Patent Application
20240316253
Peritoneal dialysis is a renal replacement therapy for patients who suffer from renal disease. Techniques for peritoneal dialysis include Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). CAPD is performed on an ongoing basis and spent dialysate drains into a drain bag that is later discarded and replaced. APD uses a cycler to deliver and drain the dialysate, typically while the patient is stationary (e.g., while sleeping). In APD, spent dialysate may drain into a bag, a sink, or another location.
Because peritoneal dialysis uses the peritoneum, it is a risk factor for peritonitis. For example, peritoneal dialysis may inadvertently introduce bacteria to the abdomen. By some measures, there is about one incident of peritonitis per 24 to 48 patient-months. Peritonitis is a leading cause of mortality and treatment failure in peritoneal dialysis patients. Rapid diagnosis and treatment are essential for therapeutic success.
Because of the risks associated with peritonitis, it is important to monitor for symptoms and indicators of peritonitis in peritoneal dialysis patients. Indicators of peritonitis include, for example, increased white blood cell (WBC) counts and differentiation. Spent dialysate (e.g., in a drain bag) may provide indicators of peritonitis. When peritonitis is sufficiently advanced, those indicators may even be visible to the naked eye. For example, spent dialysate may appear cloudy. Cloudiness may be assessed by various manual techniques, such as placing a newspaper under the drain bag and evaluating whether the letters are hard to read. When spent dialysate appears cloudy, patients are encouraged to do another drain and bring the newly drained bag to a clinic for testing. In some cases, a patient may send a photo of the spent dialysate to a clinician, to obtain the clinician's subjective opinion based on its appearance. However, relying on such techniques means that peritonitis may not be detected until an infection is relatively advanced, particularly for patients with visual impairments that make it more difficult for them to subjectively assess the “cloudiness” of spent dialysate. By some estimates, over sixty percent of peritoneal dialysis patients have visual impairment.
As a reactive measure, patients may be placed on antibiotics before the clinician has a chance to properly test the spent dialysate. While the patient starts antibiotics, the clinician sends the spent dialysate to a lab, where it is inspected for white blood cell counts and bacteria. Depending on the lab results, the clinician may continue, discontinue, or change the patient's antibiotic treatment. Thus, traditional methods of monitoring for peritonitis are reactive, inefficient, and may delay appropriate medical treatment. In addition, traditional methods may result in unnecessary and/or partial antibiotic treatments in cases of false positives.
One or more approaches described herein may incorporate findings and techniques described in (a) Carlson, D., & Van Brackle, C. Particle Sizing with a Smartphone (2014), and/or (b) Yang, Ye, et al. “Blood cell counting and classification by nonflowing laser light scattering method.” Advanced Photonic Sensors and Applications. Vol. 3897. International Society for Optics and Photonics, 1999, both of which are incorporated herein by reference in their entirety.
Approaches described in this section have not necessarily been conceived and/or pursued prior to the filing of this application. Accordingly, unless otherwise indicated, approaches described in this section should not be construed as prior art.
One or more embodiments allow for earlier diagnosis of peritonitis than traditional approaches. Systems and methods described herein allow for point-of-care (e.g., at home) analysis of spent dialysate, by detecting indicators (e.g., white blood cell counts, differentiation, and/or bacteria) associated with peritonitis. Techniques described herein may detect such indicators even when the patient is not experiencing or aware of related symptoms (e.g., abdominal pain). Early diagnosis may allow for faster treatment of peritonitis, while avoiding inappropriate treatments in cases of false positives. Techniques described herein allow a patient to monitor for peritonitis using objective measurements, rather than relying on subjective observations such as “cloudiness.” For example, one or more embodiments provide an apparatus that helps ensure consistent measurement conditions over multiple uses. In addition, techniques described herein may be combined with other medical monitoring and diagnostic techniques, to provide a multi-featured tool for monitoring peritoneal dialysis patients. Moreover, one or more embodiments may be used to analyze spent dialysate during and/or after a course of antibiotic treatment, to predict or evaluate the effectiveness of the treatment. One or more embodiments include an apparatus with one or more integrated light source(s) and/or light sensor(s). Alternatively or additionally, one or more embodiments make use of a smartphone, tablet, or other computing device already in a patient's possession, thus reducing the cost that might otherwise be associated with techniques described herein. Techniques described herein may be performed in a matter of seconds (e.g., about 30-40 seconds), in comparison to traditional techniques that require contact with a clinician's office and possibly also sending spent dialysate to a lab for analysis.
In general, in one aspect, an apparatus includes: at least one surface configured to accommodate a dialysate drain bag or drain line in a predetermined position; a light source positioned to emit light through the dialysate drain bag or drain line; and a light sensor positioned to sense light emitted by the light source through the dialysate drain bag or drain line. The light source may have an adjustable position to accommodate placement of the dialysate drain bag or drain line in the predetermined position.
The apparatus may further include one or more processors and one or more non-transitory computer-readable media storing instructions that, when executed by the one or more processors, cause the one or more processors to perform operations including: analyzing spent dialysate in the dialysate drain bag or drain line, based at least on the light sensed by the light sensor. The apparatus may further include a display, and the operations may further include presenting an alert on the display when the spent dialysate satisfies an alert condition. The apparatus may further include a scale configured to measure a weight of the dialysate drain bag when the dialysate drain bag is in the predetermined position, analyzing the spent dialysate being further based on the weight of the dialysate drain bag. Analyzing the spent dialysate may include one or more of: measuring turbidity of the spent dialysate; estimating glucose concentration in the spent dialysate; estimating a proportion of white blood cells in the spent dialysate; or estimating a proportion of polymorphonuclear cells in the spent dialysate. Analyzing the spent dialysate may include estimating a risk of peritonitis. Analyzing the spent dialysate may include transmitting data to a server and receiving an analysis result from the server.
The apparatus may further include a scale configured to measure a weight of the dialysate drain bag when the dialysate drain bag is in the predetermined position. The light sensor may be one of a multiple light sensors collectively configured to sense light at a multiple wavelengths. The wavelengths may correspond to two or more of near-infrared, ultraviolet, visible, or fluorescent light.
In general, in another aspect, a method includes: accommodating, by an apparatus, a dialysate drain bag or drain line in a predetermined position, the dialysate drain bag or drain line including spent dialysate; emitting, by a light source of the apparatus, light through the dialysate drain bag or drain line; sensing, by a light sensor of the apparatus, light emitted through the dialysate drain bag or drain line; and determining, by the apparatus, a risk of peritonitis based at least on the light sensed by the light sensor. The method may further include determining a weight of the dialysate drain bag, determining the risk of peritonitis being further based on the weight of the dialysate drain bag.
Determining the risk of peritonitis may include measuring turbidity of the spent dialysate. Determining the risk of peritonitis may include estimating a proportion of white blood cells in the spent dialysate. Determining the risk of peritonitis may include estimating a proportion of polymorphonuclear cells in the spent dialysate. Estimating the proportion of polymorphonuclear cells in the spent dialysate may include analyzing light scattering data obtained by the light sensor. The method may further include estimating fluorescence intensity at one or more of multiple wavelengths or multiple spectrums. The method may further include obtaining a baseline light reading for the light sensor, and determining the risk of peritonitis may include determining a difference between the baseline light reading and the light emitted through the dialysate drain bag or drain line. Analyzing the spent dialysate may include transmitting data to a server and receiving an analysis result from the server.
One or more embodiments described in this Specification and/or recited in the claims may not be included in this General Overview section.
According to at least one aspect of the present disclosure, a method is presented for analyzing spent dialysate, the method comprising accommodating, by an apparatus, a dialysate drain bag or drain line in a predetermined position, the dialysate drain bag or drain line comprising spent dialysate; emitting, by a light source of the apparatus, light through the dialysate drain bag or drain line; sensing, by a light sensor of the apparatus, light emitted through the dialysate drain bag or drain line; and determining, by the apparatus, a risk of peritonitis based at least on the light sensed by the light sensor.
In some examples, determining the risk of peritonitis comprising measuring turbidity of the spent dialysate. In some examples, determining the risk of peritonitis comprising estimating a proportion of white blood cells in the spent dialysate. In some examples, determining the risk of peritonitis comprising estimating a proportion of polymorphonuclear cells in the spent dialysate. In some examples, estimating the proportion of polymorphonuclear cells in the spent dialysate comprising analyzing light scattering data obtained by the light sensor. In some examples, the method further comprises estimating fluorescence intensity at one or more of a plurality of wavelengths or a plurality of spectrums. In some examples, the method further comprises determining a weight of the dialysate drain bag, determining the risk of peritonitis being further based on the weight of the dialysate drain bag. In some examples, the method further comprises obtaining a baseline light reading for the light sensor, determining the risk of peritonitis comprising determining a difference between the baseline light reading and the light emitted through the dialysate drain bag or drain line. In some examples, analyzing the spent dialysate comprising transmitting data to a server and receiving an analysis result from the server.
According to at least one aspect of the present disclosure, a non-transitory computer-readable medium is presented, the non-transitory computer-readable medium containing thereon instructions for analyzing spent dialysate, the instructions instructing at least one processor to: control a light source to emit a light through spent dialysate in a dialysate drain bag or dialysate drain line; receive an indication of one or more characteristics of the light from a light sensor situated opposite the light source; and determine, based on the one or more characteristics of the light, a risk of peritonitis.
In some examples, the instructions further instruct the at least one processor to determine the risk of peritonitis based on a turbidity of the spent dialysate, the turbidity of the spent dialysate being determined at least in part based on the one or more characteristics of the light. In some examples, the instructions further instruct the at least one processor to determine the risk of peritonitis based at least in part on a proportion of white blood cells in the spent dialysate, the proportion of white blood cells being based at least in part on the one or more characteristics of the light. In some examples, the instructions further instruct the at least one processor to estimate a proportion of polymorphonuclear cells in the spent dialysate. In some examples, the instructions further instruct the at least one processor to determine the proportion of polymorphonuclear cells based on light scattering data of the light. In some examples, the instructions further instruct the at least one processor to estimate a fluorescence intensity at one or more wavelengths of one or more spectrums of light. In some examples, the instructions further instruct the at least one processor to receive an indication of a weight of the dialysate drain bag from a scale, determine a dialysate weight of the spent dialysate based on the weight of the dialysate drain bag, and further determine the risk of peritonitis based at least in part on the weight of the dialysate drain bag or the dialysate weight. In some examples, the instructions further instruct the at least one processor to obtain a baseline reading from the light sensor and determine the risk of peritonitis by determining a difference between the baseline reading and the one or more characteristics of the light emitted through the spent dialysate. In some examples, the instructions further instruct the at least one processor to transmit the one or more characteristics of the light to a server, and receive an analysis of the one or more characteristics of the light from the server.
According to at least one aspect of the present disclosure, a method is presented, comprising: accommodating, by an apparatus, a dialysate drain bag or drain line in a predetermined position, the dialysate drain bag or drain line comprising spent dialysate; emitting, by a light source of the apparatus, light through the dialysate drain bag or drain line; sensing, by a light sensor of the apparatus, light emitted through the dialysate drain bag or drain line; and determining, by the apparatus, a risk of peritonitis based at least on the light sensed by the light sensor.
In some examples, determining the risk of peritonitis comprising measuring turbidity of the spent dialysate. In some examples, determining the risk of peritonitis comprising estimating a proportion of white blood cells in the spent dialysate. In some examples, determining the risk of peritonitis comprising estimating a proportion of polymorphonuclear cells in the spent dialysate. In some examples, estimating the proportion of polymorphonuclear cells in the spent dialysate comprising analyzing light scattering data obtained by the light sensor. In some examples, the method further comprises further comprising estimating fluorescence intensity at one or more of a plurality of wavelengths or a plurality of spectrums and/or determining a weight of the dialysate drain bag, determining the risk of peritonitis being further based on the weight of the dialysate drain bag and/or obtaining a baseline light reading for the light sensor, determining the risk of peritonitis comprising determining a difference between the baseline light reading and the light emitted through the dialysate drain bag or drain line. In some examples, analyzing the spent dialysate comprising transmitting data to a server and receiving an analysis result from the server.
According to at least one aspect of the present disclosure, a non-transitory computer-readable medium containing thereon instructions for analyzing spent dialysate is presented, the instructions instructing at least one processor to: control a light source to emit a light through spent dialysate in a dialysate drain bag or dialysate drain line; receive an indication of one or more characteristics of the light from a light sensor situated opposite the light source; and determine, based on the one or more characteristics of the light, a risk of peritonitis.
In some examples, the instructions further instruct the at least one processor to determine the risk of peritonitis based on a turbidity of the spent dialysate, the turbidity of the spent dialysate being determined at least in part based on the one or more characteristics of the light. In some examples, the instructions further instruct the at least one processor to determine the risk of peritonitis based at least in part on a proportion of white blood cells in the spent dialysate, the proportion of white blood cells being based at least in part on the one or more characteristics of the light. In some examples, the instructions further instruct the at least one processor to estimate a proportion of polymorphonuclear cells in the spent dialysate. In some examples, the instructions further instruct the at least one processor to determine the proportion of polymorphonuclear cells based on light scattering data of the light. In some examples, the instructions further instruct the at least one processor to estimate a fluorescence intensity at one or more wavelengths of one or more spectrums of light. In some examples, the instructions further instruct the at least one processor to receive an indication of a weight of the dialysate drain bag from a scale, determine a dialysate weight of the spent dialysate based on the weight of the dialysate drain bag, and further determine the risk of peritonitis based at least in part on the weight of the dialysate drain bag or the dialysate weight. In some examples, the instructions further instruct the at least one processor to obtain a baseline reading from the light sensor and determine the risk of peritonitis by determining a difference between the baseline reading and the one or more characteristics of the light emitted through the spent dialysate. In some examples, the instructions further instruct the at least one processor to transmit the one or more characteristics of the light to a server, and receive an analysis of the one or more characteristics of the light from the server.
Various aspects of at least one embodiment are discussed below with reference to the accompanying Figures, which are not intended to be drawn to scale. The Figures are included to provide illustration and a further understanding of the various aspects and embodiments, and are incorporated in and constitute a part of this specification, but are not intended to define the limits of the disclosure. In the Figures, each identical or nearly identical component that is illustrated in various Figures is represented by a like numeral. For the purposes of clarity, some components may not be labeled in every figure. In the Figures:
The following table of contents is provided for the reader's convenience and is not intended to define the limits of the disclosure.
In general, one or more embodiments include a point-of-care (POC) system configured to analyze spent peritoneal dialysate.
As illustrated in
In an embodiment, the light source 102 is configured to emit a single wavelength of light through the spent dialysate 106. Alternatively, the light source 102 may be configured to emit multiple wavelengths of light. The light source 102 may be configured to emit light at about 1300 nm, about 810 nm, and/or about 660 nm. Light emitted at about 1300 nm may be used for calibration, e.g., by emitting light through clear water or clean dialysate (not shown). Light emitted at about 810 nm may be used to detect hemoglobin in the spent dialysate 106. Light emitted at about 660 nm may be used to detect white blood cells in the spent dialysate 106. One or more other wavelengths may be used. In an embodiment, the light source 102 is configured to emit near-infrared light, which may be used to detect glucose concentrate in dialysate, as described in further detail below.
In an embodiment, a light sensor 108 is configured to sense light passing through the spent dialysate 106. Specifically, the light sensor 108 is configured to sense light transmittance through the spent dialysate 106. The light sensor 108 may be positioned approximately opposite the light source 102, with the spent dialysate 106 disposed between them. Some embodiments may perform better (i.e., obtain more reliable light measurements) if the system 100 is placed in a relatively dark environment, such as a dark room and/or by placing the light sensor 108 within an enclosure that substantially blocks light from sources other than the light source 102. In some examples, the light source 102 and light sensor 108 both are integrated into a single apparatus, as described in examples herein.
In an embodiment, a dialysate analysis device 110 (or, in some examples, hardware, firmware, and/or software integrated in an apparatus that includes the light source 102 and light sensor 108) is configured to use data from the light sensor 108 to analyze the spent dialysate 106. If separate from the apparatus, the dialysate analysis device 110 may be a multi-purpose computing device, such as a smartphone, tablet, laptop computer, desktop computer, or other type of multi-purpose device. For example, the dialysate analysis device 110 may be configured to execute an installable application that includes instructions for analyzing spent dialysate 106 based on data from a light sensor 108. Alternatively, the dialysate analysis device 110 may be a special-purpose medical device configured to analyze spent dialysate 106. For example, the dialysate analysis device 110 may be part of a peritoneal dialysis (PD) cycler and/or other type of dialysis equipment.
In an embodiment, the light sensor 108 is part of the dialysate analysis device 110, as illustrated in
In an embodiment, the light source 102 and light sensor 108 are components of an apparatus that is configured to accommodate (e.g., on a tray, as in the examples below, or in another manner) a dialysate drain bag containing the spent dialysate 106. References herein to a dialysate analysis device 110 may be interpreted as referring to hardware, firmware, and/or software integrated in the apparatus. For example, the apparatus may include one or more processors and one or more non-transitory computer-readable media storing instructions that are executable by the processor(s), to analyze the spent dialysate 106 and/or perform other dialysis-related functions. Some non-limiting examples of such an apparatus are provided below. An apparatus with components integrated in this manner may make the apparatus more accessible to patients who do not have smartphones (or other similar devices as described herein) that could be used as an external dialysate analysis device, and/or who are not proficient at using smartphones.
In an embodiment, the dialysate analysis device 110 includes and/or is communicatively coupled with one or more additional hardware components that is/are configured to gather data associated with dialysis. Alternatively, one or more additional hardware components described herein may be integrated into the apparatus itself (for example, in embodiments that do not use a physically separate dialysate analysis device 110). For example, the dialysate analysis device 110 may include or be communicatively coupled with a microscope (not shown). The microscope may be part of a camera, a camera magnifying attachment, or a physically separate microscope device. For example, a smartphone attachment may be used to magnify a smartphone's camera by about 400 times or another suitable magnification factor. The dialysate analysis device 110 may use images from the microscope to help detect and analyze Gram-stained bacteria in the spent dialysate 106.
As another example, the dialysate analysis device 110 may include or be communicatively coupled with a proximity sensor (not shown). The dialysate analysis device 110 may use the proximity sensor to help detect placement of the dialysate analysis device 110 relative to an apparatus (e.g., the example apparatus 200 illustrated in
As yet another example, the dialysate analysis device 110 may include or be communicatively coupled with a gyroscope (not shown). The dialysate analysis device 110 may use the gyroscope to detect movement of the dialysate analysis device 110, and may use movement data to generate visual and/or auditory instructions that help a patient or other human operator guide the dialysate analysis device 110 to a specific location (e.g., the device placement area 206 illustrated in
In an embodiment, the dialysate analysis device 110 is configured to combine data from multiple components. For example, the dialysate analysis device 110 may combine data from a gyroscope and a proximity sensor to generate visual and/or auditory instructions that help a patient or other human operator to guide the dialysate analysis device 100 to a specific location. One or more components of the dialysate analysis device 110, or communicatively coupled with the dialysate analysis device 110, may be used for multiple purposes. For example, the dialysate analysis device 110 may be configured to use data from a camera (e.g., a camera that is part of the dialysate analysis device 110 or physically separate from the dialysate analysis device 110) both for light sensing and to obtain images of lateral flow assay or dry chemistry test strips to be evaluated as described in further detail below.
In an embodiment, the dialysate analysis device 110 is configured to control operation of one or more components described herein, such as the light source 102 and/or light sensor 108. For example, the dialysate analysis device 110 may be configured to transmit an electrical signal to turn on the light source 102, turn off the light source 102, and/or change an operational parameter of the light source 102 (e.g., brightness, wavelength, etc.). As another example, the dialysate analysis device 110 may be configured to transmit an electrical signal to instruct the light sensor 108 to begin or stop sensing light. Application software executing in the dialysate analysis device 110 may determine whether and/or when to transmit electrical signals to control operation of such components. For example, application software may transmit an electrical signal responsive to user input (e.g., via user interface 111) instructing the dialysate analysis device 110 to begin a process for analyzing spend dialysate 106.
In an embodiment, a server 112 is located apart from the dialysate analysis device 110 (e.g., in a separate device and/or a data center communicatively coupled with the dialysate analysis device 110 via one or more network connections). The server 112 may be configured to perform one or more operations described herein for analyzing the spent dialysate 106 and/or performing other analysis functions related to dialysis (e.g., analyzing data from a camera, microscope, proximity sensor, gyroscope, and/or another type of data or combination thereof). The dialysate analysis device 110 may be configured to transmit data to the server 112 for analysis and receive analysis results from the server 112. One or more operations described herein as being performed by the dialysate analysis device 110 may instead be performed by the server 112.
In an embodiment, the dialysate analysis device 110 includes or is communicatively coupled with a user interface 111. A user interface 111 refers to hardware, firmware, and/or software configured to facilitate communications between a user and the dialysate analysis device 110. A user interface 111 renders user interface elements and receives input via user interface elements. A user interface 111 may be a graphical user interface (GUI), a command line interface (CLI), a haptic interface, a voice command interface, and/or any other kind of interface or combination thereof. Examples of user interface elements include checkboxes, radio buttons, dropdown lists, list boxes, buttons, toggles, text fields, date and time selectors, command lines, sliders, pages, and forms. Different components of the user interface 111 may be specified in different languages. The behavior of user interface elements may be specified in a dynamic programming language, such as JavaScript. The content of user interface elements may be specified in a markup language, such as hypertext markup language (HTML), Extensible Markup Language (XML), or XML User Interface Language (XUL). The layout of user interface elements may be specified in a style sheet language, such as Cascading Style Sheets (CSS). Alternatively or additionally, aspects of a user interface 111 may be specified in one or more other languages, such as Java, Python, Perl, C, C++, and/or any other language or combination thereof.
In an embodiment, the user interface 111 is configured to provide audio and/or visual cues, as described below. Audio and/or visual cues may be particularly helpful, for example, when a patient is visually impaired and would otherwise have difficultly positioning a drain bag and/or dialysate analysis device 110 for effective dialysate analysis. It should be noted that a patient with a visual impairment would be particularly unlikely to detect peritonitis at an early stage using the traditional “cloudiness” method.
In an embodiment, the dialysate analysis device 110 and/or server 112 is/are configured to store data in one or more data repositories 113. A data repository 113 is any type of storage unit and/or device (e.g., a file system, database, collection of tables, or any other storage mechanism) for storing data. A data repository 113 may include multiple different storage units and/or devices. The multiple different storage units and/or devices may or may not be of the same type or located at the same physical site. Further, a data repository 113 may be implemented or may execute on the same computing system as one or more other components of the system 100. Alternatively or additionally, a data repository 113 may be implemented or executed on a computing system separate from one or more other components of the system 100. A data repository 113 may be logically integrated with one or more other components of the system 100. Alternatively or additionally, a data repository 113 may be communicatively coupled to one or more other components of the system 100 via a direct connection or via a network. Alternatively or additionally, information may be implemented and/or distributed across any of the components of the system 100.
In an embodiment, the system 100 is located in a patient's home, to provide home-based point-of-care analysis of spent dialysate. Alternatively, the system 100 may be located in a clinical setting, such as a dialysis center or hospital.
In an embodiment, one or more components of the system 100 are implemented on one or more digital devices. The term “digital device” generally refers to any hardware device that includes a processor. A digital device may refer to a physical device executing an application or a virtual machine. Examples of digital devices include a computer, a tablet, a laptop, a desktop, a netbook, a server, a web server, a network policy server, a proxy server, a generic machine, a function-specific hardware device, a hardware router, a hardware switch, a hardware firewall, a hardware network address translator (NAT), a hardware load balancer, a mainframe, a television, a content receiver, a set-top box, a printer, a mobile handset, a smartphone, a personal digital assistant (“PDA”), a wireless receiver and/or transmitter, a base station, a communication management device, a router, a switch, a controller, an access point, and/or a client device.
In an embodiment, an apparatus is provided that facilitates placement of a light sensor relative to spent dialysate in a drain bag. Specifically, the apparatus may help ensure that the light sensor and drain bag are positioned, relative to each other, in a configuration that helps ensure accurate and consistent light readings. In the following example, the light sensor is assumed to be part of a dialysate analysis device, such as a smartphone or tablet. In other examples (not shown), the light sensor may be physically separate from the dialysate analysis device and references below to a “device” or “dialysate analysis device” may refer to the light sensor only. In some examples described herein, the light sensor is integrated into the apparatus.
In an embodiment, the apparatus 200 includes a scale configured to weigh the dialysate drain bag 208. For case of discussion, as used herein, the terms “weigh” and “weight” may refer to measuring either the mass or weight of the dialysate drain bag 208, as those terms are defined in the art. For example,
As in the example of
In an embodiment, the apparatus 1200 includes a monochromator (not shown). A monochromator may be used, for example, to ensure that a light-emitting component disposed in the light compartment 1204 emits a narrow wavelength or radiation, to help improve the accuracy of light readings and subsequent analysis. Alternatively or additionally, the apparatus 1200 may include a cover and/or enclosure (not shown) that fully or partially surrounds the apparatus 1200 (e.g., fully or partially surrounding the light compartment 1204 and/or light sensor 1206), to reduce ambient light (e.g., creating an environment akin to a dark room), for improved detection of light emitted from the light compartment 1204.
As illustrated in
A circuit board 1222 implements logic in hardware, firmware, and/or software to control operation of the electrical components. In an embodiment, the circuit board 1222 includes one or more processors configured to execute instructions to perform operations described herein. The apparatus 1200 may include one or more computer-readable media (not shown) storing such instructions. A wireless module (not shown) (e.g., a Bluetooth® and/or Wi-Fi module) is configured to transmit and receive data in communication with one or more other components (e.g., a dialysis system and/or server as described herein). In this example, there are three light sources 1226, two of them being concealed by the circuit board 1222. A potentiometer 1223 may be included, for example, for use with an integrated display as described below.
In some examples (not shown), an apparatus as described herein may be integrated with a hook scale. The hook scale may be used to weigh the dialysate drain bag, as an alternative or in addition to force sensitive resistors integrated in the apparatus. The apparatus may be configured to clamp onto the drain bag while it is hanging from a hook scale. Alternatively, the apparatus itself may include an integrated hook scale. A light source and light sensor may be positioned so that analyzing spent dialysate can be performed while the drain bag hangs from the separate or integrated hook scale. For example, the light source and light sensor may be disposed on opposing faces of a clamp that fastens to the drain bag while it is hanging from a separate or integrated hook scale. For example, apparatus 1200 may be configured such that hinge 1206 is spring loaded, causing rotation of light compartment 1204 toward bag tray 1202, which may enable clamping of the apparatus 1200 to a drain bag. For such an embodiment, bag tray 1202 may be reduced in size to generally correspond to the profile of light compartment 1204.
In an embodiment, an apparatus as described herein is configured so that the light compartment and light sensor are disposed on opposing faces of a clamp that fastens to a drain line. For example, apparatus 1200 may be configured such that hinge 1206 is spring loaded, causing rotation of the light compartment 1204 toward the light sensor 1206 disposed in an opposing surface of the apparatus 1200, which may enable clamping of the apparatus 1200 to a drain line (e.g., at a clear section of the drain line or a light-permeable chamber). In such examples, the term “predetermined position” may refer to a suitable alignment of the drain line with the light compartment 1204 and light sensor 1206. For such an embodiment, bag tray 1202 may be omitted.
The examples above describe apparatuses that, among other features, help ensure consistent positioning of a dialysate drain bag. The dialysis drain bag itself may be designed to provide positioning guidance. For example, the drain bag may include one or more lines, a ruler, and/or other marking(s) that indicate(s) the intended position of the drain bag on a drain bag tray. Such markings may be designed to align with corresponding markings on the drain bag tray. The relative transparency of the drain bag may allow the patient or other human operator to use the marking(s) to position the drain bag in a relatively consistent location. In light of the present disclosure, many different types of apparatus and/or other guiding features may be envisioned that help ensure consistent positioning of a dialysate drain bag.
The operations described below include embodiments where dialysate analysis features are included in a dialysate analysis device physically separate from the apparatus on which the drain bag is placed. In embodiments where dialysate analysis features are integrated into the apparatus itself (for example, as in the example of
The operations described below refer generally to embodiments using a drain bag. As described herein, other embodiments may use a drain line, for example by clamping to a drain line. Accordingly, where appropriate, references in this section to a drain bag may apply, mutatis mutandis, to a drain line.
In an embodiment, spent dialysate analysis is performed using an apparatus (e.g., the example apparatus of
In an embodiment, a dialysate analysis device is aligned with the apparatus (Operation 404). Specifically, the dialysate analysis device may be placed in a particular position indicated by a physical configuration of the apparatus (for example, the device placement area 206 of the example apparatus 200 illustrated in
In an embodiment, the dialysate analysis device is calibrated (Operation 406). Calibrating the dialysate analysis device may involve taking one or more light readings, using a light sensor, when the drain bag containing spent dialysate is not present. Calibrating the dialysate analysis device may thus provide a baseline light reading for comparison with a light reading taken when the drain bag containing spent dialysate is present. For example, the baseline may be based on a historical average of readings. Alternatively or additionally, a baseline may be based on data (e.g., an average or mean) of readings taken from multiple non-peritonitis drain bags, in a laboratory setting and/or in practice.
In an embodiment, the drain bag containing spent dialysate is aligned with the apparatus (Operation 408). Specifically, the drain bag may be placed in a particular position indicated by a physical configuration of the apparatus (for example, the bag tray 202 of the example apparatus 200 illustrated in
In an embodiment, light is emitted through the drain bag (Operation 410). The light emitted through the drain bag may be ambient light (e.g., from sunlight and/or one or more general-purpose lamps) in the environment. Alternatively, a dedicated light source may emit light through the drain bag (for example, one or more light sources 226 of an apparatus 200 as illustrated in
In an embodiment, a light sensor senses light emitted through the drain bag (Operation 412). Specifically, the light sensor senses light emitted at one or more particular wavelengths of interest for analyzing the spent dialysate. As discussed above, the light sensor may sense the light responsive to an electrical signal or other type of instruction transmitted by the dialysate analysis device. The light sensor may sense the light in a single reading. Alternatively, the light sensor may take multiple readings. When evaluating data received from the light sensor as described below, the dialysate analysis device may determine an average, mean, or other statistic based on multiple readings. In addition, the dialysate analysis device may discard outliers that deviate significantly from an average, mean, or other reference value. The light sensor may output a light reading (e.g., relative luminosity).
In an embodiment, the dialysate analysis device evaluates data received from the light sensor and/or one or more other sources (Operation 414). The dialysate analysis device may evaluate many different types of data to determine various properties (or suspected/predicted properties) of the spent dialysate. For example:
In an embodiment, the dialysate analysis device determines whether an alert criterion is satisfied (Operation 416). An alert criterion is a rule that, when satisfied, indicates a condition that may require or benefit from human attention. For example, an alert criterion may indicate, based on evaluation of one or more types of data as described above, that the patient has an increased risk or likelihood of peritonitis. The increased risk or likelihood may be based on an absolute value (e.g., turbidity above a threshold amount, or a threshold ratio of granulocytes), a trend (e.g., turbidity or a ratio of a particular class of white blood cells increasing above a threshold rate), and/or another kind of metric or combination thereof.
In an embodiment, an alert criterion is a composite rule that combines one or multiple factors (e.g., turbidity, particle sizes, ratios of particle types, leukocyte esterase, presence of bacteria, and/or another factor or combination thereof) to compute the patient's risk or likelihood of having peritonitis and/or another condition. Additional factors may include, for example: social/environmental factors, such as smoking, living distantly from the peritoneal dialysis unit, and/or pets; medical factors such as obesity, depression, hypokalemia, hypoalbuminemia, absence of vitamin D supplementation, and/or invasive interventions (e.g., a colonoscopy); dialysis-related factors such as prior hemodialysis, peritoneal dialysis against the patient's choice, training, bioincompatible fluids, and/or wet contamination; infection-related factors such as nasal Staphylococcus aureus carrier status and/or previous exit-site infection; and/or another factor or combination thereof. Still more factors may include, for example, whether the patient has taken a day off from peritoneal dialysis, whether the spent dialysate is from the first drain of an APD patient with a dry day, and/or how long the dwell time lasted. In some cases, one or more factors may indicate a likelihood that turbidity is caused by peritoneal debris, and rinsing may be suggested rather than any approaches directed to treating infection.
In an embodiment, the patient's risk or likelihood of a particular condition may be computed as a numerical score and compared with a threshold numerical value. If an alert criterion is satisfied, then the dialysate analysis device generates an alert (Operation 418). The alert may include a risk score, diagnosis, recommended course of action (e.g., antibiotic treatment or rinsing), and/or other information relating to peritoneal dialysis and/or other health concerns. In some cases, a recommended course of treatment may be informed by self-reported symptoms (e.g., symptoms gathered via a graphical user interface as described below). If test outcomes are positive for a medical condition (e.g., peritonitis) and self-reported symptoms also are positive for that condition, an appropriate treatment (e.g., antibiotics) may be recommended. If test outcomes are negative and symptoms also are negative, no treatment may be recommended. If test outcomes and symptoms are inconsistent with each other (i.e., one is positive for a condition and the other is negative for that condition), clinical evaluation may be recommended. Generating an alert may help ensure early detection and treatment of peritonitis and/or one or more other conditions associated with peritoneal dialysis. In some cases, generating an alert may prompt the application of further techniques to confirm the validity of the alert, for example, by sending the dialysate drain bag and/or some or all of the spent dialysate to a laboratory for further analysis.
In an embodiment, a dialysate analysis device includes a user interface (e.g., user interface 111 discussed above with respect to
In an embodiment, a user interface that provides audio and/or visual cues helps ensure more accurate dialysate analysis, and/or more consistent dialysate analysis over multiple uses, than if a patient or other human operators were not provided with such cues.
In an embodiment, an apparatus is provided that facilitates placement of a light sensor relative to spent dialysate along a drain line (e.g., a clear section of drain line tubing or a light-permeable chamber positioned along the drain line). Specifically, the apparatus may help ensure that the light sensor is positioned, relative to a clear section of the drain line, drain line visualization chamber, or light-permeable chamber, in a configuration that helps ensure accurate and consistent light readings. In the following example, the light sensor is assumed to be part of a device separate from the dialysate analysis device. In other examples (not shown), the light sensor may be part of the dialysate analysis device.
In an embodiment, the light-permeable chamber 602 and/or light-sensing device 605 are similar in construction to equipment used to measure blood properties such as hematocrit, percent change in blood volume, and/or oxygen saturation. For example, the light-permeable chamber 602 may be similar in construction to a Crit-Line blood chamber manufactured by Fresenius Medical Care, which is typically used with a Crit-Line III monitor also manufactured by Fresenius Medical Care. The light-permeable chamber 602 may include structural modifications from the blood chamber construction, for example to allow the light-permeable chamber 602 to be positioned along the drain line. The light-sensing device 605 may be a CLiC™ device manufactured by Fresenius Medical Care, which is designed to clamp onto a Crit-Line blood chamber. The Crit-Line blood chamber and CLiC™ device are designed for mutual compatibility. Specifically, the Crit-Line blood chamber has flat external surfaces that accommodate the CLiC™ device's light source 606 and light sensor 608 in approximately parallel and opposing positions, such that light from the light source 606 is directed through the chamber toward the light sensor 608. Modifying and/or repurposing existing equipment that is typically used in blood analysis may provide cost savings to a company manufacturing the equipment, while extending the equipment's utility to unconventional dialysate analysis techniques described herein.
In an embodiment, the light-permeable chamber 602 is a removable, disposable, single- or multiple-use chamber. Alternatively, the light-permeable chamber 602 may be fixed to the drain line and/or designed for multiple uses prior to disposal.
While examples are described above with reference to the illustrations of
In an embodiment, a light-sensing device (e.g., the example light-sensing device 605 illustrated in
In an embodiment, light is emitted through the spent dialysate (Operation 704). Specifically, light is emitted through the clear section of the drain line, drain line visualization chamber, or light-permeable chamber where the light-sensing device is situated. The light emitted through the spent dialysate may be ambient light (e.g., from sunlight and/or one or more general-purpose lamps) in the environment. Alternatively, a dedicated light source may emit light through the spent dialysate (for example, one or more light sources 606 of a light-sensing device 605 as illustrated in
In an embodiment, a light sensor in the light-sensing device senses the light emitted through the spent dialysate (Operation 706). Specifically, the light sensor senses light emitted at one or more particular wavelengths used to analyze the spent dialysate. As discussed above, the light sensor may sense the light responsive to an electrical signal or other type of instruction transmitted by the dialysate analysis device. The light sensor may sense the light in a single reading. Alternatively, the light sensor may take multiple readings. When evaluating data received from the light sensor as described below, the dialysate analysis device may determine an average, mean, or other statistic based on multiple readings. In addition, the dialysate analysis device may discard outliers that deviate significantly from an average, mean, or other reference value.
In an embodiment, the dialysate analysis device evaluates data received from the light sensor and/or one or more other sources (Operation 708). The dialysate analysis device may determine whether an alert criterion is satisfied (Operation 710). If an alert criterion is satisfied, then the dialysate analysis device may generate an alert (Operation 712). Evaluating data, determining whether an alert criterion is satisfied, and generating an alert may be performed as described above with respect to
In an embodiment, a dialysate analysis device (and/or the apparatus itself) includes hardware, firmware, and/or software that tracks a patient's history, which may include a history of any type of measurement and/or computation described herein. The history may also include self-reported data, such as symptoms, urine volume, etc. The patient's history may be uploaded and saved to the patient's electronic health record. The dialysate analysis device and/or apparatus may be configured to present information about patient tracking in a user interface (e.g., user interface 111 discussed above with respect to
In an embodiment, a system includes one or more devices, including one or more hardware processors, that are configured to perform any of the operations described herein and/or recited in any of the claims.
In an embodiment, a non-transitory computer-readable storage medium stores instructions that, when executed by one or more hardware processors, cause performance of any of the operations described herein and/or recited in any of the claims.
Any combination of the features and functionalities described herein may be used in accordance with an embodiment. In the foregoing specification, embodiments have been described with reference to numerous specific details that may vary from implementation to implementation. Accordingly, the specification and figures are to be regarded in an illustrative rather than a restrictive sense. The sole and exclusive indicator of the scope of the invention, and what is intended by the Applicant to be the scope of the invention, is the literal and equivalent scope of the set of claims that issue from this application, in the specific form in which such claims issue, including any subsequent correction.
In an embodiment, techniques described herein are implemented by one or more special-purpose computing devices (i.e., computing devices specially configured to perform certain functionality). The special-purpose computing device(s) may be hard-wired to perform the techniques and/or may include digital electronic devices such as one or more application-specific integrated circuits (ASICs), field programmable gate arrays (FPGAs), and/or network processing units (NPUs) that are persistently programmed to perform the techniques. Alternatively or additionally, a computing device may include one or more general-purpose hardware processors programmed to perform the techniques pursuant to program instructions in firmware, memory, and/or other storage. Alternatively or additionally, a special-purpose computing device may combine custom hard-wired logic, ASICs, FPGAs, or NPUs with custom programming to accomplish the techniques. A special-purpose computing device may include a desktop computer system, portable computer system, handheld device, networking device, and/or any other device(s) incorporating hard-wired and/or program logic to implement the techniques.
For example,
Computer system 900 also includes a main memory 906, such as a random access memory (RAM) or other dynamic storage device, coupled to bus 902 for storing information and instructions to be executed by processor 904. Main memory 906 also may be used for storing temporary variables or other intermediate information during execution of instructions to be executed by processor 904. Such instructions, when stored in one or more non-transitory storage media accessible to processor 904, render computer system 900 into a special-purpose machine that is customized to perform the operations specified in the instructions.
Computer system 900 further includes a read only memory (ROM) 908 or other static storage device coupled to bus 902 for storing static information and instructions for processor 904. A storage device 910, such as a magnetic disk or optical disk, is provided and coupled to bus 902 for storing information and instructions.
Computer system 900 may be coupled via bus 902 to a display 912, such as a liquid crystal display (LCD), plasma display, electronic ink display, cathode ray tube (CRT) monitor, or any other kind of device for displaying information to a computer user. An input device 914, including alphanumeric and other keys, may be coupled to bus 902 for communicating information and command selections to processor 904. Alternatively or additionally, computer system 900 may receive user input via a cursor control 916, such as a mouse, a trackball, a trackpad, or cursor direction keys for communicating direction information and command selections to processor 904 and for controlling cursor movement on display 912. This input device typically has two degrees of freedom in two axes, a first axis (e.g., x) and a second axis (e.g., y), that allows the device to specify positions in a plane. Alternatively or additionally, computer system 9 may include a touchscreen. Display 912 may be configured to receive user input via one or more pressure-sensitive sensors, multi-touch sensors, and/or gesture sensors. Alternatively or additionally, computer system 900 may receive user input via a microphone, video camera, and/or some other kind of user input device (not shown).
Computer system 900 may implement the techniques described herein using customized hard-wired logic, one or more ASICs or FPGAs, firmware, and/or program logic which in combination with other components of computer system 900 causes or programs computer system 900 to be a special-purpose machine. According to one embodiment, the techniques herein are performed by computer system 900 in response to processor 904 executing one or more sequences of one or more instructions contained in main memory 906. Such instructions may be read into main memory 906 from another storage medium, such as storage device 910. Execution of the sequences of instructions contained in main memory 906 causes processor 904 to perform the process steps described herein. Alternatively or additionally, hard-wired circuitry may be used in place of or in combination with software instructions.
The term “storage media” as used herein refers to one or more non-transitory media storing data and/or instructions that cause a machine to operate in a specific fashion. Such storage media may comprise non-volatile media and/or volatile media. Non-volatile media includes, for example, optical or magnetic disks, such as storage device 910. Volatile media includes dynamic memory, such as main memory 906. Common forms of storage media include, for example, a floppy disk, a flexible disk, hard disk, solid state drive, magnetic tape or other magnetic data storage medium, a CD-ROM or any other optical data storage medium, any physical medium with patterns of holes, a RAM, a programmable read-only memory (PROM), an erasable PROM (EPROM), a FLASH-EPROM, non-volatile random-access memory (NVRAM), any other memory chip or cartridge, content-addressable memory (CAM), and ternary content-addressable memory (TCAM).
A storage medium is distinct from but may be used in conjunction with a transmission medium. Transmission media participate in transferring information between storage media. Examples of transmission media include coaxial cables, copper wire, and fiber optics, including the wires that comprise bus 902. Transmission media may also take the form of acoustic or light waves, such as those generated during radio-wave and infra-red data communications.
Various forms of media may be involved in carrying one or more sequences of one or more instructions to processor 904 for execution. For example, the instructions may initially be carried on a magnetic disk or solid state drive of a remote computer. The remote computer may load the instructions into its dynamic memory and send the instructions over a network, via a network interface controller (NIC), such as an Ethernet controller or Wi-Fi controller. A NIC local to computer system 900 may receive the data from the network and place the data on bus 902. Bus 902 carries the data to main memory 906, from which processor 904 retrieves and executes the instructions. The instructions received by main memory 906 may optionally be stored on storage device 910 either before or after execution by processor 904.
Computer system 900 also includes a communication interface 918 coupled to bus 902. Communication interface 918 provides a two-way data communication coupling to a network link 920 that is connected to a local network 922. For example, communication interface 918 may be an integrated services digital network (ISDN) card, cable modem, satellite modem, or a modem to provide a data communication connection to a corresponding type of telephone line. As another example, communication interface 918 may be a local area network (LAN) card to provide a data communication connection to a compatible LAN. Wireless links may also be implemented. In any such implementation, communication interface 918 sends and receives electrical, electromagnetic or optical signals that carry digital data streams representing various types of information.
Network link 920 typically provides data communication through one or more networks to other data devices. For example, network link 920 may provide a connection through local network 922 to a host computer 924 or to data equipment operated by an Internet Service Provider (ISP) 926. ISP 926 in turn provides data communication services through the world wide packet data communication network now commonly referred to as the “Internet” 928. Local network 922 and Internet 928 both use electrical, electromagnetic or optical signals that carry digital data streams. The signals through the various networks and the signals on network link 920 and through communication interface 918, which carry the digital data to and from computer system 900, are example forms of transmission media.
Computer system 900 can send messages and receive data, including program code, through the network(s), network link 920 and communication interface 918. In the Internet example, a server 930 might transmit a requested code for an application program through Internet 928, ISP 926, local network 922, and communication interface 918.
The received code may be executed by processor 904 as it is received, and/or stored in storage device 910, or other non-volatile storage for later execution.
In an embodiment, a computer network provides connectivity among a set of nodes running software that utilizes techniques as described herein. The nodes may be local to and/or remote from each other. The nodes are connected by a set of links. Examples of links include a coaxial cable, an unshielded twisted cable, a copper cable, an optical fiber, and a virtual link.
A subset of nodes implements the computer network. Examples of such nodes include a switch, a router, a firewall, and a network address translator (NAT). Another subset of nodes uses the computer network. Such nodes (also referred to as “hosts”) may execute a client process and/or a server process. A client process makes a request for a computing service (for example, a request to execute a particular application and/or retrieve a particular set of data). A server process responds by executing the requested service and/or returning corresponding data.
A computer network may be a physical network, including physical nodes connected by physical links. A physical node is any digital device. A physical node may be a function-specific hardware device. Examples of function-specific hardware devices include a hardware switch, a hardware router, a hardware firewall, and a hardware NAT. Alternatively or additionally, a physical node may be any physical resource that provides compute power to perform a task, such as one that is configured to execute various virtual machines and/or applications performing respective functions. A physical link is a physical medium connecting two or more physical nodes. Examples of links include a coaxial cable, an unshielded twisted cable, a copper cable, and an optical fiber.
A computer network may be an overlay network. An overlay network is a logical network implemented on top of another network (for example, a physical network). Each node in an overlay network corresponds to a respective node in the underlying network. Accordingly, each node in an overlay network is associated with both an overlay address (to address the overlay node) and an underlay address (to address the underlay node that implements the overlay node). An overlay node may be a digital device and/or a software process (for example, a virtual machine, an application instance, or a thread). A link that connects overlay nodes may be implemented as a tunnel through the underlying network. The overlay nodes at either end of the tunnel may treat the underlying multi-hop path between them as a single logical link. Tunneling is performed through encapsulation and decapsulation.
In an embodiment, a client may be local to and/or remote from a computer network. The client may access the computer network over other computer networks, such as a private network or the Internet. The client may communicate requests to the computer network using a communications protocol, such as Hypertext Transfer Protocol (HTTP). The requests are communicated through an interface, such as a client interface (such as a web browser), a program interface, or an application programming interface (API).
In an embodiment, a computer network provides connectivity between clients and network resources. Network resources include hardware, firmware, and/or software configured to execute server processes. Examples of network resources include a processor, a data storage, a virtual machine, a container, and/or a software application. Network resources may be shared amongst multiple clients. Clients request computing services from a computer network independently of each other. Network resources are dynamically assigned to the requests and/or clients on an on-demand basis. Network resources assigned to each request and/or client may be scaled up or down based on, for example, (a) the computing services requested by a particular client, (b) the aggregated computing services requested by a particular tenant, and/or (c) the aggregated computing services requested of the computer network. Such a computer network may be referred to as a “cloud network.”
In an embodiment, a service provider provides a cloud network to one or more end users. Various service models may be implemented by the cloud network, including but not limited to Software-as-a-Service (SaaS), Platform-as-a-Service (PaaS), and Infrastructure-as-a-Service (IaaS). In SaaS, a service provider provides end users the capability to use the service provider's applications, which are executing on the network resources. In PaaS, the service provider provides end users the capability to deploy custom applications onto the network resources. The custom applications may be created using programming languages, libraries, services, and tools supported by the service provider. In IaaS, the service provider provides end users the capability to provision processing, storage, networks, and other fundamental computing resources provided by the network resources. Any applications, including an operating system, may be deployed on the network resources.
In an embodiment, various deployment models may be implemented by a computer network, including but not limited to a private cloud, a public cloud, and a hybrid cloud. In a private cloud, network resources are provisioned for exclusive use by a particular group of one or more entities (the term “entity” as used herein refers to a corporation, organization, person, or other entity). The network resources may be local to and/or remote from the premises of the particular group of entities. In a public cloud, cloud resources are provisioned for multiple entities that are independent from each other (also referred to as “tenants” or “customers”). In a hybrid cloud, a computer network includes a private cloud and a public cloud. An interface between the private cloud and the public cloud allows for data and application portability. Data stored at the private cloud and data stored at the public cloud may be exchanged through the interface. Applications implemented at the private cloud and applications implemented at the public cloud may have dependencies on each other. A call from an application at the private cloud to an application at the public cloud (and vice versa) may be executed through the interface.
In an embodiment, a system supports multiple tenants. A tenant is a corporation, organization, enterprise, business unit, employee, or other entity that accesses a shared computing resource (for example, a computing resource shared in a public cloud). One tenant (through operation, tenant-specific practices, employees, and/or identification to the external world) may be separate from another tenant. The computer network and the network resources thereof are accessed by clients corresponding to different tenants. Such a computer network may be referred to as a “multi-tenant computer network.” Several tenants may use a same particular network resource at different times and/or at the same time. The network resources may be local to and/or remote from the premises of the tenants. Different tenants may demand different network requirements for the computer network. Examples of network requirements include processing speed, amount of data storage, security requirements, performance requirements, throughput requirements, latency requirements, resiliency requirements, Quality of Service (QoS) requirements, tenant isolation, and/or consistency. The same computer network may need to implement different network requirements demanded by different tenants.
In an embodiment, in a multi-tenant computer network, tenant isolation is implemented to ensure that the applications and/or data of different tenants are not shared with each other. Various tenant isolation approaches may be used. In an embodiment, each tenant is associated with a tenant ID. Applications implemented by the computer network are tagged with tenant ID's. Additionally or alternatively, data structures and/or datasets, stored by the computer network, are tagged with tenant ID's. A tenant is permitted access to a particular application, data structure, and/or dataset only if the tenant and the particular application, data structure, and/or dataset are associated with a same tenant ID. As an example, each database implemented by a multi-tenant computer network may be tagged with a tenant ID. Only a tenant associated with the corresponding tenant ID may access data of a particular database. As another example, each entry in a database implemented by a multi-tenant computer network may be tagged with a tenant ID. Only a tenant associated with the corresponding tenant ID may access data of a particular entry. However, the database may be shared by multiple tenants. A subscription list may indicate which tenants have authorization to access which applications. For each application, a list of tenant ID's of tenants authorized to access the application is stored. A tenant is permitted access to a particular application only if the tenant ID of the tenant is included in the subscription list corresponding to the particular application.
In an embodiment, network resources (such as digital devices, virtual machines, application instances, and threads) corresponding to different tenants are isolated to tenant-specific overlay networks maintained by the multi-tenant computer network. As an example, packets from any source device in a tenant overlay network may only be transmitted to other devices within the same tenant overlay network. Encapsulation tunnels may be used to prohibit any transmissions from a source device on a tenant overlay network to devices in other tenant overlay networks. Specifically, the packets, received from the source device, are encapsulated within an outer packet. The outer packet is transmitted from a first encapsulation tunnel endpoint (in communication with the source device in the tenant overlay network) to a second encapsulation tunnel endpoint (in communication with the destination device in the tenant overlay network). The second encapsulation tunnel endpoint decapsulates the outer packet to obtain the original packet transmitted by the source device. The original packet is transmitted from the second encapsulation tunnel endpoint to the destination device in the same particular overlay network.
Systems 100 and 101, as described herein, may configured to be part of or communicate with a connected health (CH) system 1000.
This application claims priority under 35 U.S.C. § 121 as a Divisional to U.S. patent application Ser. No. 17/097,299, titled “SYSTEM AND METHOD FOR ANALYZING SPENT DIALYSATE,” filed on Nov. 13, 2020, which is incorporated by reference in its entirety for all purposes.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 17097299 | Nov 2020 | US |
| Child | 18733259 | US |
