Customized dialysate solution using spikes

1. A method, comprising the steps of:

adding a base concentrate to a concentrate reservoir of a dialysate system wherein the base concentrate contains one or more of potassium, magnesium, calcium, and glucose:

customizing a dialysate by adding one or more spikes to the concentrate reservoir containing the base concentrate wherein the spikes are selected from the group of potassium, magnesium, calcium, glucose, and combinations thereof;

conveying fluid from the concentrate reservoir to a dialysate flow path at a set ratio to obtain a dialysate with a predetermined solute concentration based on a dialysate prescription;

wherein the set ratio is a ratio of a dialysate flow rate to a concentrate flow rate;

sensing a conductivity of dialysate in the dialysate flow path downstream of the concentrate line using a sensor;

determining an actual conductivity of the dialysate;

comparing the actual conductivity of the dialysate to the dialysate prescription; and

if the actual conductivity of the dialysate is lower than the dialysate prescription, adding one or more spikes to the concentrate reservoir.

2. The method of claim 1 , wherein the dialysate prescription is determined, at least in part, on a concentration of one or more solutes in a patient's blood.

3. The method of claim 1 , wherein the dialysate prescription is determined, at least in part, on a outcome of a patient in one or more previous dialysis sessions.

4. The method of claim 1 , wherein the set ratio of the dialysate flow rate to the concentrate flow rate is between any of 100:1 and 300:1, 100:1 and 250:1, 200:1 and 300:1, or 225:1 and 275:1.

5. The method of claim 1 , wherein the base concentrate comprises potassium in a concentration of between 0 and 600 mmol/L, calcium in a concentration of between 0 and 900 mmol/L, magnesium in a concentration of between 37 and 115 mmol/L, and glucose in a concentration of between 0 and 600 mmol/L.

6. The method of claim 1 , wherein the step of adding one or more spikes to the concentrate reservoir results in any one of:

a) an increase in dialysate potassium concentration of between 0.5 and 2 mmol/L;

b) an increase in dialysate calcium concentration of between 0.2 and 1 mmol/L;

c) an increase in dialysate magnesium concentration of between 0.1 and 0.3 mmol/L; or

d) an increase in dialysate glucose concentration of between 0.5 and 2 mmol/L.

7. The method of claim 1 , wherein the step of adding one or more spikes to the concentrate reservoir comprises adding one or more powders to the concentrate reservoir.

8. The method of claim 1 , wherein the step of adding one or more spikes to the concentrate reservoir comprises adding one or more spike solutions to the concentrate reservoir.

9. The method of claim 1 , wherein the step of adding a base concentrate to the concentrate reservoir comprises adding a base solution to the concentrate reservoir.

10. The method of claim 1 , wherein the step of adding a base concentrate to the concentrate reservoir comprises dissolving a base powder in water.

11. A dialysis system, comprising:

a concentrate reservoir configured to contain a base concentrate solution wherein the concentrate reservoir is configured to receive one or more spikes and is fluidly connected to a dialysate flow path via a concentrate line, wherein the base concentrate contains one or more of potassium, magnesium, calcium, and glucose and wherein the spikes are selected from the group of potassium, magnesium, calcium, glucose, and combinations thereof;

a concentrate pump for conveying fluid from the concentrate reservoir to the dialysate flow path; and

a conductivity sensor in the dialysate flow path downstream of the concentrate line wherein the conductivity sensor determines a conductivity of dialysate in the dialysate flow path;

wherein the system provides instructions to add one or more spikes to the concentrate reservoir if the concentration of any one or more of magnesium, calcium, potassium, or glucose in the dialysate flow path is less than dialysate prescription.

12. The dialysis system of claim 11 , further comprising a processor for performing the method of claim 1 .

13. The dialysis system of claim 11 , wherein the dialysate flow path comprises a dialysate pump; and wherein a ratio of flow rates of the dialysate pump and concentrate pump is a set ratio.

14. The dialysis system of claim 13 , wherein the ratio of flow rates of the dialysate pump and concentrate pump is between any of 100:1 and 300:1, 100:1 and 250:1, 200:1 and 300:1, or 225:1 and 275:1.

15. The dialysis system of claim 11 , wherein the system provides an alert if the conductivity of the dialysate in the dialysate flow path differs from a dialysate prescription.