US3825493A - Peritoneal artificial kidney - Google Patents

Peritoneal artificial kidney Download PDF

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US3825493A
US3825493A US00293474A US29347472A US3825493A US 3825493 A US3825493 A US 3825493A US 00293474 A US00293474 A US 00293474A US 29347472 A US29347472 A US 29347472A US 3825493 A US3825493 A US 3825493A
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peritoneal
fluid
cavity
blood
solution
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C Brown
M Frommer
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T-HYDRONAUTICS Inc A CORP OF TX
Tracor Hydronautics Inc
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Priority to DE2321188A priority patent/DE2321188A1/en
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Priority to FR7401730A priority patent/FR2258189B1/fr
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1694Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
    • A61M1/1696Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid with dialysate regeneration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/281Instillation other than by gravity
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/282Operational modes
    • A61M1/284Continuous flow peritoneal dialysis [CFPD]
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B01PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
    • B01DSEPARATION
    • B01D61/00Processes of separation using semi-permeable membranes, e.g. dialysis, osmosis or ultrafiltration; Apparatus, accessories or auxiliary operations specially adapted therefor
    • B01D61/24Dialysis ; Membrane extraction
    • B01D61/243Dialysis
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B01PHYSICAL OR CHEMICAL PROCESSES OR APPARATUS IN GENERAL
    • B01DSEPARATION
    • B01D61/00Processes of separation using semi-permeable membranes, e.g. dialysis, osmosis or ultrafiltration; Apparatus, accessories or auxiliary operations specially adapted therefor
    • B01D61/24Dialysis ; Membrane extraction
    • B01D61/28Apparatus therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2209/00Ancillary equipment
    • A61M2209/08Supports for equipment
    • A61M2209/088Supports for equipment on the body

Definitions

  • This invention relates to artificial kidneys for removing toxic substances in the blood normally excreted through the human kidney, and more particularly, to a compact, wearable artificial kidney for removing the toxic substances by peritoneal dialysis.
  • kidneys have prolonged the lives of human beings with damaged or inoperative kidneys.
  • the physiology of the human kidney is fairly well understood and involves the removal of nonvolatile wastes from the blood stream and the continuous regulation of the blood composition such that the conditions in body tissues necessary for the life of cells are maintained. Accordingly, when the kidneys are not operating properly, these functions must be performed by artificial means to prevent any imbalance from developing and the build-up of toxic conditions in the blood.
  • a variety of artificial devices has been developed for assuming the function of a human kidney. Most commonly, these devices withdraw blood from the body and pass the blood through an external dialyzer to draw out or remove the undesired toxic substances from the blood and then the blood is returned to the body. When these devices are used for several hours, several times per week, they are capable of reducing the level of concentration of toxic substances in the blood to a safe level.
  • dialysate or wash solution must be carefully formulated so as to be isotonic to the blood and so that certain desirable constituents of the blood, such as electrolytes, are not lost in the dialysis procedure.
  • the devices all commonly operate on an intermittent basis, requiring a high volume of dialysate and in turn necessitating a bulky and immobile reservoir for the solution. Further, the intermittent use of such devices causes the concentrations of toxic substances in the patients blood stream to oscillate from an abnormally high position just prior to treatment to a low point immediately following treatment. This creates undesirable side effects in the patients general condition. Finally, the fact that the blood is being used for the treatment involves the risk of clotting and anticoagulants must be utilized in the treatment.
  • a completely recirculating artificial kidney suitable for use in removing toxic substances from the blood by peritoneal dialysis.
  • the device operates on the well known technique of peritoneal dialysis, in which a prepared solution is circulated through the peritoneal cavity and the unwanted metabolites, such as urea, creatinine, uric acid, etc. are drawn into the solution by natural diffusion from the blood stream across the peritoneal membranes, resulting in what is commonly referred to as peritoneal fluid.
  • This fluid now containing the unwanted toxic substances is removed from the body, and passed through an external dialyzer to remove the toxic substances from the peritoneal fluid, and the purified fluid is then returned to the peritoneal cavity.
  • an external dialyzer to remove the toxic substances from the peritoneal fluid
  • the purified fluid is then returned to the peritoneal cavity.
  • means are also provided for purifying, reconstituting, and re cycling the dialysate for the external dialyzer.
  • the device comprises two recirculating loops; one for the body fluid and one for the dialysate.
  • this invention comprises circulating a prepared solution through the peritoneal cavity to withdraw toxic metabolites from the blood across the peritoneal membranes and into the solution forming peritoneal fluid; removing the peritoneal fluid from the peritoneal cavity; filtering the fluid to remove toxic substances from the peritoneal fluid; reconstituting and recycling the filtered fluid back to the peritoneal cavity; and discarding the rejected wastes.
  • FIG. 1 illustrates a schematic representation of the peritoneal artificial kidney of this invention
  • FIG. 2 is a suitable filter cell employing reverse osmosis membranes.
  • the artificial kidney of this invention is particularly adapted for use with peritoneal fluid.
  • peritoneal fluid is meant not only that fluid naturally existing in the peritoneal cavity, but the prepared conventional peritoneal dialysis solutions added to the cavity to supplement its volume.
  • peritoneal dialysis for performing the function of a natural kidney and other examples of previous methods for performing recirculation peritoneal dialysis, reference is made to an article by J. H. Shinaberger, L. Shear and K. G. Barry, entitled Increasing Efiiciency of Peritoneal Dialysis," Transactions of American Society of Artificial Internal Organs, Vol. II, pages 76-82, 1965.
  • peritoneal fluid 2 is withdrawn from conventional catheters 4, preferably of silicone rubber, implanted surgically in the peritoneum or peritoneal cavity and forced by the pumping action of a high-pressure pump 6 to the intake side 8 of a filtration means 10.
  • filtration means or filter cell 10 in cludes as the filter element 12 a membrane with hyperfiltration characteristics, such as reverse osmosis membranes, mounted within a suitable housing and having inlet means 14 for the peritoneal fluid, toxic metabolite eflluent means 16, both on the same side 8 of the filtration element 12, and a purified filtrate outlet means 18.
  • Cell ber of alternative devices having hyperfilter characteristics that were used to cleanse the dialysate for the external dialyzer.
  • Peritoneal fluid is fed to filter cell 10 under pressure and at a rate of from to 50 ml./min., where it travels through the cell with a motion parallel to the filtering element 12, emerging as a concentrated solution of low molecular weight solutes or metabolites, such as urea, creatinine, uric acid, and electrolytes from outlet 16.
  • Pressure is maintained on the order of 400 to 600 p.s.i. to pro vide a pressure differential across membrane 12 in filter cell by pump 6, and pressure regulating valve 20 in the waste rejection line 22.
  • Relief or regulating valve 20 is designed to permit a continuous flow of peritoneal fluid through filter cell 10 and a continuous flow of wastes 22 to a urinal 24.
  • peritoneal dialysis treatment Water is also removed in the peritoneal fluid. This is accomplished by providing the solution fed to the peritoneal cavity with sorbitol or a sugar, such as dextrose, to produce an osmotic pressure difference between the body and the solution, causing a flow of water across the peritoneal membranes 1 and into the solution forming peritoneal fluid.
  • sorbitol or a sugar such as dextrose
  • the metabolites and electrolytes do not pass through membrane 12, but are rejected, and essentially only pure water tion may be added to the filtrate after it leaves filter cell 10 or, preferably, and as schematically shown in FIG. 1, is added at 19 to the low pressure side 26 of cell 10 and at the opposite end of the cell from peritoneal fluid inlet 14 so that its flow is countercurrent to the flow of peritoneal fluid.
  • the osmotic pressure of the solution can be used to also assist in the flow of water through membrane 12 of the filter cell.
  • the reconstituted water 28 is recycled back to the peritoneum through suitable catheters for further removal of toxic substances by peritoneal dialysis.
  • High pressure pump 6 and metering pump 32 are preferably cam driven by a suitable electric motor which is in turn powered by a portable, re-chargeable battery to pro- 1' vide a convenient wearable system.
  • the pump and metering system are conventional and are more fully described in the above-mentioned patent.
  • the present invention provides a wearable, yet compact, artificial kidney Aminum Previous for use with peritoneal dialysis that recovers, filters, and reconstitutes peritoneal fluid in use and that requires only a small volume of fluid and a single recirculating loop.
  • peritoneal dialysis that recovers, filters, and reconstitutes peritoneal fluid in use and that requires only a small volume of fluid and a single recirculating loop.
  • any source of power, portable or non-portable could be used with the invention.
  • a portable and wearable artificial kidney for continuously removing toxic metabolites from the blood comprising means for continuously circulating a prepared solution through the peritoneal cavity to draw toxic metabolites from the blood across the peritoneal membranes and into the fluid in the cavity forming peritoneal fluid; filtration means for continuously removing the toxic metabolites from the peritoneal fluid; means for continuously conveying the peritoneal fluid from the peritoneal cavity to the filtration means; means for continuously, recycling purified filtrate from the filtration means back to the peritoneal cavity; and means for reconstituting the recycled peritoneal fluid to make it suitable for re-use in the peritoneal cavity.
  • the filtration means comprises a plurality of membranes with hyperfiltration characteristics and means for pressurizing the peritoneal fluid conveyed to the membranes to provide a pressure differential across the membrane.
  • the kidney of claim 2, wherein the filtration means includes a housing having peritoneal fluid inlet means and toxic metabolite eflluent means on the high pressure side of the membranes and purified filtrate outlet means on the low pressure side of the membranes.
  • kidney of claim 2 wherein the housing also includes reconstituting fluid inlet means for introducing make-up solution to the low pressure side of the membranes in countercurrent flow to the flow of peritoneal fluid on the high pressure side of the membrane.
  • a method for continuously removing toxic metabolites from the blood comprising continuously circulating a prepared solution through the peritoneal cavity to draw toxic metabolites from the blood across the peritoneal membranes and into the solution forming peritoneal fluid, continuously withdrawing the peritoneal fluid from the cavity, continuously filtering the fluid to remove the toxic metabolites, reconstituting and continuously recycling the filtered fluid to the peritoneal cavity for further use, and withdrawing and discharging the rejected residue as waste.

Abstract

A PERTIONEAL ARTIFICIAL KIDNEY IN WHICH A PREPARED SOLUTION IS CIRCULATED THROUGH THE PERITONEAL CAVITY AND THE RESULTING PERITONEAL FLUID CONTAINING UNWANTED TOXIC METABOLITES IS WITHDRAWN FROM THE THE CAVITY AND PASSED THROUGH FILTRATION MEANS THAT PERMITS ESSENTIALLY ONLY

PASSED OF PURE WATER WHILE REJECTING THE METABOLITES. THE FILTERED PERITONEAL FLUID IS THEN RECONSTITUTED WITH A CONTROLLED MAKE-UP SOLUTION FOR RECYCLE TO THE PERITONEAL CAVITY AND THE REJECTED RESIDUE IS DISCHARGED AS WASTE.

Description

July 23, 1974 C BRQWN ETAL 3,825,493
PERI'I'ONEAL ARTIFICIAL KIDNEY Filed Sept. 29, 1972 RECON STITUT NG SOLUTION PRESSURE REGULATING VALVE METERING PUMP IMPLANTED PERITONEUM 26\- CATHETER 2 HIGH PRESSURE PUMP PERITONEAL CAVITY RECONSTITUTINGL SOLUTION MEMBRANE PERITONEAL FLUID United States Patent 3,825,493 PERITONEAL ARTIFICIAL KIDNEY Clinton E. Brown, Silver Spring, Md., and Moshe-Aharou Frommer, Rehovoth, Israel, assignors to Hydronautics, Incorporated. Laurel, Md.
Filed Sept. 29, 1972, Ser. No. 293,474 Int. Cl. B01d 31/00, 13/00 US. Cl. 210-23 7 Claims ABSTRACT OF THE DISCLOSURE A peritoneal artificial kidney in which a prepared solution is circulated through the peritoneal cavity and the resulting peritoneal fluid containing unwanted toxic metabolites is withdrawn from the cavity and passed through filtration means that permits essentially only passage of pure water while rejecting the metabolites. The filtered peritoneal fluid is then reconstituted with a controlled make-up solution for recycle to the peritoneal cavity and the rejected residue is discharged as waste.
This invention relates to artificial kidneys for removing toxic substances in the blood normally excreted through the human kidney, and more particularly, to a compact, wearable artificial kidney for removing the toxic substances by peritoneal dialysis.
In recent years, the development of artificial kidneys has prolonged the lives of human beings with damaged or inoperative kidneys. The physiology of the human kidney is fairly well understood and involves the removal of nonvolatile wastes from the blood stream and the continuous regulation of the blood composition such that the conditions in body tissues necessary for the life of cells are maintained. Accordingly, when the kidneys are not operating properly, these functions must be performed by artificial means to prevent any imbalance from developing and the build-up of toxic conditions in the blood.
A variety of artificial devices has been developed for assuming the function of a human kidney. Most commonly, these devices withdraw blood from the body and pass the blood through an external dialyzer to draw out or remove the undesired toxic substances from the blood and then the blood is returned to the body. When these devices are used for several hours, several times per week, they are capable of reducing the level of concentration of toxic substances in the blood to a safe level.
The dialysate or wash solution, however, must be carefully formulated so as to be isotonic to the blood and so that certain desirable constituents of the blood, such as electrolytes, are not lost in the dialysis procedure. The devices all commonly operate on an intermittent basis, requiring a high volume of dialysate and in turn necessitating a bulky and immobile reservoir for the solution. Further, the intermittent use of such devices causes the concentrations of toxic substances in the patients blood stream to oscillate from an abnormally high position just prior to treatment to a low point immediately following treatment. This creates undesirable side effects in the patients general condition. Finally, the fact that the blood is being used for the treatment involves the risk of clotting and anticoagulants must be utilized in the treatment.
Accordingly, more recent efforts in the field of artificial kidneys have been to develop devices that can operate independently of the blood and that can consistently maintain the concentration of toxic substances at an acceptable level. In order to provide a continuously operating kidney, of course, the devices must be portable and wearable by the patient and desirably compact, reliable, and of minimum discomfort.
In US. Pat. No. 3,799,873 of Clinton E. Brown, for
ice
example, which patent is assigned to the assignee of the present invention, there is described a completely recirculating artificial kidney, suitable for use in removing toxic substances from the blood by peritoneal dialysis. The device operates on the well known technique of peritoneal dialysis, in which a prepared solution is circulated through the peritoneal cavity and the unwanted metabolites, such as urea, creatinine, uric acid, etc. are drawn into the solution by natural diffusion from the blood stream across the peritoneal membranes, resulting in what is commonly referred to as peritoneal fluid. This fluid now containing the unwanted toxic substances is removed from the body, and passed through an external dialyzer to remove the toxic substances from the peritoneal fluid, and the purified fluid is then returned to the peritoneal cavity. To provide a completely portable device, however, means are also provided for purifying, reconstituting, and re cycling the dialysate for the external dialyzer. In essence, the device comprises two recirculating loops; one for the body fluid and one for the dialysate.
While this represents a significant improvement in the art of developing wearable, compact, and efl'lcient artificial kidneys, it obviously involves more operations than the more common intermittent, but immobile, devices heretofore used to dialyze the blood. In accordance with the present invention, however, there is provided a much more simplified artificial kidney that requires only one recirculating loop like a blood dialysis device, but without the necessity of doing something with the spent dialysate that has heretofore plagued the development of a truly satisfactory mobile device. More specifically, it has been found that the need for an external circuit to cleanse the dialysate in order to provide a portable device can be eliminated by filtering the peritoneal fluid of its toxic substances and returning the filtered fluid after being reconstituted to the peritoneal cavity. Thus, in contrast to earlier intermittent devices where the dialysate is discarded, or portable devices where the dialysate must be purified and recirculated, the device of the present invention filters the peritoneal fluid and returns it for further use.
As embodied and broadly described, therefore, this invention comprises circulating a prepared solution through the peritoneal cavity to withdraw toxic metabolites from the blood across the peritoneal membranes and into the solution forming peritoneal fluid; removing the peritoneal fluid from the peritoneal cavity; filtering the fluid to remove toxic substances from the peritoneal fluid; reconstituting and recycling the filtered fluid back to the peritoneal cavity; and discarding the rejected wastes.
Of the accompanying drawings:
FIG. 1 illustrates a schematic representation of the peritoneal artificial kidney of this invention; and
FIG. 2 is a suitable filter cell employing reverse osmosis membranes.
The artificial kidney of this invention is particularly adapted for use with peritoneal fluid. By peritoneal fluid is meant not only that fluid naturally existing in the peritoneal cavity, but the prepared conventional peritoneal dialysis solutions added to the cavity to supplement its volume. For a more thorough discussion of peritoneal dialysis for performing the function of a natural kidney and other examples of previous methods for performing recirculation peritoneal dialysis, reference is made to an article by J. H. Shinaberger, L. Shear and K. G. Barry, entitled Increasing Efiiciency of Peritoneal Dialysis," Transactions of American Society of Artificial Internal Organs, Vol. II, pages 76-82, 1965.
With reference to FIG. 1, peritoneal fluid 2 is withdrawn from conventional catheters 4, preferably of silicone rubber, implanted surgically in the peritoneum or peritoneal cavity and forced by the pumping action of a high-pressure pump 6 to the intake side 8 of a filtration means 10. Preferably, filtration means or filter cell 10 in cludes as the filter element 12 a membrane with hyperfiltration characteristics, such as reverse osmosis membranes, mounted within a suitable housing and having inlet means 14 for the peritoneal fluid, toxic metabolite eflluent means 16, both on the same side 8 of the filtration element 12, and a purified filtrate outlet means 18. Cell ber of alternative devices having hyperfilter characteristics that were used to cleanse the dialysate for the external dialyzer.
Peritoneal fluid is fed to filter cell 10 under pressure and at a rate of from to 50 ml./min., where it travels through the cell with a motion parallel to the filtering element 12, emerging as a concentrated solution of low molecular weight solutes or metabolites, such as urea, creatinine, uric acid, and electrolytes from outlet 16. Pressure is maintained on the order of 400 to 600 p.s.i. to pro vide a pressure differential across membrane 12 in filter cell by pump 6, and pressure regulating valve 20 in the waste rejection line 22. Relief or regulating valve 20 is designed to permit a continuous flow of peritoneal fluid through filter cell 10 and a continuous flow of wastes 22 to a urinal 24.
In the usual peritoneal dialysis treatment, Water is also removed in the peritoneal fluid. This is accomplished by providing the solution fed to the peritoneal cavity with sorbitol or a sugar, such as dextrose, to produce an osmotic pressure difference between the body and the solution, causing a flow of water across the peritoneal membranes 1 and into the solution forming peritoneal fluid. Generally,
the metabolites and electrolytes do not pass through membrane 12, but are rejected, and essentially only pure water tion may be added to the filtrate after it leaves filter cell 10 or, preferably, and as schematically shown in FIG. 1, is added at 19 to the low pressure side 26 of cell 10 and at the opposite end of the cell from peritoneal fluid inlet 14 so that its flow is countercurrent to the flow of peritoneal fluid. By this arrangement, the osmotic pressure of the solution can be used to also assist in the flow of water through membrane 12 of the filter cell.
The reconstituted water 28 is recycled back to the peritoneum through suitable catheters for further removal of toxic substances by peritoneal dialysis.
High pressure pump 6 and metering pump 32 are preferably cam driven by a suitable electric motor which is in turn powered by a portable, re-chargeable battery to pro- 1' vide a convenient wearable system. The pump and metering system are conventional and are more fully described in the above-mentioned patent.
Thus, the present invention provides a wearable, yet compact, artificial kidney uitable for use with peritoneal dialysis that recovers, filters, and reconstitutes peritoneal fluid in use and that requires only a small volume of fluid and a single recirculating loop. Of course, it is to be recognized that it is within the scope of this invention to modify the nature of the power source needed to operate the pump, and any source of power, portable or non-portable, could be used with the invention. Many other modifications are also possible, including fail-safe features to protect against punctures, leaks, ruptures in the fluid lines as well as clogging of the filters, sensing devices to sense the concentration of toxic substances in the recycled peritoneal fluid and the accumulation of waste in the urinal as well as automatic shut-01f and warning devices to alert the patient of any malfunction and the need for service to the system. The invention, therefore, is not limited to the specific details shown and described and departures may be made from such details without departing from the principles of the invention and without sacrificing its chief advantages.
What is claimed is:
. 1. A portable and wearable artificial kidney for continuously removing toxic metabolites from the blood comprising means for continuously circulating a prepared solution through the peritoneal cavity to draw toxic metabolites from the blood across the peritoneal membranes and into the fluid in the cavity forming peritoneal fluid; filtration means for continuously removing the toxic metabolites from the peritoneal fluid; means for continuously conveying the peritoneal fluid from the peritoneal cavity to the filtration means; means for continuously, recycling purified filtrate from the filtration means back to the peritoneal cavity; and means for reconstituting the recycled peritoneal fluid to make it suitable for re-use in the peritoneal cavity.
2. The kidney of claim 1, wherein the filtration means comprises a plurality of membranes with hyperfiltration characteristics and means for pressurizing the peritoneal fluid conveyed to the membranes to provide a pressure differential across the membrane.
3. The kidney of claim 2, wherein the filtration means includes a housing having peritoneal fluid inlet means and toxic metabolite eflluent means on the high pressure side of the membranes and purified filtrate outlet means on the low pressure side of the membranes.
4. The kidney of claim 2, wherein the housing also includes reconstituting fluid inlet means for introducing make-up solution to the low pressure side of the membranes in countercurrent flow to the flow of peritoneal fluid on the high pressure side of the membrane.
5. A method for continuously removing toxic metabolites from the blood, comprising continuously circulating a prepared solution through the peritoneal cavity to draw toxic metabolites from the blood across the peritoneal membranes and into the solution forming peritoneal fluid, continuously withdrawing the peritoneal fluid from the cavity, continuously filtering the fluid to remove the toxic metabolites, reconstituting and continuously recycling the filtered fluid to the peritoneal cavity for further use, and withdrawing and discharging the rejected residue as waste.
6. The method of claim 5, wherein the filtered fluid is reconstituted by the addition of a control solution of make-up electrolytes and sorbitol or a sugar.
7. The method of claim 5, wherein the peritoneal fluidis filtered by pressurizing the fluid and forcing it through membranes with hyperfiltration characteristics.
References Cited UNITED STATES PATENTS 3,506,126 4/1970 Serfass et al. 210-96 3,579,441 5/1971 Brown 210321 X 3,545,438 12/1970 De Vries 210-321 X 3,483,867 12/ 1969 Markovitz 210-23 X 3,619,423 11/1971 Galletti et al. 21022 FRANK A. SPEAR, JR., Primary Examiner US. Cl. X.R. 2l0321
US00293474A 1968-04-19 1972-09-29 Peritoneal artificial kidney Expired - Lifetime US3825493A (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
US00161864A US3799873A (en) 1968-04-19 1971-07-09 Artificial kidney
US00293474A US3825493A (en) 1972-09-29 1972-09-29 Peritoneal artificial kidney
DE2321168A DE2321168A1 (en) 1972-09-29 1973-04-26 DEVICE FOR SEPARATING TOXIC SUBSTANCES FROM BODY FLUIDS, IN PARTICULAR FOR USE AS ARTIFICIAL KIDNEY
DE2321188A DE2321188A1 (en) 1972-09-29 1973-04-26 PERITONEAL ARTIFICIAL KIDNEY
GB229874A GB1455772A (en) 1972-09-29 1974-01-17 Artificial kidneys
FR7401730A FR2258189B1 (en) 1972-09-29 1974-01-18

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DE2903894A1 (en) * 1978-02-01 1979-08-02 Exxon Research Engineering Co BLOOD DIALYSIS METHOD AND DEVICE FOR CARRYING OUT THE METHOD USING STABILIZED LIQUID MEMBRANE CAPSULES
US4190047A (en) * 1977-08-26 1980-02-26 University Of Utah Method and apparatus for peritoneal dialysis
US4204957A (en) * 1975-11-21 1980-05-27 Sartorius Membranfilter Gmbh Artificial kidney
US4233434A (en) * 1975-01-27 1980-11-11 Ramot Plastics Polyamide from aromatic phosphorus containing diamine
US4244816A (en) * 1979-01-22 1981-01-13 Exxon Research & Engineering Co. Liquid membrane capsule systems resistant to coalescence by means of an irreversible coating
US4276175A (en) * 1979-07-19 1981-06-30 Bower John D Regeneratable peritoneal dialysis bag
US4311587A (en) * 1979-12-10 1982-01-19 Japan Foundation For Artificial Organs Filter arrangement denying bacteria entry to peritoneum
US4312755A (en) * 1979-06-29 1982-01-26 Dow Corning Corporation Reverse osmosis system
US4338190A (en) * 1976-02-13 1982-07-06 A. T. Ramot Plastics Ltd. Peritoneal artificial kidney
US4832684A (en) * 1986-06-13 1989-05-23 Popovich Robert P Peritoneal membrane plasmapheresis
DE19540079A1 (en) * 1995-10-27 1997-04-30 Joachim Dr Med Boehler Dialysis device with haemodialyser
US6527735B1 (en) * 2000-04-27 2003-03-04 Renaltech International Llc Method of peritoneal dialysis
US20040019320A1 (en) * 2002-07-19 2004-01-29 Childers Robert W. Systems and metods for performing peritoneal dialysis
US20040082903A1 (en) * 2002-07-19 2004-04-29 Micheli Brian R. Systems and methods for peritoneal dialysis
US6758975B2 (en) 2001-02-16 2004-07-06 Piedmont Renal Clinic, Pa Automated peritoneal dialysis system and process with in-line sterilization of dialysate
EP1480690A2 (en) * 2001-12-13 2004-12-01 National Quality Care, Inc. Wearable peritoneal dialysis system
US7153286B2 (en) 2002-05-24 2006-12-26 Baxter International Inc. Automated dialysis system
US20070213665A1 (en) * 2006-03-08 2007-09-13 Conor Curtin Wearable kidney
US20100010429A1 (en) * 2002-07-19 2010-01-14 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US20100051552A1 (en) * 2008-08-28 2010-03-04 Baxter International Inc. In-line sensors for dialysis applications
US20100114012A1 (en) * 2008-11-03 2010-05-06 Sandford Harold F Portable Peritoneal Dialysis System
US20110060273A1 (en) * 2009-09-08 2011-03-10 Fresenius Medical Care Holdings, Inc. Peritoneal dialysis system
US8206338B2 (en) 2002-12-31 2012-06-26 Baxter International Inc. Pumping systems for cassette-based dialysis
US9514283B2 (en) 2008-07-09 2016-12-06 Baxter International Inc. Dialysis system having inventory management including online dextrose mixing
US9582645B2 (en) 2008-07-09 2017-02-28 Baxter International Inc. Networked dialysis system
US9675745B2 (en) 2003-11-05 2017-06-13 Baxter International Inc. Dialysis systems including therapy prescription entries
US9675744B2 (en) 2002-05-24 2017-06-13 Baxter International Inc. Method of operating a disposable pumping unit
US10232103B1 (en) 2001-11-13 2019-03-19 Baxter International Inc. System, method, and composition for removing uremic toxins in dialysis processes
US10646634B2 (en) 2008-07-09 2020-05-12 Baxter International Inc. Dialysis system and disposable set
US11495334B2 (en) 2015-06-25 2022-11-08 Gambro Lundia Ab Medical device system and method having a distributed database
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DE3020756A1 (en) * 1980-05-31 1981-12-10 Salvia Regel- Und Medizintechnik Gmbh, 6231 Schwalbach Measuring fluid withdrawal rate in dialysis system - by aligning floats recording flow rates before and after membrane
FR2502959A1 (en) * 1981-04-03 1982-10-08 Fournier Gilles Haemodialysis appts. having large volumetric capacity - operates without need for regeneration system
JPS58165865A (en) * 1982-03-26 1983-09-30 川澄化学工業株式会社 Body liquid treating apparatus
EP0097863A3 (en) * 1982-06-30 1984-04-18 Gambro Lundia AB Mixing fluids by means of semipermeable membranes
DE8714464U1 (en) * 1986-10-30 1988-01-21 Sartorius Gmbh, 3400 Goettingen, De

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US4392960A (en) * 1975-01-27 1983-07-12 A. T. Ramot Plastics, Ltd. Process for the removal of urea from aqueous solutions
US4233434A (en) * 1975-01-27 1980-11-11 Ramot Plastics Polyamide from aromatic phosphorus containing diamine
US4204957A (en) * 1975-11-21 1980-05-27 Sartorius Membranfilter Gmbh Artificial kidney
US4338190A (en) * 1976-02-13 1982-07-06 A. T. Ramot Plastics Ltd. Peritoneal artificial kidney
US4190047A (en) * 1977-08-26 1980-02-26 University Of Utah Method and apparatus for peritoneal dialysis
DE2903894A1 (en) * 1978-02-01 1979-08-02 Exxon Research Engineering Co BLOOD DIALYSIS METHOD AND DEVICE FOR CARRYING OUT THE METHOD USING STABILIZED LIQUID MEMBRANE CAPSULES
US4244816A (en) * 1979-01-22 1981-01-13 Exxon Research & Engineering Co. Liquid membrane capsule systems resistant to coalescence by means of an irreversible coating
US4312755A (en) * 1979-06-29 1982-01-26 Dow Corning Corporation Reverse osmosis system
US4276175A (en) * 1979-07-19 1981-06-30 Bower John D Regeneratable peritoneal dialysis bag
US4311587A (en) * 1979-12-10 1982-01-19 Japan Foundation For Artificial Organs Filter arrangement denying bacteria entry to peritoneum
US4832684A (en) * 1986-06-13 1989-05-23 Popovich Robert P Peritoneal membrane plasmapheresis
DE19540079A1 (en) * 1995-10-27 1997-04-30 Joachim Dr Med Boehler Dialysis device with haemodialyser
DE19540079C2 (en) * 1995-10-27 2000-06-21 Joachim Boehler Dialysis machine
US6527735B1 (en) * 2000-04-27 2003-03-04 Renaltech International Llc Method of peritoneal dialysis
US6758975B2 (en) 2001-02-16 2004-07-06 Piedmont Renal Clinic, Pa Automated peritoneal dialysis system and process with in-line sterilization of dialysate
US10980931B2 (en) 2001-11-13 2021-04-20 Baxter International Inc. System, method, and composition for removing uremic toxins in dialysis processes
US10232103B1 (en) 2001-11-13 2019-03-19 Baxter International Inc. System, method, and composition for removing uremic toxins in dialysis processes
EP1480690A2 (en) * 2001-12-13 2004-12-01 National Quality Care, Inc. Wearable peritoneal dialysis system
EP1480690A4 (en) * 2001-12-13 2010-09-29 Nat Quality Care Inc Wearable peritoneal dialysis system
US9675744B2 (en) 2002-05-24 2017-06-13 Baxter International Inc. Method of operating a disposable pumping unit
US10137235B2 (en) 2002-05-24 2018-11-27 Baxter International Inc. Automated peritoneal dialysis system using stepper motor
US9775939B2 (en) 2002-05-24 2017-10-03 Baxter International Inc. Peritoneal dialysis systems and methods having graphical user interface
US10751457B2 (en) 2002-05-24 2020-08-25 Baxter International Inc. Systems with disposable pumping unit
US9504778B2 (en) 2002-05-24 2016-11-29 Baxter International Inc. Dialysis machine with electrical insulation for variable voltage input
US8529496B2 (en) 2002-05-24 2013-09-10 Baxter International Inc. Peritoneal dialysis machine touch screen user interface
US7789849B2 (en) 2002-05-24 2010-09-07 Baxter International Inc. Automated dialysis pumping system using stepper motor
US7153286B2 (en) 2002-05-24 2006-12-26 Baxter International Inc. Automated dialysis system
US7815595B2 (en) 2002-05-24 2010-10-19 Baxter International Inc. Automated dialysis pumping system
US8403880B2 (en) 2002-05-24 2013-03-26 Baxter International Inc. Peritoneal dialysis machine with variable voltage input control scheme
US8357113B2 (en) 2002-07-19 2013-01-22 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US7208092B2 (en) 2002-07-19 2007-04-24 Baxter International Inc. Systems and methods for peritoneal dialysis
US7922911B2 (en) 2002-07-19 2011-04-12 Baxter International Inc. Systems and methods for peritoneal dialysis
US11235094B2 (en) 2002-07-19 2022-02-01 Baxter International Inc. System for peritoneal dialysis
US20040019320A1 (en) * 2002-07-19 2004-01-29 Childers Robert W. Systems and metods for performing peritoneal dialysis
US7867214B2 (en) 2002-07-19 2011-01-11 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US20040082903A1 (en) * 2002-07-19 2004-04-29 Micheli Brian R. Systems and methods for peritoneal dialysis
US8597227B2 (en) 2002-07-19 2013-12-03 Baxter International Inc. Weight/sensor-controlled sorbent system for hemodialysis
US10363352B2 (en) 2002-07-19 2019-07-30 Baxter International Inc. Disposable set and system for dialysis
US7922686B2 (en) 2002-07-19 2011-04-12 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US8815095B2 (en) 2002-07-19 2014-08-26 Baxter International Inc. Peritoneal dialysis systems and methods that regenerate dialysate
US8998839B2 (en) 2002-07-19 2015-04-07 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US10179200B2 (en) 2002-07-19 2019-01-15 Baxter International Inc. Disposable cassette and system for dialysis
US9814820B2 (en) 2002-07-19 2017-11-14 Baxter International Inc. Weight-controlled sorbent system for hemodialysis
US20090264812A1 (en) * 2002-07-19 2009-10-22 Baxter International Inc. Systems and methods for peritoneal dialysis
US9764074B1 (en) 2002-07-19 2017-09-19 Baxter International Inc. Systems and methods for performing dialysis
US20100010429A1 (en) * 2002-07-19 2010-01-14 Baxter International Inc. Systems and methods for performing peritoneal dialysis
US8206338B2 (en) 2002-12-31 2012-06-26 Baxter International Inc. Pumping systems for cassette-based dialysis
US9675745B2 (en) 2003-11-05 2017-06-13 Baxter International Inc. Dialysis systems including therapy prescription entries
US20070213665A1 (en) * 2006-03-08 2007-09-13 Conor Curtin Wearable kidney
US8715221B2 (en) 2006-03-08 2014-05-06 Fresenius Medical Care Holdings, Inc. Wearable kidney
US9690905B2 (en) 2008-07-09 2017-06-27 Baxter International Inc. Dialysis treatment prescription system and method
US9697334B2 (en) 2008-07-09 2017-07-04 Baxter International Inc. Dialysis system having approved therapy prescriptions presented for selection
US9582645B2 (en) 2008-07-09 2017-02-28 Baxter International Inc. Networked dialysis system
US9514283B2 (en) 2008-07-09 2016-12-06 Baxter International Inc. Dialysis system having inventory management including online dextrose mixing
US10561780B2 (en) 2008-07-09 2020-02-18 Baxter International Inc. Dialysis system having inventory management including online dextrose mixing
US10646634B2 (en) 2008-07-09 2020-05-12 Baxter International Inc. Dialysis system and disposable set
US20100051552A1 (en) * 2008-08-28 2010-03-04 Baxter International Inc. In-line sensors for dialysis applications
US11400193B2 (en) 2008-08-28 2022-08-02 Baxter International Inc. In-line sensors for dialysis applications
US8777892B2 (en) 2008-11-03 2014-07-15 Fresenius Medical Care Holdings, Inc. Portable peritoneal dialysis system
US20100114012A1 (en) * 2008-11-03 2010-05-06 Sandford Harold F Portable Peritoneal Dialysis System
US20110060273A1 (en) * 2009-09-08 2011-03-10 Fresenius Medical Care Holdings, Inc. Peritoneal dialysis system
US9078969B2 (en) 2009-09-08 2015-07-14 Fresenius Medical Care Holdings, Inc. Peritoneal dialysis system
US11495334B2 (en) 2015-06-25 2022-11-08 Gambro Lundia Ab Medical device system and method having a distributed database
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Also Published As

Publication number Publication date
DE2321168A1 (en) 1974-11-21
GB1455772A (en) 1976-11-17
DE2321188A1 (en) 1974-04-04
FR2258189A1 (en) 1975-08-18
FR2258189B1 (en) 1980-08-08

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