Therapy prediction and optimization for renal failure blood therapy, especially home hemodialysis
View Patent ↗A method of predicting serum phosphorus concentrations in a patient during hemodialysis includes measuring serum phosphorus concentrations of the patient over a hemodialysis treatment session time and an ultrafiltration rate calculated by a difference between pre- and post-dialytic body weight of the patient during an initial hemodialysis treatment session divided by a total treatment time of the treatment session and estimating a phosphorous mobilization clearance and a pre-dialysis distribution volume of phosphorus for the patient. Serum phosphorus concentrations of the patient can then be predicted at any time during any hemodialysis treatment session with the estimated phosphorous mobilization clearance and pre-dialysis distribution volume of phosphorus of the patient.
1. A renal failure blood therapy system comprising:
a renal failure blood therapy machine;
a therapy prescription for a patient treated by the renal failure blood therapy machine to remove a solute from the patient's blood;
a test including multiple blood samples taken at multiple times during a test therapy to determine concentration levels of the solute at each of the multiple times;
a non-transitory computer readable medium including a pseudo one-compartment kinetic model in which a compartment of the model has a volume that is ignored and a constant solute concentration equal to a pre-dialytic concentration for the solute; and
a device programmed to use the kinetic model for the solute (i) in a first instance with at least one of the concentration levels of the solute to estimate at least one estimated patient parameter and (ii) in a second instance with the at least one estimated patient parameter and a desired therapy result for the solute to determine at least one of a therapy duration, a therapy frequency, a dialysate flowrate or a blood flowrate for the therapy prescription.
2. The renal failure blood therapy system of claim 1 , wherein the therapy prescription is stored in a memory of the renal failure blood therapy machine.
3. The renal failure blood therapy system of claim 1 , wherein at least one of (i) the renal failure blood therapy machine is a home hemodialysis machine, (ii) the device includes a doctor computer, or (iii) the home hemodialysis machine is in data-networked communication with the doctor computer.
4. The renal failure blood therapy system of claim 1 , wherein the device in the first instance is programmed to use each of the concentration levels of the solute to estimate the at least one estimated patient parameter.
5. The renal failure blood therapy system of claim 1 , wherein the device in the first instance is programmed to use a combination of the concentration levels of the solute to estimate the at least one estimated patient parameter.
6. The renal failure blood therapy system of claim 1 , wherein the device in the first instance is programmed to use the at least one of the concentration levels of the solute to estimate a plurality of different estimated patient parameters.
7. The renal failure blood therapy system of claim 1 , wherein the device in the first instance is programmed to use the at least one estimated patient parameter and the desired therapy result for the solute to determine a plurality of therapy duration and therapy frequency combinations that satisfy the desired therapy result.
8. The renal failure blood therapy system of claim 7 , wherein at least one of the satisfactory therapy duration and therapy frequency combinations is selected for use with the renal failure blood therapy machine.
9. The renal failure blood therapy system of claim 1 , wherein the at least one estimated patient parameter is selected from the group consisting of: generation rate (G), mobilization clearance (K M ) and pre-dialysis distribution volume (V PRE ).
10. The renal failure blood therapy system of claim 1 , wherein the device is additionally programmed to use at least one inputted machine operating parameter in performing at least one of (i) or (ii).
11. The renal failure blood therapy system of claim 10 , wherein the at least one machine operating parameter is selected from the group consisting of: blood flowrate, dialysate flowrate, dialysate total volume, ultrafiltration flowrate and ultrafiltration volume.
12. The renal failure blood therapy system of claim 1 , the solute a first solute, the kinetic model a first kinetic model, and which includes a plurality of solutes and corresponding kinetic models, the device programmed to use each of the kinetic models (i) in the first instance with at least one of the concentration levels of the corresponding solute to estimate at least one estimated patient parameter and (ii) in the second instance with the at least one estimated patient parameter and the desired therapy result for the corresponding solute to determine at least one of the therapy duration or the therapy frequency for the therapy prescription.
13. The renal failure blood therapy system of claim 12 , wherein the device is further programmed to allow an operator to select which of the solutes, corresponding kinetic models and desired therapy results to include in (ii), namely, in the second instance with the at least one estimated patient parameter and the desired therapy result for the corresponding solute to determine at least one of the therapy duration or the therapy frequency for the therapy prescription.
14. The renal failure blood therapy system of claim 12 , wherein one of the solutes is phosphate, its corresponding kinetic model assuming mobilization of phosphate to be proportional to a difference between an instantaneous phosphate concentration in the patient's blood and a pre-therapy phosphate concentration in the patient's blood.
15. A renal failure blood therapy system comprising:
a renal failure blood therapy machine;
a therapy prescription for a patient treated by the renal failure blood therapy machine to remove a solute from the patient's blood;
a test including multiple blood samples taken at multiple times during a test therapy to determine concentration levels of the solute at each of the multiple times;
a non-transitory computer readable medium including a pseudo one-compartment kinetic model in which a compartment of the model has a volume that is ignored and a constant solute concentration equal to a pre-dialytic concentration for the solute; and
a device programmed to use the kinetic model for the solute (i) in a first instance with at least one of the concentration levels of the solute to estimate at least one estimated patient parameter and (ii) in a second instance with the at least one estimated patient parameter and at least one of a therapy duration or a therapy frequency to predict a therapy result for the parameter.
16. The renal failure blood therapy system of claim 15 , wherein the device is additionally programmed to use at least one inputted machine operating parameter in at least one of (i) or (ii).
17. The renal failure blood therapy system of claim 16 , wherein the at least one machine operating parameter is selected from the group consisting of: blood flowrate, dialysate flowrate, dialysate total volume, ultrafiltration flowrate and ultrafiltration volume.
18. The renal failure blood therapy system of claim 15 , wherein the solute is a first solute, the kinetic model a first kinetic model, and which includes a plurality of solutes and corresponding kinetic models, the device programmed to use each of the kinetic models (i) in the first instance with at least one of the concentration levels of the corresponding solute to estimate at least one estimated patient parameter and (ii) in the second instance with the at least one estimated patient parameter and at least one of the therapy duration or the therapy frequency to predict the therapy result for the parameter.
19. The renal failure blood therapy system of claim 18 , the device further programmed to allow an operator to select which of the solutes and corresponding kinetic model and desired therapy result to include in (ii).
20. A renal failure blood therapy system comprising:
a renal failure blood therapy machine;
a therapy prescription for a patient treated by the renal failure blood therapy machine to remove a solute from the patient's blood;
a test including multiple blood samples taken at multiple times during a test therapy to determine concentration levels of the solute at each of the multiple times;
a non-transitory computer readable medium including a pseudo one-compartment kinetic model in which a compartment of the model has a volume that is ignored and a constant solute concentration equal to a pre-dialytic concentration for the solute; and
a device programmed to use the kinetic model for the solute in a first instance with at least one of the concentration levels of the solute to estimate at least one estimated patient parameter, the device further programmed to enable a user to select between using the kinetic model for the solute (i) in a second instance with the at least one estimated patient parameter and at least one of a therapy duration or a therapy frequency to predict a therapy result for the parameter, or (ii) in a second instance with the at least one estimated patient parameter and a desired therapy result for the solute to determine at least one of a therapy duration, a therapy frequency, a dialysate flowrate or a blood flowrate for the therapy prescription.