JPS6036060A - dialysis machine - 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 dialysis device that prevents deterioration of the pi-carbo dialysate, has a simple configuration, can perform dialysis without reducing dialysis efficiency, and is easily moved.

As is well known, dialysis treatment is widely used to prolong the life of patients with renal failure or uremia, and there are dedicated dialysis centers equipped with dialysis equipment for these patients, who receive treatment two to three times a week. Receiving regular dialysis treatment. In dialysis treatment,
It is well known in the art that it is desirable to include bicarbonate ions [I G O,i in the dialysate.

Bicarbonate ion HCo; is an important ion that exists in blood and controls acid-base balance, but this hydrogen carbonate ion HCO3 tends to cause carbonate precipitation in the dialysate.

In addition, picarbonate dialysate is made by diluting and mixing picarbonate stock solution, dialysate stock solution, and dilution water at a fixed ratio, but picarbonate dialysate is unstable and its pH increases over time. Carbonate precipitation tends to occur. When carbonate precipitation occurs, Ca”, M in the dialysate
F: This causes loss of rt, which adversely affects patients due to Ca't+ and Mgt+ deficiencies, and causes scaling in dialysis machines. For these reasons, in conventional dialysis, those containing acetate ion CH3COO have been used.

This acetate ion CH3COO is metabolized in the body and becomes bicarbonate ion HCo3. However, acetate ion C
If more H3C00- enters the body than necessary, it causes an imbalance syndrome, so recently bicarbonate ions HCo3
So-called picarbonate dialysis, which supplies acetate, has been reconceived as an alternative to conventional acetate dialysis, and various devices have been announced that can operate picarbonate dialysis without trouble. It is known that an increase in pH occurs when bicarbonate ions HCO3 in the picarbonate dialysate gradually become carbon dioxide and are released, and there are methods to prevent this.

(1) Seal the picarbonate dialysate circuit (2)
Measures such as filling the picarbonate dialysate circuit with carbon dioxide gas CO2 (3) blowing carbon dioxide gas CO2 into the picarbonate dialysate fluid, and (4) storing it at low temperatures have been considered. All of these methods are complicated in practical use, so by diluting and mixing the picarbonate stock solution, dialysate stock solution, and dilution water at a certain ratio and using it as quickly as possible, it is possible to solve problems such as the increase in pT( Most conventional picarbonate dialysis machines use a method of continuously diluting and mixing picarbonate stock solution, dialysate stock solution, and dilution water, or using dilution and mixing intermittently. This method has been used to solve problems with the equipment and has been put into practical use.

The dilution water used for the picarbonate dialysate should be soft water, pure water, or pure water that does not contain calcium ions (Ca), magnesium ions (Mgf+), etc., in order to prevent carbonate scaling and reduce the total amount of hydrogen carbonate ions (14C06).
The use of O water is well known.

Therefore, in order to perform picarbonate dialysis treatment using a conventional picarbonate dialysis device that continuously uses picarbonate stock solution, dialysate stock solution, and dilution water by mixing them, dilution water (soft water, pure water, RO Water) supply equipment, drainage equipment, or wastewater treatment equipment was required. =
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Directions, I, C, U, (Intensive Care
In some cases, it is necessary to urgently perform dialysis treatment on drug addicted patients or patients with acute renal failure.

Because dialysis treatment is infrequent, it is uneconomical to install special dilution water supply and drainage equipment, and most places do not have such equipment. For this reason, there was a problem in that picarbonate dialysis treatment could not be performed using conventional picarbonate dialysis equipment that uses a mixture of picarbonate stock solution, dialysate stock solution, and dilution water continuously or intermittently. . In this case, a dialysate storage tank in which a dialysate stock solution containing acetate ion CH3C○0 and dilution water are mixed and stored in advance is used, and ace7--1-dialysis treatment is performed while the dialysate is recirculated. Ta.

This method is widely used because the amount of ultrafiltration can be determined by measuring the amount of overflow from the dialysate storage tank.

However, when dialysis treatment is performed on picarbonate-1 using this method, the storage time of the picarbonate dialysate is approximately 5 hours, which corresponds to the time of one dialysis, which is a long time, and the pH decreases due to the release of carbon dioxide gas CO1. There was a problem that carbonate was likely to precipitate due to an increase in carbonate. In order to prevent this, the above (1) (2) (3) (4)
There are two methods, but they all have the disadvantage that they are complicated in practice and have complicated mechanisms, making them expensive.

Furthermore, because the dialysate is recirculated for use, the used dialysate, in which the concentration of waste products in the dialysate is higher than the waste products removed from the blood, mixes with fresh dialysate in the storage tank. During dialysis treatment, the concentration of waste products in the dialysate increases over time, and as a result, the difference between the concentration of waste products in the dialysate and blood decreases, so dialysis is performed in proportion to the concentration difference. However, there was a drawback that the efficiency decreased over time. Furthermore, components that are removed from the blood into the dialysate adhere to the entire inner surface of the dialysate circuit, often causing clogging or other malfunctions in the dialysate circuit. The drawback was that labor costs for cleaning and disinfecting the circuits were high.

The object of the present invention is to provide a simple structure and a method for carrying out dialysis without deteriorating the dialysate and reducing dialysis efficiency when performing dialysis treatment using a diluted and mixed picarbonate dialysate. The object of the present invention is to provide a picarbonate dialysis device that is easy to use. Another object of the present invention is to provide a picarbonate dialysis device that has a simple configuration that allows picarbonate dialysis treatment even in places without dilution water supply equipment and drainage equipment, and that is economical and less prone to breakdowns.

The present invention provides a dialysis machine having a dialysis chamber separated by a dialysis membrane that enables blood dialysis and ultrafiltration at the same time. using two dialysate containers separated into a dialysate container, a closed dialysate container connected to the inlet of the dialysis chamber, and an open dialysate container connected to the dialysate outlet;
5. Relating to a dialysis apparatus, characterized in that a newly diluted and mixed picarbonate dialysate is introduced into the sealed dialysate container, and a flow of the picarbonate dialysate is generated from the inlet to the outlet of the dialyzer using a transfer pump. In the present invention,
If the flexible septum is disposable, it can also be drained by puncturing or tearing the septum after a dialysis treatment. According to this configuration, the diluted and mixed fresh picarbonate dialysate is sealed from the atmosphere by a flexible partition.
Furthermore, the weight of the used dialysate pressurizes the sealed dialysate container, and the picarbonate dialysate is maintained at a positive pressure, which suppresses the release of carbon dioxide gas CO2 and contains bicarbonate ions HCO,i. Variations in amount and pl-1 can be almost eliminated. In addition, since fresh dialysate and used dialysate are not mixed, there is no decrease in dialysis efficiency due to increase in waste product concentration in dialysate over time during dialysis. Furthermore, it is possible to provide an apparatus that does not have malfunctions such as clogging of the dialysis circuit due to waste products adhering to the entire surface of the dialysis circuit.

By pre-sterilizing the flexible bulkhead and making it a disposable item that can be used only once, the need for disinfecting the bulkhead can be omitted, resulting in labor savings and the need to puncture or tear the bulkhead. This allows for easy drainage. According to the present invention, picarbonate dialysate is prepared in advance at a location with dilution water supply equipment, and 1. C,U.

Picarbonate dialysis treatment can be carried out by moving the device to a place where treatment is urgently needed, such as a doctor, and after the treatment is completed, the device can be moved to a place with drainage equipment to drain the fluid. In this way, it is possible to provide an economical picarbonate dialysis device with a simple configuration and less trouble.

Furthermore, it is of course possible to accurately determine the amount of ultrafiltration by measuring the amount of used dialysate that overflows from an open container as in the conventional method.

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will now be described in detail by way of example with reference to the accompanying drawings.

FIG. 1 is a system diagram of a conventional personal picarbonate dialysis device. It is driven by the water pressure supplied from the water supply pipe 32, and is driven in common by the dilution water pumped by the water pressure driven pump 40, and the water pressure driven pump 40 from the picarbonate dialysate supply pipe 34 and the dialysate supply pipe 36. <Through the ica carbonate stock solution measuring pump 38 and the dialysis stock solution measuring pump 42, the picarbonate stock solution and the dialysate stock solution, each measured by JL, are diluted and mixed stepwise in the mixing tank 44. The dialysate is heated to an appropriate temperature with a heater 24, adjusted to a constant flow rate with a flow control valve 25 and a flowmeter 26, and supplied to the dialyzer via a dialysate supply pipe 18. The used dialysate from the dialyzer enters the pressure pump 28 via the dialysate outlet pipe 20, is set to a pressure control valve 30 so that the amount of water removed becomes a desired value, and is discharged from the drain pipe 16. Drained.

This method requires equipment for supplying dilution water and drainage equipment, and could not be used in locations without these equipment.

Next, an embodiment of a personal picarbonate dialysis apparatus to which the method of the present invention is applied will be described with reference to FIGS. 2 and 3.

FIG. 2 is a system diagram showing a personal positive pressure type picarbonate dialysis device according to the present invention. The dialysate container A is separated by a flexible partition wall B into an open dialysate container 12 and a closed dialysate container 10 which is sealed from the atmosphere. The picarbonate dialysate, which has been diluted and mixed at a fixed ratio of picarbonate stock solution, dialysate stock solution, and dilution water in advance at a place with dilution water supply equipment, is transferred from the container 10 via the transfer pump C to a constant flow rate with the flow rate adjustment valve 25. The dialysate is heated to an appropriate temperature by the heater 24, and then supplied to the dialyzer via the dialysate supply pipe 18. The used dialysate from the dialyzer enters the open dialysate container 12 through the dialysate outlet tube 20. As the dialysis time progresses, the fresh picarbonate dialysate in the container 10 is consumed and becomes spent dialysate in the container 12, but the closed dialysate container 10 and the open dialysate container 12 are flexible. Since they are separated by a certain partition wall B, the displacement of partition iB allows the transfer from fresh dialysate to used dialysate to occur without any problems.

Since the sealed dialysate container 10 is always maintained at a positive pressure by the weight of the used dialysate, the release of carbon dioxide gas CO from the picarbonate dialysate is suppressed, and the bicarbonate ions of the picarbonate dialysate are suppressed. The decrease in HCOi content and the increase in pH can be minimized, thus keeping the problem of carbonate precipitation free.

Since the picarbonate dialysate is separated from the used dialysate by the flexible partition wall B and does not mix, the dialysis efficiency decreases due to the concentration of waste products in the dialysate increasing over time during dialysis.
No deterioration occurs over time. When the dialysis treatment is completed, the dialysis apparatus is moved to a location with drainage equipment, the flexible partition wall B is broken, the drainage valve 14 is opened, and the used dialysate is discharged from the drainage pipe J6.

Next, the present invention will be explained with reference to usage examples.

Picarbonate 1 was diluted and mixed according to the prescribed dilution ratio using Kinderly solution AF-IP as the dialysate stock solution.
15011 into the sealed dialysate container 10 shown in FIG.
I have prepared one. The temperature of the picarbonate dialysate at this time was 23° C. The heater 24 used was of an intermittent type.

The dialysate flow rate was set to 500 mQ/min, the temperature of the dialysate supplied to the dialyzer was set to 37°C, and dialysis was performed for 5 hours. A sample of fresh dialysate is collected from the drain valve 16 every hour, and a sample of pH 1 bicarbonate ion HCO3 (mIiq/L
) and PC:O(mm)Ig) were measured.

The results were very good as shown in FIG. No carbonate precipitation was observed even after dialysis was performed five times. Regarding dialysis efficiency, results comparable to those obtained with the personal picarbonate dialysis device shown in FIG. 1 were obtained.

[Brief explanation of drawings]

Fig. 1 is a system diagram of a conventional personal picarbonate dialysis machine, Fig. 2 is a personal positive pressure picarbonate dialysis machine using the method according to the present invention, and Fig. 3 is a system diagram of a personal picarbonate dialysis machine using the method according to the present invention. FIG. 1 is a system diagram of a personal positive pressure type picarbonate dialysis device. FIG. 4 shows changes in the characteristics of fresh picarbonate dialysate in a closed container of a personal pressure-reducing type carbonate dialysis machine, which is not shown in FIG. 10 Closed dialysate container 12 Open dialysate container 14 Drain valve 16 Drain pipe 22 Blood line 24 Heater 25 Flow rate adjustment valve 26 Flow meter 28 Depressurization pump 30 Pressure adjustment valve 32 Water supply pipe 34 Picarbonate stock solution supply pipe 36 Dialysate Stock solution supply pipe 38 Bicarbonate stock solution metering pump 40 Water pressure driven pump 42 Dialysate stock solution metering pump 44 4 tank A Dialysate container B Flexible partition C Transfer pump D Dialyzer patent applicant Nikkiso Co., Ltd. Representative Patent attorney Front 1) Atsushi-FIG, 1 FIG, 2 FIG, 3

Claims (2)

[Claims] (1) In a dialysis machine that has a dialysis chamber separated by a dialysis membrane that enables blood dialysis and ultrafiltration at the same time, the dialysate container is sealed from the atmosphere by a flexible partition, and the atmosphere is On the other hand, using two dialysate containers separated into an open dialysate container, connecting the entrance of the dialysis chamber to the closed dialysate container, and connecting the outlet of the dialysis chamber to the open dialysate container, A dialysis apparatus characterized in that fresh picarbonate dialysate diluted and mixed from the sealed dialysate container is distributed from the inlet to the outlet of the dialyzer by a transfer pump. (2) Claim (1) characterized in that the flexible partition wall is disposable, and the liquid is drained by punching or tearing the partition wall. The dialysis machine described.