Urea monitoring during dialysis for improved quality control and treatment guidance
AssigneeUniversity of lowa Research Foundation
InventorsMark Arnold, Jonathon Olesberg
Life of this patent
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Abstract
A method of measuring a dialysis efficacy, dialysis dose, and impacts of dialysis on a patient. The method including measuring a concentration of urea in a dialysis effluent over time; determining a rate of change in urea concentration; and determining the rate of peripheral perfusion from the rate of change in urea concentration. The concentration of urea may be taken in real time or near-real time. The method including determining changes in the rate of peripheral perfusion in real time or near real-time. The method including detecting disequilibrium between the core and peripheral blood and early onset of clinically adverse conditions.
Claims17
A method of conducting dialysis, comprising:
- measuring a concentration of urea in a dialysis effluent over time;
- determining a rate of change in urea concentration;
- identifying a rate of peripheral perfusion and changes in the rate of peripheral perfusion from the rate of change in urea concentration in real-time or near real-time using a multi-compartment model, and
- operating a dialysis machine based on the identified rate of peripheral perfusion and changes in the rate of peripheral perfusion,
- wherein the rate of peripheral perfusion is determined from the following equations:
- dU
- c
- dt
- =
- -
- K
- V
- c
-
- U
- c
- +
- Q
- p
- (
- U
- p
- -
- U
- c
- )
-
- and
-
- dU
- p
- dt
- =
- -
- Q
- p
- (
- U
- p
- -
- U
- c
- )
- V
- p
- ;
- wherein Up is a peripheral concentration,
- wherein Uc is a core concentration,
- wherein Qp is the rate of peripheral perfusion,
- wherein Vp is a peripheral volume
- wherein Vc is a core volume, and
- wherein K is a dialyzer clearance value.
A system for monitoring dialysis, comprising:
- (a) a dialysis machine;
- (b) a urea monitoring sensor disposed on the dialysis machine, the urea monitoring sensor configured to measure a concentration of urea over time;
- and
- (c) a processor in communication with the urea monitoring sensor, wherein the processor determines a rate of change in the concentration of urea over time using a multi-compartment model, and wherein the processor determines a rate of peripheral perfusion;
- wherein the dialysis machine is configured to control dialysis parameters based on a determination of the rate of peripheral perfusion;
- wherein the rate of peripheral perfusion is determined from the following equations:
- dU
- c
- dt
- =
- -
- K
- V
- c
-
- U
- c
- +
- Q
- p
- (
- U
- p
- -
- U
- c
- )
- and
- dU
- p
- dt
- =
- -
- Q
- p
- (
- U
- p
- -
- U
- c
- )
- V
- p
- ;
- wherein Up is a peripheral concentration,
- wherein Uc is a core concentration,
- wherein Qp is the rate of peripheral perfusion,
- wherein Vp is a peripheral volume
- wherein Vc is a core volume, and
- wherein K is a dialyzer clearance value.
A method of conducting hemodialysis measuring peripheral perfusion during hemodialysis comprising:
- measuring urea concentration in used dialysate;
- generating a urea concentration profile;
- determining a rate of change in urea concentration over time;
- and
- determining a rate of peripheral perfusion from the following equations:
- dU
- c
- dt
- =
- -
- K
- V
- c
-
- U
- c
- +
- Q
- p
- (
- U
- p
- -
- U
- c
- )
- and
- dU
- p
- dt
- =
- -
- Q
- p
- (
- U
- p
- -
- U
- c
- )
- V
- p
- ;
- wherein Up is a peripheral concentration,
- wherein Uc is a core concentration,
- wherein Qp is the rate of peripheral perfusion,
- wherein Vp is a peripheral volume,
- wherein Vc is a core volume, and
- wherein K is a dialyzer clearance value;
- and
- operating a dialysis machine based on the identified rate of peripheral perfusion and changes in the rate of peripheral perfusion.
Dependencies are inferred from the claim text.