control of the apparatus can be simplified.
The storage vessel may include a displaceable partition wall which partitions the inside of the storage vessel into two storage chambers, and the dialysate storage circuit may be configured to be capable of selectively supplying the dialysate in the first chamber to the respective storage chambers of the storage vessel, and of selectively discharging the dialysate in each of the storage chambers. In the foregoing case, since the dialysate can be alternately supplied to the two storage chambers of the storage vessel and, while supplying the dialysate to one storage chamber, the dialysate in the other storage chamber can be discharged, the dialysate can be continuously supplied to the storage vessel. Thus, ultrafiltration from the blood can be performed continuously, and ultrafiltration can be performed efficiently.
The dialysate storage circuit may be configured to be capable of discharging the dialysate in each of the storage chambers to the dialysate exchange circuit. In the foregoing case, the circuit for discharging the dialysate in the storage vessel can be simplified.
The foregoing hemodialysis apparatus further includes a control unit which implements a first step of supplying the dialysate to the first chamber of the vessel through the dialysate exchange circuit, displacing the partition wall of the vessel to the second chamber side, and discharging the waste dialysate in the second chamber of the vessel through the dialysate exchange circuit; a second step of displacing the partition wall of the vessel to the first chamber side in a state where blood is being supplied to the dialyzer so as to supply the dialysate in the first chamber to the storage vessel through the dialysate storage circuit, and discharging the water content of the blood from the dialyzer to the second chamber through the dialysate supply circuit by utilizing a negative pressure of the second chamber that has been generated by the displacement of the partition wall to the first chamber side; and a third step of supplying the dialysate in the first chamber to the dialyzer through the dialysate supply circuit and discharging the waste dialysate from the dialyzer to the second chamber by the displacement of the partition wall to the first chamber side, and the control unit alternately implements at least either the second step or the third step, and the first step. Note that only one of either the second step or the third step may be implemented, or the second step and the third step may be implemented intermittently, continuously or simultaneously. Moreover, the order thereof may be such that the third step is implemented first.
Moreover, with the foregoing hemodialysis apparatus, the vessel, the storage vessel, at least a part of the dialysate exchange circuit, at least a part of the dialysate supply circuit, and at least a part of the dialysate storage circuit may be formed on a cassette unit which can be freely attached to and detached from the hemodialysis apparatus. In the foregoing case, the cassette unit formed with the vessel, the storage vessel and the like can be removed from the apparatus, and the maintenance of the hemodialysis apparatus can be performed by replacing that cassette unit with a new cassette unit. Consequently, even a person without any professional knowledge, skill or experience can perform the maintenance easily, and the quality of maintenance can also be ensured. Thus, the patient can perform ongoing hemodialysis treatment by using the hemodialysis apparatus even at home or in a depopulated area and, for instance, the patient's QOL (Quality of Life) can be improved.
The foregoing hemodialysis apparatus may further include a blood removal-side circuit which supplies blood of a living subject to the dialyzer, and a retransfusion-side circuit which returns the blood in the dialyzer to the living subject, and at least a part of the blood removal-side circuit and at least a part of the retransfusion-side circuit may be formed on a cassette unit which can be freely attached to and detached from the hemodialysis apparatus.
In addition, in a valve for supplying and discharging the fluid to and from the vessel and the storage vessel, a portion that comes into contact with the fluid may be formed on the cassette unit and a portion that does not come into contact with the fluid may be formed on a body of the hemodialysis apparatus. In the foregoing case, upon replacing the cassette unit, the portion that does not come into contact with the fluid and will not become contaminated or deteriorated easily can be left on the body of the apparatus, and the portion that comes into contact with the fluid and will become contaminated or deteriorated easily can be replaced. Thus, it is possible to replace only the portion that has a substantial need for maintenance, and the maintenance cost of the hemodialysis apparatus can be reduced.
From a different perspective, the present invention provides a method of operating a hemodialysis apparatus, the hemodialysis apparatus including a dialyzer, a vessel including a displaceable partition wall which partitions the inside of the vessel into a first chamber and a second chamber, a storage vessel which stores a dialysate, a dialysate exchange circuit which supplies the dialysate to the first chamber and discharges a waste dialysate in the second chamber to the outside by the consequent displacement of the partition wall to the second chamber side, a dialysate supply circuit which supplies the dialysate in the first chamber to the dialyzer and discharges the waste dialysate from the dialyzer to the second chamber by the displacement of the partition wall to the first chamber side, and a dialysate storage circuit which supplies the dialysate in the first chamber to the storage vessel by the displacement of the partition wall to the first chamber side, wherein the method includes a step of causing a control unit to implement a first step of supplying the dialysate to the first chamber of the vessel through the dialysate exchange circuit, displacing the partition wall of the vessel to the second chamber side, and discharging the waste dialysate in the second chamber of the vessel through the dialysate exchange circuit; a second step of displacing the partition wall of the vessel to the first chamber side in a state where blood is being supplied to the dialyzer so as to supply the dialysate in the first chamber to the storage vessel through the dialysate storage circuit, and discharging the water content of the blood from the dialyzer to the second chamber through the dialysate supply circuit by utilizing a negative pressure of the second chamber that has been generated by the displacement of the partition wall to the first chamber side; and a third step of supplying the dialysate in the first chamber to the dialyzer through the dialysate supply circuit and discharging the waste dialysate from the dialyzer to the second chamber through the dialysate supply circuit by the displacement of the partition wall to the first chamber side, and a step of causing the control unit to alternately implement at least either the second step or the third step, and the first step. Note that only one of either the second step or the third step may be implemented, or the second step and the third step may be implemented intermittently, continuously or simultaneously. Moreover, the order thereof may be such that the third step is implemented first.
Moreover, from yet a different perspective, the present invention provides a water content removal system for removing water content from blood, comprising a separator through which blood passes and which separates the water content from the blood, a vessel including a displaceable partition wall which partitions the inside of the vessel into a first chamber and a second chamber, a storage vessel which stores a predetermined fluid, a first circuit which supplies the fluid to the first chamber of the vessel, a second circuit which discharges the water content in the second chamber of the vessel, a third circuit which supplies the fluid in the first chamber of the vessel to the storage vessel, and a fourth circuit which discharges the water content from the separator to the second chamber, wherein the vessel is configured to be capable of displacing the partition wall to the first chamber side to push out the fluid from the first chamber and store the fluid in the storage vessel through the third circuit, and of discharging the water content from the separator to the second chamber through the fourth circuit by utilizing a negative pressure of the second chamber that has been generated by the displacement of the partition wall to the first chamber side.
According to the present invention, it is possible to supply a predetermined fluid in the first chamber to the storage vessel based on the displacement of the partition wall of the vessel, and cause the water content of the blood corresponding to the amount of such fluid to become separated from the separator and flow into the second chamber by utilizing the negative pressure of the second chamber that is consequently generated. Thus, an amount of water content removal from blood can be controlled with high precision based on easier control and mechanism.
According to the present invention, since the amount of water content removal from blood can be controlled with high precision based on easier control and mechanism, it is possible, for instance, to realize an inexpensive hemodialysis apparatus and a water content removal system. Moreover, it is also possible to achieve the downsizing of the apparatus and the reduction of power consumption. In addition, since a pump for water content removal is not required, it is possible to eliminate the maintenance of such a pump. It is also possible to reduce troubles related to the pump. Moreover, since components related to the pump can be reduced in the least, it is possible to reduce the malfunction risk and additionally reduce noise.
The preferred embodiments of the present invention are now explained with reference to the drawings.
The hemodialysis apparatus 1 includes, for example, a dialyzer 10, a blood removal-side circuit 11, a retransfusion-side circuit 12, a quantitative vessel 13, a storage vessel 14, a dialysate exchange circuit 15, a dialysate supply circuit 16, a dialysate storage circuit 17, and a control unit 18.
The dialyzer 10 is, for example, a hollow fiber module with a hollow fiber membrane built therein, and can pass a dialysate through a secondary side 10b while passing the patient's blood through a primary side 10a, and cause waste products as unwanted components of the blood on the primary side 10a to permeate to the secondary side 10b through a membrane, and thereby dialyze the blood. Moreover, the dialyzer 10 can separate the water content of blood from the blood on the primary side 10a to the secondary side 10b through the membrane. Note that the foregoing water content includes at least the water contained in the blood, and may also contain micro substances such as ions and waste products contained in the blood that pass through the membrane.
The blood removal-side circuit 11 is connected, for example, from a needle part 30 that is inserted into the patient to an inlet end 10c on the primary side 10a of the dialyzer 10. The retransfusion-side circuit 12 is connected from an outlet end 10d on the primary side 10a of the dialyzer 10 to another needle part 31. The blood removal-side circuit 11 is provided with a pump 32.
The quantitative vessel 13 is formed, for example, in a cylindrical shape, and includes, for instance, a displaceable partition wall 52 which partitions an inner space having a constant volume into a first chamber 50 and a second chamber 51 in an axial direction, and a spring 53 as a resilience application device which applies resilience to the partition wall 52 for returning to the first chamber 50 side while allowing the displacement of the partition wall 52. Thus, the quantitative vessel 13 includes a self return-type partition wall 52.
The partition wall 52 is formed, for example, in a piston shape which moves in the axial direction. When the partition wall 52 moves to the first chamber 50 side and the volume of the first chamber 50 decreases, the volume of the second chamber 51 increases by that much. When the partition wall 52 moves to the second chamber 51 side and the volume of the second chamber 51 decreases, the volume of the first chamber 50 increases by that much. The spring 53 is provided, for example, to the second chamber 51 side of the partition wall 52, connected to a bottom face of the second chamber 51 and a lower face of the partition wall 52, and generates resilience to the first chamber 50 side when the partition wall 52 moves to the second chamber 51 side.
Note that when there is only one system configured from the vessel 13, the dialysate exchange circuit 15 and the dialysate supply circuit 16 as shown in the drawings, the supply of the dialysate to the dialyzer 10 will be intermittent. In order to prevent this, two same systems may be installed and these may be connected to the dialyzer 10 in parallel. In these two systems, with the vessel 13 of one system and the vessel 13′ of the other system, by controlling the valves so that the replenishment of a new dialysate in the vessel 13 and the discharge of the waste dialysate from the vessel 13, and the supply of a new dialysate from the vessel 13′ to the dialyzer 10 and the supply of the waste dialysate from the dialyzer 10 to the vessel 13′ are performed alternately, the hemodialysis can be performed without any pause, and, for example, it is possible to shorten the dialyzing time and alleviate the burden on the dialytic patient.
The storage vessel 14 includes a displaceable partition wall 60 which partitions an inner space of a constant volume into a first storage chamber 14a and a second storage chamber 14b, and can store a dialysate as the predetermined fluid in the respective storage chambers 14a, 14b. The partition wall 60 is configured, for example, from a rubber diaphragm or the like. With the first storage chamber 14a and the second storage chamber 14b, the partition wall 60 is displaced based on an internal pressure and changes the volume, and, when the volume of one chamber increases, the volume of the other chamber decreases by that much. The partition wall 60 is provided at the center inside the storage vessel 14, and the maximum volume of the second storage chamber 14b when the partition wall 60 moves maximally to the first storage chamber 14a side and the maximum volume of the first storage chamber 14a when the partition wall 60 moves maximally to the second storage chamber 14b side are the same. Moreover, the maximum volume of the first storage chamber 14a and the second storage chamber 14b is smaller than the maximum volume of the first chamber 50 of the quantitative vessel 13.
The dialysate exchange circuit 15 includes, for example, a first circuit 71 that leads from the dialysate supply source 70 to the first chamber 50 of the quantitative vessel 13, and a second circuit 72 that leads from the second chamber 51 of the quantitative vessel 13 to the outside of the apparatus. The first circuit 71 is provided with a pump 73 for pressure-feeding the dialysate of the dialysate supply source 70 to the first chamber 50, and an on-off valve 74 for opening and closing the circuit 71. The second circuit 72 is provided with an on-off valve 75 for opening and closing the circuit 72.
The dialysate supply circuit 16 includes, for example, a third circuit 80 that leads from the first chamber 50 of the quantitative vessel 13 to the secondary side 10b of the dialyzer 10, and a fourth circuit 81 that leads from the secondary side 10b of the dialyzer 10 to the second chamber 51 of the quantitative vessel 13. The third circuit 80 and the fourth circuit 81 are respectively provided with on-off valves 82, 83.
The dialysate storage circuit 17 includes, for example, a fifth circuit 90 that leads to the first chamber 50 of the quantitative vessel 13 and the respective storage chambers 14a, 14b of the storage vessel 14, and a sixth circuit 91 that leads to the respective storage chambers 14a, 14b of the storage vessel 14 and the second circuit 72.
Guiding branches 90a, 90b that lead to the storage chambers 14a, 14b are formed on the fifth circuit 90, and the guiding branches 90a, 90b are provided with on-off valves 100, 101 as switching devices for selectively supplying the dialysate from the first chamber 50 of the quantitative vessel 13 to the two storage chambers 14a, 14b.
Guiding branches 91a, 91b that lead to the storage chambers 14a, 14b are formed on the sixth circuit 91, and the guiding branches 91a, 91b are provided with on-off valves 110, 111 as switching devices for selectively discharging the dialysate from the two storage chambers 14a, 14b.
Note that, in this embodiment, the upstream part of the third circuit 80 and the fifth circuit 90 is a common circuit, and is branched midway.
The control unit 18 controls the operation of, for example, the dialysate supply source 70, the pumps 32, 73, and the on-off valves 74, 75, 82, 83, 100, 101, 110, 111. The control unit 18 is, for example, a computer, and can implement the method of operating the hemodialysis apparatus 1 described later by executing a predetermined program stored in a memory.
The method of operating the hemodialysis apparatus 1 configured as described above is now explained. During hemodialysis treatment, the needle parts 30, 31 are inserted into the patient, and the patient's blood is supplied to the dialyzer 10 through the blood removal-side circuit 11. The blood passes through the primary side 10a of the dialyzer 10, and is thereafter returned to the patient through the retransfusion-side circuit 12.
Meanwhile, on the supplying side of the dialysate, for example, as shown in
Subsequently, for example, as shown in
With the storage vessel 14, when the dialysate is supplied to the second storage chamber 14b, the partition wall 60 moves to the first storage chamber 14a side, and the dialysate that was consequently pushed out is discharged outside through the sixth circuit 91 and the second circuit 72. Note that, if the circuit 91 through which the pushed-out dialysate flows takes on a configuration of being connected to the fluid channel 11 or 12 on the blood circuit side, the dialysate that is discharged from the storage vessel 14 will function as a replenisher to the patient. In the foregoing case, since the amount of dialysate that is discharged from the storage vessel 14 and the amount that is subject to ultrafiltration will coincide, it is guaranteed that the replenisher amount and the fluid volume subject to ultrafiltration will be balanced (On-line HDF).
When the second storage chamber 14b is filled with the dialysate and the water content of the blood flows into the second chamber 51, subsequently, as shown in
Subsequently, as shown in
Subsequently, for example, as shown in
When the first storage chamber 14a is filled with the dialysate and the water content flows into the second chamber 51, as shown in
Thereafter, the first step, the second step, and the third step are sequentially repeated as described above. Moreover, in the second step, the first case where the dialysate is supplied to the second storage chamber 14b side and the second case where the dialysate is supplied to the first storage chamber 14a side are alternately performed.
According to the embodiment described above, it is possible to displace the partition wall 52 of the quantitative vessel 13 to the first chamber 50 side, store the dialysate that was pushed out from the first chamber 50 in the storage vessel 14, and discharge the water content in the blood in the dialyzer 10 to the second chamber 51 based on the negative pressure that is consequently generated in the second chamber 51. Since it is thereby possible to discharge, to the second chamber 51, the water content of the blood in the same amount as the amount of dialysate (volume of the storage chamber of the storage vessel 14) that was discharged from the first chamber 50 to the storage vessel 14, an amount of water content removal from blood can be controlled with high precision based on easier control and mechanism. Moreover, since the dialysate can be supplied from the first chamber 50 to the dialyzer 10 through the third circuit 80 and the waste dialysate can be discharged from the dialyzer 10 to the second chamber 51 through the fourth circuit 81 by the displacement of the partition wall 52 to the first chamber 50 side, hemodialysis can also be performed appropriately.
Since the quantitative vessel 13 includes a spring 53 which applies resilience to the partition wall 52 for returning to the first chamber 50 side when the partition wall 52 is displaced to the second chamber 51 side, the displacement of the partition wall 52 of the quantitative vessel 13 can be performed based on resilience. Thus, for instance, a drive source that is needed for power feeding is not required, and the configuration and control of the apparatus can be simplified.
The storage vessel 14 includes a displaceable partition wall 60 which partitions the inside of the storage vessel into two storage chambers 14a, 14b, and the dialysate storage circuit 17 is configured to be capable of selectively supplying the dialysate in the first chamber 50 to the respective storage chambers 14a, 14b of the storage vessel 14, and of selectively discharging the dialysate in each of the storage chambers 14a, 14b. Consequently, since the dialysate can be alternately supplied to the two storage chambers 14a, 14b of the storage vessel 14 and, while supplying the dialysate to one storage chamber, the dialysate in the other storage chamber can be discharged, the dialysate can be continuously supplied to the storage vessel 14. Thus, ultrafiltration from the blood can be performed continuously, and ultrafiltration can be performed efficiently.
Since the dialysate storage circuit 17 is configured to be capable of discharging the dialysate in each of the storage chambers 14a, 14b to the second circuit 72 of the dialysate exchange circuit 15, the circuit for discharging the dialysate in the storage vessel 14 can be simplified. Note that the dialysate storage circuit 17 can also be configured to be capable of discharging the dialysate in the respective storage chambers 14a, 14b to the dialysate supply source 70.
In the foregoing embodiment, the control unit 18 sequentially and repeatedly implements a first step of supplying the dialysate to the first chamber 50 of the quantitative vessel 13 through the dialysate exchange circuit 15, displacing the partition wall 52 of the quantitative vessel 13 to the second chamber 51 side, and discharging the waste dialysate in the second chamber 51 of the quantitative vessel 13 through the dialysate exchange circuit 15; a second step of displacing the partition wall 52 of the quantitative vessel 13 to the first chamber 50 side in a state where blood is being supplied to the primary side 10a of the dialyzer 10 to supply a part of the dialysate in the first chamber 50 to the storage vessel 14 through the dialysate storage circuit 17, and discharging the water content of the blood from the secondary side 10b of the dialyzer 10 to the second chamber 51 through the dialysate supply circuit 16 by utilizing a negative pressure of the second chamber 51 that has been generated by the displacement of the partition wall 52 to the first chamber 50 side; and a third step of supplying the remaining dialysate in the first chamber 50 to the secondary side 10b of the dialyzer 10 through the dialysate supply circuit 16 and discharging the waste dialysate from the secondary side 10b of the dialyzer 10 to the second chamber 51 by the displacement of the partition wall 52 to the first chamber 50 side. It is thereby possible to efficiently perform dialysis and ultrafiltration while controlling the fluid removal with high precision. Note that the first step may be implemented in a state where the blood is passing through the primary side 10a of the dialyzer 10, or in a state where the blood is not passing therethrough.
Moreover, in the foregoing embodiment, although the control unit 18 implemented the third step after the second step, a part of the second step and a part of the third step may also be implemented simultaneously. For example, as shown in
Here, since a part of the dialysate, which was pushed out as a result of the partition wall 52 moving to the first chamber 50 side, is stored in the second storage chamber 14b, the supplied amount of dialysate to the dialyzer 10 decreases by that much, and a negative pressure is generated in the second chamber 51. The water content in the blood on the primary side 10a of the dialyzer 10 flows into the secondary side 10b due to the consequent negative pressure of the second chamber 51, and the water content is discharged to the second chamber 51 through the fourth circuit 81. In other words, the water content in the blood corresponding to the difference between the overall amount of dialysate that was discharged from the first chamber 50 of the quantitative vessel 13 and the amount of waste dialysate that was returned to the second chamber 51 is discharged to the second chamber 51. A predetermined amount of water content is thereby removed from the blood. When the second storage chamber 14b is filled with the dialysate, the on-off valve 101 is closed, and, after the movement of the partition wall 52 to the first chamber 50 side is complete, the on-off valve 82 and the on-off valve 83 are closed.
In the foregoing case also, dialysis and ultrafiltration can be performed efficiently while controlling the fluid removal with high precision.
Note that, in the foregoing examples, the third step was performed after the second step or the second step and the third step were simultaneously started, but it will suffice so as long as at least one of either the second step or the third step, and the first step are alternately performed. For example, the start timing and the end timing of the second step and the third step may be a timing other the foregoing examples. Moreover, the second step may be started and ended while the third step is being performed, or the third step may be started and ended while the second step is being performed.
Moreover, upon repeating the first step and the second and third steps in the foregoing embodiment, there may be cases where the second step is not implemented, and the first step and the third step are alternately implemented. In the foregoing case, in the first step, the dialysate is supplied to the first chamber 50 of the quantitative vessel 13 through the first circuit 71, the partition wall 52 of the quantitative vessel 13 is displaced to the second chamber 51 side, and the dialysate and the water content in the blood in the second chamber 51 are discharged through the second circuit 72. Subsequently, in the third step, in a state where the blood is passing through the primary side 10a of the dialyzer 10, the partition wall 52 is displaced to the first chamber 50 side, the dialysate in the first chamber 50 is pushed out and supplied to the secondary side 10b of the dialyzer 10, and the dialysate that passed through the dialyzer 10 is discharged to the second chamber 51. The first step and the third step are sequentially repeated, the second step is implemented once every predetermined number of times of such repetition, and the water content contained in the blood is thereby removed. Consequently, the fluid removal can be more strictly adjusted.
The foregoing embodiment applied the present invention to a hemodialysis apparatus 1, but the present invention from a different perspective may also be a water content removal system which removes the water content of blood. In the foregoing case, the water content removal system may include the function of performing dialysis as with the hemodialysis apparatus described in the foregoing embodiment, or may be a type which only performs ultrafiltration as shown below. For example, as shown in
The ultrafiltration treatment using the water content removal system 160 is performed by operating the control unit 18. For example, as shown in
Subsequently, as shown in
According to this embodiment, since it is thereby possible to discharge, to the second chamber 51, the water content of the blood in the same amount as the amount of dialysate (volume of the storage chambers 14a, 14b of the storage vessel 14) that was discharged from the first chamber 50 to the storage vessel 14, fluid removal from blood can be controlled with high precision based on easier control and mechanism. Moreover, since the dialysate can be alternately supplied to the two storage chambers 14a, 14b of the storage vessel 14, and, while supplying the dialysate to one storage chamber, the dialysate in the other storage chamber can be discharged, the dialysate can be continuously supplied to the storage vessel 14. Thus, ultrafiltration from the blood can be performed continuously, and ultrafiltration can be performed efficiently.
Note that, in this embodiment, dialysate was used as the fluid to be supplied to the first chamber 50 of the quantitative vessel 13 and the storage vessel 14, it may also be other fluids such as saline, water or the like.
For example, in the foregoing embodiments, the partition wall 52 of the quantitative vessel 13 generated resilience based on a spring 53, but the partition wall 52 can also generate resilience by using other resilience application devices configured from an elastic diaphragm or the like. Moreover, without using resilience, the partition wall 52 can be driven with other drive sources. Moreover, the partition wall 52 is not limited to having a piston shape, and can also be configured in the form of a membrane such as a diaphragm.
With the hemodialysis apparatus 1 described above, the quantitative vessel 13, the storage vessel 14, at least a part of the dialysate exchange circuit 15, at least a part of the dialysate supply circuit 16, and at least a part of the dialysate storage circuit 17 may be formed on a cassette unit which can be freely attached to and detached from the apparatus body. Moreover, with the hemodialysis apparatus 1, at least a part of the blood removal-side circuit 11 and at least a part of the retransfusion-side circuit 12 may be formed on a cassette unit which can be freely attached to and detached from the apparatus body.
An example of the foregoing case is now explained with reference to the drawings.
The hemodialysis apparatus 1 includes, for example, a plurality of (for instance, three) cassette units 140, 141, 142 provided so that they can be freely attached to and detached from the apparatus body 130. As shown in
As shown in
For example, as shown
Certain portions of the dialysate supply source 70 and the pump 73 within the dialysate exchange circuit 15 are formed on the second cassette unit 141. For example, with the first cassette unit 140 and the second cassette unit 141, the vessels 13, 14 and the circuits 15, 16, 17 are formed on the inside or surface thereof via DSI (Die Slide Injection) molding.
A blood removal-side circuit 11 and a retransfusion-side circuit 12 are formed on the third cassette unit 142. The dialyzer 10 can be attached to and detached from the third cassette unit 142.
During the maintenance of the foregoing hemodialysis apparatus 1, for instance, the cassette units 140 to 142 are removed from the apparatus body 130 as needed, and replaced with new cassette units 140 to 142.
According to this embodiment, the cassette units 140 to 142 can be removed from the apparatus body 130, and the maintenance of the hemodialysis apparatus 1 can be performed by replacing the cassette units 140 to 142 with new cassette units. Consequently, even a person without any professional knowledge, skill or experience can perform the maintenance of the hemodialysis apparatus 1 easily, and the quality of maintenance can also be ensured. Thus, the patient can perform ongoing hemodialysis treatment by using the hemodialysis apparatus 1 even at home or in a depopulated area and, for instance, the patient's QOL can be improved.
Note that, in this embodiment, three cassette units 140 to 142 were provided to the hemodialysis apparatus 1, but the quantity thereof can be arbitrarily selected. For example, the various vessels and circuits of the first cassette unit 140 and the second cassette unit 141 can also be formed on a single cassette unit.
In the foregoing embodiment, in each of the valves, for instance, the on-off valves 74, 75, 82, 83, 100, 101, 110, 111 (hereinafter collectively referred to as the “on-off valve V”) for supplying and discharging the fluid to and from the quantitative vessel 13 and the storage vessel 14, a portion that comes into contact with the fluid may be formed on the cassette unit and a portion that does not come into contact with the fluid may be formed on the apparatus body.
In the foregoing case, the on-off valve V is configured so that it can be separated into a portion that comes into contact with the fluid and a portion that does not come into contact with the fluid. For example, the on-off valve V includes, as shown in
The pressing member 151 is provided, for example, by being exposed to the surface of the cassette housing part 130a of the apparatus body 130, and the deformable membrane 150 is provided by being exposed to the surface of the first cassette unit 140. When the first cassette unit 140 is housed in the cassette housing part 130a, the pressing member 151 on the apparatus body 130 side and the deformable membrane 150 on the first cassette unit 140 side deformable membrane 150 become fitted together, and thereby form the on-off valve V.
According to the foregoing embodiment, since the portion of the on-off valve V that comes into contact with the fluid is provided to the first cassette unit 140 side and the portion that does not come into contact with the fluid is provided to the apparatus body 130 side, for instance, the portion that will become contaminated or deteriorated easily can be replaced together with the cassette unit 140, and the portion that will not become contaminated or deteriorated easily or the expensive portion can be left on the apparatus body 130. Thus, the maintenance can be performed effectively and, for example, the maintenance cost of the hemodialysis apparatus 1 can be reduced.
Note that the structure of the on-off valve V is not limited to the above, and may also be of a different structure.
The preferred embodiments of the present invention were explained above with reference to the appended drawings, but the present invention is not limited to such examples. It is obvious that a person skilled in the art can conceive various modified examples or revised examples within the nature of the concept described in the claims, and it should be understood that such modified examples and revised examples also belong within the technical scope of the present invention as a matter of course.
The present invention is useful upon controlling the fluid removal from the blood with high precision based on easy control and fluid removal.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2009-244590 | Oct 2009 | JP | national |
| 2010-050844 | Mar 2010 | JP | national |
| 2010-075753 | Mar 2010 | JP | national |
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/JP2010/068682 | 10/22/2010 | WO | 00 | 4/20/2012 |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2011/049196 | 4/28/2011 | WO | A |
| Number | Name | Date | Kind |
|---|---|---|---|
| 4037616 | Pinkerton | Jul 1977 | A |
| 4178240 | Pinkerton | Dec 1979 | A |
| 4197196 | Pinkerton | Apr 1980 | A |
| 4209391 | Landau et al. | Jun 1980 | A |
| 4267040 | Schal | May 1981 | A |
| 4530759 | Schal | Jul 1985 | A |
| 4770769 | Schael | Sep 1988 | A |
| 4857199 | Cortial | Aug 1989 | A |
| 4935125 | Era et al. | Jun 1990 | A |
| 5871694 | Beden et al. | Feb 1999 | A |
| 6042784 | Wamsiedler et al. | Mar 2000 | A |
| 20050020959 | Brugger et al. | Jan 2005 | A1 |
| 20080202591 | Grant et al. | Aug 2008 | A1 |
| 20090107902 | Childers et al. | Apr 2009 | A1 |
| 20130118970 | Beden et al. | May 2013 | A1 |
| Number | Date | Country |
|---|---|---|
| 1658916 | Aug 2005 | CN |
| 52-120593 | Oct 1977 | JP |
| 55-073264 | Jun 1980 | JP |
| 62-059592 | Dec 1987 | JP |
| 64-062168 | Mar 1989 | JP |
| 4-048061 | Aug 1992 | JP |
| 5-31181 | Feb 1993 | JP |
| 5-146505 | Jun 1993 | JP |
| 5-146506 | Jun 1993 | JP |
| 07-59848 | Mar 1995 | JP |
| 8-10319 | Jan 1996 | JP |
| 2000-126284 | May 2000 | JP |
| 2001-153050 | Jun 2001 | JP |
| 2003-284772 | Oct 2003 | JP |
| 4395204 | Oct 2009 | JP |
| 2008106538 | Sep 2008 | WO |
| Entry |
|---|
| Search report from International Application No. PCT/JP2010/068682, mail date is Dec. 7, 2010. |
| Search report from International Preliminary Report on Patentability and Written Opinion for International Application No. PCT/JP2010/068682, mail date is May 24, 2012. |
| Taiwan Office action, mail date is Feb. 26, 2013. |
| Search report from E.P.O., mail date is Jan. 7, 2014. |
| Tokuma Nachi et al., “Physical Properties and Application to Lithium Batteries of Fluorinated Diethyl Carbonate”, The 49th Battery Symosium in Japan, Nov. 5-7, 2008, in Sakai. |
| T. Kitagawa et al., “Application of highly oxidation-resistant fluoro-electrolyte to lithium-ion battery”, The 49th Battery Symosium in Japan, Nov. 5-7, 2008, in Sakai. |
| Meiten Koh et al., “Properties of the electrolyte containing fluoroether”, The 49th Battery Symosium in Japan, Nov. 5-7, 2008, in Sakai. |
| Foreign Japan Official Action dated Jul. 1, 2015. |
| Number | Date | Country | |
|---|---|---|---|
| 20120199533 A1 | Aug 2012 | US |
