Online fluid generating peritoneal dialysis cycler

1. A peritoneal dialysis (“PD”) machine comprising:

a water pump;

a concentrate pump;

a water valve located upstream of the water pump, and an inlet to the water valve positioned to receive purified water;

a concentrate valve located upstream of the concentrate pump, and an inlet to the concentrate valve positioned to receive PD fluid concentrate;

a mixing line located downstream from the water pump and the concentrate pump;

a conductivity sensor positioned to sense a mixture of the purified water and the PD fluid concentrate that at least partially forms fresh PD fluid;

a flexible patient line configured to bring the at least partially formed fresh PD fluid to a patient and remove used PD fluid from the patient; and

a control unit configured to control the water pump, the concentrate pump, the water valve and the concentrate valve, the control unit also configured to receive an output from the conductivity sensor, the control unit further configured to run a disinfection sequence in which an end of the flexible patient line is directly connected to an external container of a disinfectant concentrate to receive disinfectant instead of being connected to the patient.

2. The PD machine of claim 1 , which further includes a used PD fluid line, and wherein the used PD fluid line is placed in fluid communication with a drain container or a house drain.

3. The PD machine of claim 2 , wherein during treatment, the used PD fluid line is placed in fluid communication with the drain container or the house drain.

4. The PD machine of claim 2 , wherein the drain container is a reusable container.

5. The PD machine of claim 2 , which includes a used dialysis fluid pump operable with the used PD fluid line.

6. The PD machine of claim 5 , wherein at least one of the water pump, the concentrate pump, or the used dialysis fluid pump is operated in at least one direction during the disinfection sequence.

7. The PD machine of claim 1 , which includes a final or sterile stage filter positioned and arranged to filter the at least partially formed fresh PD fluid prior to delivery to the patient.

8. The PD machine of claim 7 , wherein the final or sterile stage filter is at least one of a reusable filter or an ultrafilter.

9. The PD machine of claim 1 , which includes a mixer located along the mixing line.

10. The PD machine of claim 1 , which includes a heater, and wherein the control unit is further configured to cause the heater to heat the disinfectant during the disinfection sequence.

11. The PD machine of claim 10 , wherein the heater is an inline heater.

12. The PD machine of claim 1 , which includes an internal patient line positioned to deliver (a) the at least partially formed fresh PD fluid to the flexible patient line, wherein a used dialysis fluid line receives the used PD fluid from the flexible patient line, or (b) the at least partially formed fresh PD fluid to the flexible patient line and receive the used PD fluid from the flexible patient line.

13. The PD machine of claim 12 , wherein in option (a), a fresh PD fluid pressure sensor is operable with the internal patient line and a used PD fluid pressure sensor is operable with the used dialysis fluid line, or in option (b), a fresh and used PD fluid pressure sensor is operable with the internal patient line.

14. The PD machine of claim 12 , wherein in option (a), the conductivity sensor is operable with the mixing line and a second conductivity sensor is operable with the used dialysis fluid line, or in option (b), the conductivity sensor is operable with the mixing line and a second conductivity sensor is operable with the internal patient line.

15. The PD machine of claim 14 , wherein the control unit is configured to:

use the output from the conductivity sensor for feedback in mixing the purified water and the PD fluid concentrate; and

use a second output from the second conductivity sensor for evaluating the used PD fluid removed from the patient.

16. The PD machine of claim 12 , wherein in option (a), a first flow sensor is operable with the mixing line or the internal patient line and a second flow sensor is operable with the used dialysis fluid line, or in option (b), a first flow sensor is operable with the mixing line and a second flow sensor is operable with the used dialysis fluid line, or in option (b), a single flow sensor is operable with the internal patient line.

17. The PD machine of claim 16 , wherein the control unit is configured to use outputs from the first and second flow sensors or the single flow sensor to at least one of (i) control a flowrate of the at least partially formed fresh PD fluid, (ii) control a flowrate of the used PD fluid, (iii) determine an amount of the at least partially formed fresh PD fluid delivered to the patient, (iv) determine an amount of the used PD fluid removed from the patient, or (v) determine an amount of ultrafiltration (“UF”) removed from the patient.

18. The PD machine of claim 1 , wherein the control unit is configured to cause a performance of at least one of (a) a purified water rinse of any remaining amount of the at least partially formed fresh PD fluid and/or the used PD fluid prior to introduction of the disinfectant, (b) a rinse of any remaining amount of the at least partially formed fresh PD fluid and/or the used PD fluid using the disinfectant, (c) a purified water rinse of the disinfectant after the disinfection sequence, or (d) a filtered air purge after the disinfection sequence.

19. The PD machine of claim 1 , wherein the concentrate valve is a first concentrate valve and the PD fluid concentrate is a first PD fluid concentrate, and which includes a second concentrate valve under control of the control unit, the second concentrate valve located upstream of the concentrate pump, and an inlet to the second concentrate valve positioned to receive a second PD fluid concentrate, and wherein the control unit is further configured to manipulate the first and second concentrate valves and control the concentrate pump so as to (i) mix the first PD fluid concentrate or the second PD fluid concentrate with the purified water or (ii) mix the first PD fluid concentrate and the second PD fluid concentrate with the purified water.

20. The PD machine of claim 19 , wherein in option (ii), the mixture of the first PD fluid concentrate, the second PD fluid concentrate, and the purified water forms a final fresh PD fluid that is mixed in the mixing line or in the patient.