JPS5875558A - Mountable artificial kidney - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a wearable artificial kidney device, and more specifically, by performing hemofiltration during the day and hemodialysis during the night while sleeping, the present invention allows renal failure patients to perform social activities during the day. The purpose is to make it possible.

For patients whose urinary function has been lost or has significantly decreased due to renal diseases such as chronic renal failure or uremia, hemodialysis using an artificial kidney, peritoneal dialysis using the permeability of the living body's peritoneum, or high-dose treatment. Treatment is by blood purification methods such as blood purification, which involves exchanging body fluids. These blood purification methods include the removal of waste products such as urea uric acid and creatinine, and the removal of N
&, x%at, O&,'g, Po4ep (D Adjustment of electrolytes in the body, adjustment of acid-base balance, and removal of water excessively accumulated in the body, etc., and 6-hour hemodialysis to improve biological kidney function, or As patients undergo hemofiltration, the time constraints of hospital visits greatly hinder their daily social activities.Sometimes night dialysis and home dialysis are performed as a way to make this return to society as possible as possible. There are many problems such as difficulty in securing doctors and dialysis staff, increased financial expenses, and safety.

In addition, hemodialysis or hemofiltration performed two or three times a week is a difficult task, as compared to the biological kidneys, which function constantly during the day and night. In other words, the rapid removal of water and waste products at a rate 10 to 20 times faster is the cause of frequent complications such as imbalance syndrome and blood pressure fluctuations. Moreover, in terms of diet, the intake of water and salt must be extremely limited, which is a major pain for patients. If the frequency of hemodialysis or hemofiltration is increased, the aforementioned complications and dietary restrictions can be alleviated, but time constraints due to the increased number of hospital visits, number of beds ″−'−) □Insufficient doctors, dialysis staff This is considered to be extremely difficult to achieve due to the increase in costs and expenses.

On the other hand, in terms of equipment, blood purification treatments such as hemodialysis, hemofiltration, and peritoneal dialysis require hemodialyzers, hemofilters, and blood
A blood purification device is constructed using various tools and devices such as a tube, a shunt blood circuit, a dialysate supply device, a henolin infusion device, an infusion fluid supply device, and a monitoring device. The devices used for all therapies are large; hemodialysis machines use a large amount of dialysate; hemofiltration requires approximately 2 nt of replenishment fluid; and all blood purification methods require anticoagulants. Pumps for injecting the blood agent Henomanrin are essential, and it is extremely difficult to miniaturize and miniaturize systems based on devices, making it impossible to carry out daily activities while wearing these systems. close.

As mentioned above, conventional outpatient blood purification methods, night dialysis, home dialysis, and wearing methods are all solutions to enabling patients to return to society, where they can carry out their daily lives at a level close to that of a healthy person. I had a difficult problem to solve.

The present inventors have made extensive studies to solve these problems, and as a result, have constructed the wearable artificial kidney of the present invention, which enables patients to return to society. The present invention will be explained in detail below.

The present inventors have developed a wearable artificial kidney that can be miniaturized and lightweight, assuming that the wearable artificial kidney will perform hemofiltration during social activities during the day and perform hemodialysis during sleep at night. In order to provide a type of artificial kidney, we proceeded with the study to achieve the following items.

(1) An artificial kidney that has water removal speed close to that of a biological kidney, (2) An artificial kidney that does not require a blood pump, (3) An artificial kidney that can perform both dialysis and filtration of blood, and (4) An artificial kidney that can be used for both dialysis and filtration. Artificial kidney without.

First of all, although the artificial kidney is similar to the water removal system of the 1st K biological kidney, the amount of water removed, or urinated, by a biological kidney in a day varies depending on the biological condition, amount of water intake, body weight, age, etc. It appears, but
Approximately 1.5L to 2.5t.

On average, it is about 2t, which is about 80d per hour.
It is. The water removal capacity of the artificial kidney according to the present invention may be the average micturition rate of the living kidney. Second, as an artificial kidney that does not require a blood pump, it is an artificial kidney that can secure h flow and ultrafiltration pressure using arterial pressure, and arterial pressure is usually 70 to 1.
50 mHP, so the smaller the pressure loss of the artificial kidney for blood purification, the better, preferably 10 mHP or less.

Third, the artificial kidney according to the present invention is capable of both dialysis and filtration of blood, but during the day it only removes water through hemofiltration, and at night while sleeping, it performs hemodialysis using dialysate to adjust electrolytes and remove acid. It mainly adjusts the base balance, but -
At this time, water removal may also be performed at the same time. Fourthly, for an artificial kidney that does not require a heparin pump, p4 phosphorus can be atomized using an isobaric nebulizer, inhaled into the lungs by the patient's inhalation, and absorbed into the mast cells of the lungs. It was discovered that the drug is continuously and slowly released into the blood and exerts an anticoagulant effect, thereby eliminating the need for knee-sucking.

The wearable artificial kidney of the present invention, which is constructed according to the above four items, is extremely miniaturized and simplified so that it does not interfere with daytime daily life, and is also capable of removing water, removing waste products, adjusting electrolytes, and adjusting acid-base balance. An embodiment of the wearable artificial kidney of the present invention will be described in more detail with reference to the drawings.

#I1 and Figure 2 show examples of how the wearable artificial kidney according to the present invention is installed. An example of installation is shown below. First, to explain according to FIG. 1, the artificial kidney (1) has an ultrafiltration rate of about 10 to 10% at a hematocrit value of about 11 and a blood flow of 100 d/min.
Hf.

HR, l/ws, preferably about 20-25 yet/ws
Any membrane material that can produce Hl, HR, M” is fine.
For example, polysulfone, preethersulfone? Preferred are polymeric membrane materials such as trimethyl methacrylate, polyacrylonitrile, I-liquorate, ethylene vinyl acetate, and cellulose acetate, but more preferably polysulfone or cellulose acetate membrane materials are based on the results of experiments conducted by the present inventors. The results show that the adhesion of blood protein components and platelets is lower than that of other membrane materials, making it suitable for the wearable artificial kidney intended by the present invention. Regarding the shape of the membrane, either a hollow fiber type or a flat plate layer may be used.
Since it is necessary to perform the hemodialysis shown in the figure, and from the viewpoint of the cross-sectional structure of the membrane, a homogeneous membrane or a membrane having skin layers on both sides of the membrane, that is, on both the blood side and the dialysate side, is desirable. The membrane area is calculated based on the patient's average active time of 16 hours and bedtime of 8 hours, and the amount of water removed per day is 21. The average blood pressure across the membrane is 70-1
In the case of 50■Hf, the above-mentioned limit p passage is 20~2'5W
11/Shin HP, HRlIJ", it is clear that a membrane material of approximately 0.02 to 0.06 M" is sufficient, and that a very miniaturized artificial kidney is possible.

This artificial kidney (1) is fixed to the torso, arms, legs, etc. with a band or the like, and blood is supplied to the artificial kidney (1) at a blood flow rate of 50 to 250 d/min, preferably 100 d/min.
~150 d/win, preferably an artery and vein close to the installation position, blood taken out of the body from the artery via the shunt flows into the artificial kidney (1) through the blood inlet side connection tube (2), After the blood is filtered by blood pressure,
The blood passes through the outlet connecting tube (3) and is returned to intravenous pressure via the quinant. On the other hand, the waste TKF fluid generated by blood filtration passes through a discharge tube (4) connected to a filtrate boat (8) and is stored in a filtration bag (5) fixed at an appropriate position on the body with a band or the like. The materials of the blood inlet side connecting tube (2) and the blood outlet side connecting tube are silicone resin, I-refrethane resin, fluororesin, I-resin vinyl chloride resin, etc. However, from the viewpoint of long-term antithrombotic properties, silicone resin is used. Or? Refletane resin is preferred. The discharge tube (4) is made of silicone resin, polyurethane resin, polyvinyl chloride resin, natural rubber, synthetic rubber, or the like. The P-liquid bag (5) may have either a bag-like shape or a bag-like shape, but it may be made of soft vinyl chloride resin or ethylene copolymer for ease of attachment to the body and ease of disposal. A flexible bag-like bag made of resin, polyethylene resin, etc., or a flat &)-shaped bag is preferable, and when the F liquid is full, it is replaced with a new F liquid bag. The character 7' (6) is covered with a dialysate outlet port (7)K used during hemodialysis, which will be described later in FIG.

Next, referring to FIG. 2, a case in which hemodialysis is performed during sleep, such as at night, will be described.

The artificial kidney (1), the blood inlet side connecting tube (2), and the blood outlet side connecting tube (3) are the same as those used in the blood filtration described above. That is, one of the major features of the wearable artificial kidney of the present invention is that it can be easily switched to hemodialysis without changing the flow path system on the blood side. F provided as an outlet for the F solution in the aforementioned blood filtration.
Remove the dialysate inflow tube (9) from the dialysate port (8) and the cap (6) that was placed over the dialysate outlet port (7).
K. Connect one end of the dialysate suction tube (10), and connect the other end to the depressurization pump f (13). A required amount of dialysate is stored in a dialysate tank (11) in advance. Between the dialysate tank (11) and the dialysate inflow tube (9),
A negative pressure valve (12) such as needle pulp is provided. With this circuit configuration on the dialysate side, the dialysate is transferred from the dialysate tank (11) to the positive pressure pulp (12), the dialysate inflow tube (9), and the F liquid boat (
8), it enters the passage of the F fluid during the blood filtration described above in the artificial kidney (1), and adjusts the electrolyte balance and acid-base balance in the blood through the membrane described above, as well as removing waste. While removing substances and water, the dialysate outlet port (7) of the artificial kidney (1) and dialysate suction tube (1) are removed.
0), and is drained to sewage etc. via a pressure relief pump (13). During this operation, it is possible to speed up the removal of water from the blood by restricting the pressure relief valve (12) and applying pressure relief to the dialysate side within the artificial kidney (1).

Although the method of switching from hemofiltration to hemodialysis has been described in FIGS. 1 and 2, it is clear that it is possible to switch from hemodialysis to hemofiltration by following the completely reverse procedure. A major feature of the type artificial kidney is that it purifies blood by repeating this switching nine times as long as its performance is maintained.

Furthermore, the present inventors have discovered a method of administering heparin as described above, that is, absorption into the mast cells of the lungs, and sustained release of heparin into the blood, thereby achieving anti-heparin therapy without using a heparin infusion pump. Since we succeeded in sustaining blood coagulation, we were able to improve the clinical and social advantages of the wearable artificial kidney according to the present invention.

As described above in detail, the wearable artificial kidney according to the present invention is an extremely useful invention that greatly contributes to the rehabilitation of patients with renal diseases such as chronic renal failure into society, which is the long-awaited goal of patients with renal diseases such as chronic renal failure.

[Brief explanation of the drawing]

The drawings show one embodiment of the present invention; Fig. 1 is a schematic diagram when the artificial kidney of the present invention is installed and blood filtration is performed, and Fig. 2 is a schematic diagram when the artificial kidney of the present invention is installed and hemodialysis is performed. FIG. Patent applicant Sumitomo Bakelite Co., Ltd.: 1

Claims (1)

[Claims] By absorbing heparin into the mast cells of the lungs and gradually releasing it under blood pressure, an artificial membrane composed of a membrane that has both blood flow and hemodialysis functions under blood conditions that can maintain anticoagulant properties. During hemofiltration, a filtrate bag for storing filtrate is connected to the kidney, and during hemodialysis, the liquid bag connected to the artificial kidney is removed and the r-fluid passage in the artificial kidney is connected. A wearable artificial kidney characterized by having a structure through which dialysate can flow.