Universal portable machine for online hemodiafiltration using regenerated dialysate

Abstract

Manifolds suitable for use in hemodialysis, hemofiltration, hemodiafiltration, and peritoneal dialysis are provided. One or more of the manifolds can include a manifold body and an external tube. The manifold body can include at least one conduit including a first conduit and at least one port including a first port in fluid communication with the first conduit. The external tube can be in fluid communication with the first port and can include a main segment, a first branch segment, and a second branch segment containing at least one bacterial filter. The first branch segment and/or second branch segment can include at least one flow restrictor. Dialysis machines, systems, and kits including one or more such manifold are also provided, as are methods of performing hemodiafiltration using such manifolds.

1 - 35 . (canceled) 
     
     
         36 . A method of performing hemodiafiltration on a patient comprising:
 pumping a flow of dialysate through a dialysate circuit;   pumping a flow of blood through an extracorporeal blood circuit;   restricting the flow of dialysate in the dialysate circuit to divert a portion of the flow of dialysate into the extracorporeal blood circuit; and   passing the portion through at least one bacterial filter before the portion enters the blood circuit.   
     
     
         37 . The method of  claim 36 , wherein the flow restriction is static. 
     
     
         38 . The method of  claim 36 , wherein the flow restriction is varied. 
     
     
         39 . The method of  claim 36 , wherein the dialysate circuit comprises a branched conduit comprising a main segment, a first branch segment, and a second branch segment, wherein the second branch segment carries the portion and is in fluid communication with the extracorporeal blood circuit and the restricting comprises restricting the flow of dialysate in at least one of the first branch segment and the second branch segment. 
     
     
         40 . The method of  claim 39 , wherein the restricting comprises restricting the flow of dialysate in both the first branch segment and the second branch segment. 
     
     
         41 . The method of  claim 36 , wherein at least one of the flow of dialysate and the flow of blood is pumped through a manifold engaged with a dialysis machine. 
     
     
         42 . The method of  claim 41 , further comprising engaging the manifold with the dialysis machine. 
     
     
         43 . The method of  claim 36 , wherein at least one of the pumping the flow of dialysate and the pumping the flow of blood comprises pumping with at least one peristaltic pump. 
     
     
         44 . The method of  claim 36 , wherein the dialysate circuit comprises a sorbent cartridge capable of regenerating the dialysate. 
     
     
         45 . The method of  claim 36 , further comprising pumping an electrolyte solution into the dialysate circuit. 
     
     
         46 . The method of  claim 36 , wherein the pumping of the flow of dialysate and the pumping of the flow of blood comprises pumping through at least one dialyzer. 
     
     
         47 . The method of  claim 36 , wherein the at least one bacterial filter comprises at least one dialyzer. 
     
     
         48 . The method of  claim 36 , wherein the extracorporeal circuit comprises an arterial side and a venous side and the portion is diverted into at least one of the arterial side and the venous side. 
     
     
         49 . The method of  claim 48 , wherein the portion is diverted into the arterial side. 
     
     
         50 . The method of  claim 36 , further comprising measuring a central venous pressure of the patient. 
     
     
         51 . The method of  claim 50 , wherein the flow restriction is varied depending on the central venous pressure measured. 
     
     
         52 . The method of  claim 51 , further comprising determining a target volume of fluid to be added or removed from the patient. 
     
     
         53 . The method of  claim 52 , wherein the flow restriction is varied to add or remove the target volume.