Peritoneal dialysis filtrate sampling and adaptive prescription

1. A method for adjusting a peritoneal dialysate prescription, comprising the steps of:

removing fluid from a peritoneal cavity of a patient;

sampling one or more fluid characteristics of the removed fluid; and

adjusting a peritoneal dialysate prescription based on the one or more fluid characteristics of the removed fluid;

wherein the method uses a system having a peritoneal dialysate effluent line; at least one sensor positioned in the peritoneal dialysate effluent line; the at least one sensor configured to measure a concentration of at least one solute in a peritoneal dialysate effluent; at least one concentrate source fluidly connectable to a peritoneal dialysate flow path; and a processor; the processor configured to receive one or more fluid characteristics of a fluid removed from the peritoneal cavity of a patient from the at least one sensor and to adjust the peritoneal dialysate prescription by adjusting one or more of a dwell time, a number of cycles, and/or an osmotic agent concentration based on the concentration of the at least one solute in the peritoneal dialysate effluent.

2. The method of claim 1 , wherein the step of sampling one or more removed fluid characteristics includes determining a concentration of one or more solutes in the removed fluid, determining a given volume of fluid removed from the patient, or combinations thereof.

3. The method of claim 2 , wherein the solute is selected from urea, glucose, potassium, or combinations thereof.

4. The method of claim 2 , further comprising the step of adjusting a number of cycles, a dwell time, an osmotic agent concentration, or combinations thereof, in response to the given volume of fluid removed from the patient.

5. The method of claim 1 , wherein the fluid is from a first peritoneal dialysis cycle.

6. The method of claim 1 , further comprising the step of receiving a prior history of a patient, and wherein the peritoneal dialysate prescription is adjusted based on the prior history of the patient.

7. The method of claim 6 , wherein the prior history of the patient includes an osmotic agent concentration used in a prior session, an amount of fluid removed in a prior session, a dwell time used in the prior session, and a number of cycles for the prior session.

8. The method of claim 7 , further comprising the step of adjusting an osmotic agent concentration, a dwell time, a number of cycles, or combinations thereof, in response to the amount of fluid removed in the prior session.

9. The method of claim 1 , wherein a first amount of fluid is removed from the patient at a first time and a second amount of fluid is removed from the patient at a second time; and wherein the step of adjusting the peritoneal dialysate prescription comprises adjusting the peritoneal dialysate prescription based on a change in the fluid characteristic between the first time and the second time.

10. The method of claim 1 , wherein a first amount of fluid is removed from the patient at a first time and a second amount of fluid is removed from the patient at a second time; and further comprising the step of determining a membrane transfer efficiency based on a change in the fluid characteristic between the first time and the second time.

11. The method of claim 10 , wherein the fluid characteristic further comprises a clarity of the fluid, a color spectrum of the fluid, or combinations thereof.

12. The method of claim 10 , wherein the step of adjusting the peritoneal dialysate prescription comprises adjusting a concentration of an osmotic agent, a number of cycles, a volume of fluid in a cycle, or combinations thereof, based on the membrane transfer efficiency.

13. The method of claim 1 , further comprising the step of determining a net volume of fluid removed from the patient from the given volume of fluid removed from the patient.

14. A system for adjusting a peritoneal dialysate prescription comprising:

a peritoneal dialysate effluent line;

at least one sensor positioned in the peritoneal dialysate effluent line; the at least one sensor configured to measure a concentration of at least one solute in a peritoneal dialysate effluent;

at least one concentrate source fluidly connectable to a peritoneal dialysate generation flow path; and

a processor; the processor configured to receive one or more fluid characteristics of a fluid removed from the peritoneal cavity of a patient from the at least one sensor and to adjust one or more of a dwell time, a number of cycles, and/or an osmotic agent concentration based on the concentration of the at least one solute in the peritoneal dialysate effluent.

15. The system of claim 14 , further comprising at least a second sensor configured to sense a volume of fluid removed from a patient.

16. The system of claim 14 , wherein the at least one sensor is configured to sense a solute concentration of a fluid removed from a patient.

17. The system of claim 14 , the peritoneal dialysate generation flow path having:

i) a water source fluidly connectable to the peritoneal dialysate generation flow path;

ii) one or more water purification modules fluidly connectable to the peritoneal dialysate generation flow path;

iii) a sterilization module fluidly connectable to the peritoneal dialysate generation flow path; and

iv) an integrated cycler fluidly connected to the peritoneal dialysate generation flow path;

the processor configured to control the movement of fluid from the at least one concentrate source to the peritoneal dialysate generation flow path based on an adjusted peritoneal dialysate prescription by controlling one or more pumps and/or valves.

18. The system of claim 17 , wherein the at least one concentrate source comprises at least an osmotic agent source and an ion concentrate source.

19. The system of claim 14 , further comprising:

i) a water source fluidly connectable to a peritoneal dialysate generation flow path;

ii) one or more peritoneal dialysate regeneration modules fluidly connectable to the peritoneal dialysate generation flow path;

iii) a sterilization module fluidly connectable to the peritoneal dialysate generation flow path;

the processor configured to control the movement of fluid from the at least one concentrate source to the peritoneal dialysate generation flow path based on an adjusted peritoneal dialysate prescription by controlling one or more pumps and/or valves.

20. The system of claim 19 , further comprising an integrated cycler; the integrated cycler comprising:

(i) a cycler pump; and

(ii) an infusion line and the peritoneal dialysate effluent line, or a combined infusion and effluent line;

wherein the infusion line or combined infusion and effluent line is fluidly connected to the peritoneal dialysate generation flow path downstream of the sterilization module; and wherein the peritoneal dialysate effluent line is fluidly connected to the peritoneal dialysate generation flow path upstream of the one or more peritoneal dialysate regeneration modules.