Dialysis treatment and machine

A dialysis system comprising:

• a dialyzer;
• a fluid line for passing dialysate from bicarbonate source to a balancing system;
• a sensor configured to measure a dialysate flow rate of dialysate running in the fluid line, the dialysate comprising bicarbonate pumped out of the bicarbonate source;
• the balancing system configured to transfer clean dialysate from the fluid line to the dialyzer, and drain used dialysate from the dialyzer to a drainage, wherein the balancing system comprises a switch with a status that changes with a switching rate, wherein a change in the switch rate causes a change in the dialysis flow rate running through the fluid line;
• and
• a processor configured to perform automatic operations comprising:
• determining, based on a prescription received from an external source, a treatment time of a dialysis treatment for a patient,
• receiving, from the sensor, the dialysate flow rate, wherein the bicarbonate source has an initial amount of bicarbonate before the dialysis treatment starts,
• predicting, based on (i) the treatment time, (ii) the initial amount of bicarbonate, and (iii) the dialysate flow rate, that by end of the dialysis treatment no more than a specific threshold amount of bicarbonate will be left in the bicarbonate source, and in response,
• determining that a clearance value during the dialysis treatment is or will be higher than a specific threshold clearance value, wherein the clearance value is determined based on a urea clearance, time, and an inverse of a volume of fluid passing through a fluid line over the time, and
• changing the switching rate of the balancing system to reduce the dialysate flow rate to a reduced rate, thereby reducing a rate of bicarbonate pumped out of the bicarbonate source while maintaining a clearance value of the dialysis treatment at no less than the specific threshold clearance value.

One or more computer readable media storing instructions that are automatically executable by a processing device, and upon such execution cause the processing device to perform operations comprising:

• determining, based on a prescription received for a patient from an external source, a treatment time of a dialysis treatment for the patient;
• receiving, from at least a sensor of a dialysis machine, a dialysate flow rate of dialysate running in the dialysis machine, the dialysate comprising bicarbonate pumped out of a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial amount of bicarbonate before the dialysis treatment starts;
• predicting, based on (i) the treatment time, (ii) the initial amount of bicarbonate, and (iii) the dialysate flow rate, that by end of the dialysis treatment no more than a specific threshold amount of bicarbonate will be left in the bicarbonate source, and in response,
• determining that a clearance value during the dialysis treatment is or will be higher than a specific threshold clearance value, wherein the clearance value is determined based on a urea clearance, time, and an inverse of a volume of fluid passing through the fluid over the time, and
• changing a switching rate of a balancing system of the dialysis machine to reduce the dialysate flow rate to a reduced rate
• thereby reducing a rate of bicarbonate pumped out of the bicarbonate source while maintaining a clearance value of the dialysis treatment at no less than the specific threshold clearance value.