Therapy prediction and optimization for renal failure blood therapy, especially home hemodialysis
A renal failure blood therapy system includes a renal failure blood therapy machine, a test including multiple blood samples taken at multiple times during a test therapy to determine concentration levels for each of a first solute and a second solute at each of the multiple times, and a device programmed to (i) estimate at least one first patient parameter using the determined concentration levels for the first solute, (ii) estimate at least one second patient parameter using the determined concentration levels for the second solute, (iii) determine a first plurality of acceptable treatments using the at least one first patient parameter, (iv) determine a second plurality of acceptable treatments using the at least one second patient parameter, and (v) merge the first plurality of acceptable treatments with the second plurality of acceptable treatments to determine a plurality of clinically acceptable treatments for both the first solute and the second solute.
1. A renal failure blood therapy system comprising:
a renal failure blood therapy machine;
results from a test including multiple blood samples taken at multiple times during a test therapy, the results including concentration levels for each of a first solute and a second solute at each of the multiple times; and
a device programmed to (i) estimate at least one first patient parameter using the determined concentration levels for the first solute, (ii) estimate at least one second patient parameter using the determined concentration levels for the second solute, (iii) determine a first plurality of acceptable treatments that meet a first predetermined solute clearance for the first solute using the at least one first patient parameter, (iv) determine a second plurality of acceptable treatments that meet a second predetermined solute clearance for the second solute using the at least one second patient parameter, and (v) merge the first plurality of acceptable treatments with the second plurality of acceptable treatments to determine a plurality of clinically acceptable treatments that meet the first and second predetermined solute clearances for both the first solute and the second solute.
2. The renal failure blood therapy system of claim 1 , further including a display device configured to display the plurality of clinically acceptable treatments for selection by a patient or clinician for use with the renal failure blood therapy machine.
3. The renal failure blood therapy system of claim 2 , wherein the display device is configured to display a duration, a frequency, a blood flowrate and a dialysate flowrate for each of the clinically acceptable treatments.
4. The renal failure blood therapy system of claim 1 , wherein the at least one first patient parameter is the same as the at least one second patient parameter.
5. The renal failure blood therapy system of claim 1 , wherein the at least one first patient parameter and the at least one second patient parameter are each at least one of: (i) an inter-compartmental diffusion coefficient; (ii) a mobilization clearance; (iii) a distribution volume; (iv) a generation rate; (v) a perfused or extracellular volume; and (vi) a non-perfused or intracellular volume.
6. The renal failure blood therapy system of claim 1 , wherein the device is further programmed to (a) determine at least one of a therapy duration, a therapy frequency, a dialysate flowrate, or a blood flowrate based on the at least one first patient parameter and a desired therapy result for the first solute, and/or (b) determine at least one of a therapy duration, a therapy frequency, a dialysate flowrate, or a blood flowrate based on the at least one second patient parameter and a desired therapy result for the second solute.
7. 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 renal failure blood therapy machine is in data-networked communication with the doctor computer.
8. The renal failure blood therapy system of claim 1 , wherein the device is further programmed to use at least one inputted machine operating parameter in performing (i), (ii), (iii) or (iv), the at least one inputted machine operating parameter selected from the group consisting of: (a) a blood flowrate; (b) a dialysate flowrate; (c) an ultrafiltration flowrate; and (d) an ultrafiltration volume.
9. The renal failure blood therapy system of claim 1 , wherein the at least one first solute and the at least one second solute are each at least one of: (i) urea; (ii) beta 2-microglobulin; and (iii) phosphorus.
10. The renal failure blood therapy system of claim 1 , wherein the device is further programmed to (a) determine a first clearance value for the first solute based on the at least one first patient parameter, and/or (b) determine a second clearance value for the second solute based on the at least one second patient parameter.
11. The renal failure blood therapy system of claim 10 , wherein the device is further programmed to (a) determined whether the first clearance value meets the first predetermined solute clearance to determine the first plurality of acceptable treatments, and/or (b) determine whether the second clearance value meets the second predetermined solute clearance to determine the second plurality of acceptable treatments.
12. The renal failure blood therapy system of claim 10 , wherein the device is further programmed to (a) determine the first plurality of acceptable treatments based on the first clearance value and the at least one first patient parameter, and/or (b) determine the second plurality of acceptable treatments based on the second clearance value and the at least one second patient parameter.
13. A renal failure blood therapy system comprising:
a renal failure blood therapy machine;
results from a test including multiple blood samples taken at multiple times during a test therapy, the results including concentration levels for each of a first solute and a second solute at each of the multiple times; and
a device programmed to (i) estimate at least one first patient parameter using the determined concentration levels for the first solute, (ii) estimate at least one second patient parameter using the determined concentration levels for the second solute, (iii) determine acceptable therapy duration/frequency combinations that meet a first predetermined solute clearance for the first solute using the at least one first patient parameter and a first target parameter, and (iv) determine acceptable therapy duration/frequency combinations that meet a second predetermined solute clearance for the second solute using the at least one second patient parameter and a second target parameter; and
a display device configured to display acceptable therapy duration/frequency combinations for the first solute that overlap with acceptable therapy duration/frequency combinations for the second solute.
14. The renal failure blood therapy system of claim 13 , wherein the first target parameter is a target removal of the first solute during a therapy, and/or the second target parameter is a target removal of the second solute during the therapy.
15. The renal failure blood therapy system of claim 13 , wherein the display device is further configured to display acceptable therapy duration/frequency combinations for at least one of the first and second solutes that do not overlap with the acceptable duration/frequency combinations for the other of the first and second solutes.
16. A renal failure blood therapy method comprising:
determining a patient's concentration level of a first solute at multiple times during a therapy;
determining the patient's concentration level of a second solute at multiple times during the therapy;
estimating, via a computer, at least one first patient parameter using the determined concentration levels for the first solute;
estimating, via the computer, at least one second patient parameter using the determined concentration levels for the second solute;
determining, via the computer, a first plurality of acceptable treatments that meet a first predetermined solute clearance for the first solute using the at least one first patient parameter;
determining, via the computer, a second plurality of acceptable treatments that meet a second predetermined solute clearance for the second solute using the at least one second patient parameter; and
merging, via the computer, the first plurality of acceptable treatments with the second plurality of acceptable treatments to determine a plurality of clinically acceptable treatments that meet the first and second predetermined solute clearances for both the first solute and the second solute.
17. The method of claim 16 , further including testing the patient to determine the concentration levels of the first solute and the second solute at the multiple times.
18. The method of claim 16 , further including (a) determining, via the computer, a first clearance value for the first solute based on the at least one first patient parameter, and/or (b) determining, via the computer, a second clearance value for the second solute based on the at least one second patient parameter.
19. The method of claim 18 , further including (a) determining, via the computer, the first plurality of acceptable treatments based on the first clearance value and the at least one first patient parameter, and/or (b) determining, via the computer, the second plurality of acceptable treatments based on the second clearance value and the at least one second patient parameter.
20. The method of claim 16 , wherein determining the first and second plurality of acceptable treatments includes determining acceptable duration/frequency combinations for the first and second solutes, respectively.
21. The method of claim 16 , further including determining, via the computer, the first and second plurality of acceptable treatments based on a target removal of the first and second solutes, respectively.