Apparatus and method for peritoneal dialysis

Abstract

An apparatus and method for treatment of end stage renal decline and failure through peritoneal dialysis enabling ambulatory transfer of dialysate to and from the peritoneum of a renal patient, this in synthesis and coordination with normal physiological rhythms of the patient. The system remains unobtrusive and less restrictive of patient ambulation and orientation. The present invention includes expendables disposability of which facilitates safe reuse of more expensive portions and is sufficiently simple for use in a home care environment. It may be designed to incorporate real-time, interactive or remote monitoring and regulation and visual or audible indication of system pressures, chemical balances and other important variables.

1 . A method of performing peritoneal dialysis, comprising: 
 selection of a device system for treatment of renal decline or failure, wherein said device system comprises: 
 a portable pump including a disposable cartridge interface;  
 a receptacle system comprising exhausted dialysate storage capacity and unused or recycled dialysate storage capacity designed selectively to be worn by a renal patient, wherein said receptacle may comprise a polymer bag with at least one opening in fluid communication with said conduit;  
 a delivery conduit structured and arranged to support passage of exhausted dialysate from and unused dialysate to the peritoneum of the patient;  
 a filter assembly associated with the delivery conduit and structured and arranged to permit filtering of both air and contaminants from unused or recycled dialysate; and  
 an indicator wherein at least one, but potentially any, of a plurality of therapeutic variables may be monitored and regulated to achieve a desired therapeutic balance;  
   association of said device system with an indwelling dialysis catheter such that substantially all of an amount of exhausted dialysate within a peritoneum of the patient may be removed; and    infusion of a therapeutic volume of unused or recycled dialysate optimal for treatment of the patient.    
   
   
       2 . The method according to  claim 1 , wherein a selected volume of unused or recycled dialysate, which is in excess of the therapeutic volume and is sufficient to accomplish dialysis through an extended period of time during which the patient may be in a sleeping condition, may be selectively introduced to the peritoneum of the patient.  
   
   
       3 . The method according to  claim 1 , wherein said bag further includes structure attached to one inner side of the bag and to the opposing inner side of the bag to retain the cross-sectional dimension of the bag at a limited degree of distention without limiting flow of a dialysate within or through the bag.  
   
   
       4 . The method according to  claim 1 , wherein the exhausted dialysate may be removed and said unused or recycled dialysate may be infused simultaneously.  
   
   
       5 . The method according to  claim 1 , wherein the exhausted dialysate undergoes a process that extends its useful life.  
   
   
       6 . The method according to  claim 5 , wherein said process comprises subjection to a pulsating flow pattern.  
   
   
       7 . The method according to  claim 5 , wherein said process comprises, alone or in combination, filtration or chemical modification.  
   
   
       8 . The method according to  claim 1 , wherein said delivery conduit is structured and arranged to permit said passage or reciprocal circulation of exhausted dialysate from and unused or recycled dialysate to the peritoneum selectively either simultaneously or sequentially.  
   
   
       9 . The method according to  claim 1 , wherein said delivery conduit includes a plurality of lumens, a first of which lumens comprises a corresponding first distal orifice and is structured and arranged to permit passage of exhausted dialysate from the peritoneum and a second of which lumens, comprises a corresponding second distal orifice and permits passage of unused or recycled dialysate to the peritoneum.  
   
   
       10 . The method according to  claim 9 , wherein said first distal orifice may be located within the peritoneum at a site remote from said second distal orifice.  
   
   
       11 . The method according to  claim 1 , wherein said therapeutic variables may comprise, alone or in combination, body temperature or blood content of the patient or dialysate temperature or dialysate flow volume or dialysate flow direction or dialysate flow timing or dialysate chemistry balance including albumen, urea, uric acid, creatinine, creatine, pH, ions or electrolytes.  
   
   
       12 . The method according to  claim 1 , wherein said therapeutic variables may be monitored or regulated selectively, automatically, or by direct intervention.  
   
   
       13 . The method according to  claim 1 , wherein said operating conditions may be monitored or regulated from a source remote from the patient.  
   
   
       14 . The method according to  claim 1 , wherein said device system further comprises a patient vest structured and arranged to support the receptacle system proximal to and with minimal cross-sectional extension from the patient.  
   
   
       15 . The method according to  claim 1 , wherein said method may be performed irrespective of the location, orientation or movement of the patient.  
   
   
       16 . The method according to  claim 9 , further comprising a third lumen that carries circuitry to deliver data from at least one probe that measures therapeutic or physiologic or diagnostic parameters of the fluid adjacent the peritoneum.