Sodium and bicarbonate control
The disclosure relates to systems and methods for controlling the sodium and bicarbonate concentrations in a dialysate. The systems and methods can use conductivity sensors to control the addition of water and bicarbonate to accurately control the final concentrations of both sodium and bicarbonate.
1. A system, comprising:
a dialysate flow path; the dialysate flow path fluidly connectable to a dialysate inlet of a dialyzer and a dialysate outlet of the dialyzer;
a sorbent cartridge in the dialysate flow path;
a degasser in the dialysate flow path downstream of the sorbent cartridge;
a bicarbonate source fluidly connected to the dialysate flow path;
a water source fluidly connected to the dialysate flow path;
a first conductivity sensor downstream of the sorbent cartridge; and
a control system; the control system programmed to determine a pH of a fluid exiting the sorbent cartridge; wherein:
while pH of the fluid exiting the sorbent cartridge is below a preset pH, the control system is programmed to control a sodium concentration in the fluid based on a sodium prescription and a conductivity measured by the first conductivity sensor; and to control a bicarbonate concentration in the fluid based on a bicarbonate prescription; and
while pH of the fluid exiting the sorbent cartridge is above a preset pH, the control system controls a sodium concentration in the fluid based on a sodium prescription and a conductivity measured by a second conductivity sensor upstream of the sorbent cartridge.
2. The system of claim 1 , wherein the preset pH is about 4.8.
3. The system of claim 1 , wherein the sorbent cartridge includes zirconium phosphate at a low pH.
4. The system of claim 1 , wherein while the pH of the fluid exiting the sorbent cartridge is below the preset pH, the control system is programmed to control the sodium concentration in the fluid by adding water from a water source upstream of the sorbent cartridge to a target post-sorbent conductivity setpoint.
5. The system of claim 1 , wherein while the pH of the fluid exiting the sorbent cartridge is below the preset pH, the control system is programmed to control the bicarbonate concentration in the fluid by adding bicarbonate from a bicarbonate source upstream of the sorbent cartridge to a target post-bicarbonate conductivity setpoint.
6. The system of claim 1 , further comprising a hydrochloric acid source fluidly connected to the dialysate flow path upstream of the sorbent cartridge.
7. The system of claim 1 , further comprising at least one infusate source downstream of the sorbent cartridge.
8. The system of claim 1 , wherein the control system is programmed to detect release of sulfate ions from the sorbent cartridge.
9. The system of claim 8 , wherein the control system is programmed to dilute the fluid during the release of sulfate ions.
10. The system of claim 1 , wherein while the pH of the fluid exiting the sorbent cartridge is above the preset pH, the control system is programmed to control the sodium concentration in the fluid by adding water from a water source upstream of the sorbent cartridge to a target pre-sorbent conductivity setpoint.
11. The system of claim 10 , wherein the target pre-sorbent conductivity setpoint is a conductivity measured upstream of the sorbent cartridge while the pH is below the preset pH.
12. The system of claim 10 , wherein while the pH of the fluid exiting the sorbent cartridge is above the preset pH, the control system is programmed to control the bicarbonate concentration in the fluid by adding bicarbonate to reach a target post-bicarbonate conductivity setpoint.
13. The system of claim 12 , wherein the target post-bicarbonate conductivity setpoint is based on the sodium and a bicarbonate prescription.
14. The system of claim 1 , wherein the pH of the fluid exiting the sorbent cartridge is measured with a pH sensor downstream of the sorbent cartridge.
15. The system of claim 1 , wherein the pH of the fluid exiting the sorbent cartridge is measured based on changes to a degasser output.
16. The system of claim 1 , wherein the pH of the fluid exiting the sorbent cartridge is measured based on a conductivity change across the sorbent cartridge measured by the first conductivity sensor and a second conductivity sensor upstream of the sorbent cartridge.
17. The system of claim 4 , wherein the pH of the fluid exiting the sorbent cartridge is measured based on a volume of the water added from the water source.
18. The system of claim 1 , the control system programmed to isolate the sorbent cartridge prior to determining the pH of the fluid exiting the sorbent cartridge.