Single pass dialysis combined with multiple pass albumin dialysis

Abstract

Methods, systems, and devices are disclosed, embodiments of which provide single pass dialysis to remove water and uremic toxins is performed simultaneously with the albumin dialysis therapy by passing the albumin solution through a dialysis filter which dialyses it before the solution is returned to the cycler. In embodiments, the single pass dialysis stage is upstream of the albumin filtering stage.

1 . A device for adapting a blood treatment cycler for the simultaneous clearance of albumin-bound molecules and solutes from blood, comprising:
 a medical treatment cycler configured to balance ingoing and outgoing flows of a medical treatment fluid and adapted to provide a selectable difference between ingoing and outgoing flows, the medical treatment cycler being configured to receive and interoperate with a predefined disposable tubing set with a first filter and fluid inlet and outlet connectors for a balanced medical treatment fluid;   a supplemental fluid management system having a second filter and connectable to the inlet and outlet connectors;   the supplemental fluid management system being configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector;   the supplemental fluid management system being configured to adapt automatically to the medical treatment cycler selecting, and altering in real time, a rate of fluid flow to and from, respectively, the outlet and inlet connectors, thereby providing automatic interoperability with the medical treatment cycler.   
     
     
         2 . The device of  claim 1 , wherein the medical treatment cycler is adapted for performing at least one of dialysis, hemofiltration, and hemodiafiltration. 
     
     
         3 . (canceled) 
     
     
         4 . The device of  claim 1 , wherein the medical treatment cycler is configured to generate a flow rate from the outlet port that is higher than a flow rate to the inlet port, the difference being selectable by a user, and the supplemental fluid management system being configured to adapt automatically to the medical treatment cycler selecting to these flow rates and changing selections thereof made by the medical treatment cycler. 
     
     
         5 . The device of  claim 1 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by pumping a larger or smaller quantity of electrolyte solution. 
     
     
         6 . The device of  claim 1 , wherein the supplemental fluid management system is configured to automatically detect an imbalance between rates of flow between the inlet and outlet connectors using a pressure sensor and compensate by pumping a larger or smaller quantity of electrolyte solution. 
     
     
         7 . The device of  claim 1 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by passively permitting a larger or smaller quantity of electrolyte solution to be drawn by the medical treatment cycler from a source of electrolyte provided by the supplemental fluid management system. 
     
     
         8 . The device of  claim 1 , wherein the supplemental fluid management system is configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector by performing diffusion-based clearance, convection-based clearance, or a combination of diffusion-based clearance and convection-based clearance. 
     
     
         9 - 10 . (canceled) 
     
     
         11 . The device of  claim 1 , wherein the supplemental fluid management system is configured to adapt automatically to the medical treatment cycler selecting, and altering in real time, a rate of flow of fluid flow to and from, respectively, the outlet and inlet connectors, by receiving control signals therefrom. 
     
     
         12 - 13 . (canceled) 
     
     
         14 . A method for performing a blood treatment for the simultaneous clearance of albumin-bound molecules and solutes from blood, comprising:
 providing a medical treatment cycler configured to balance ingoing and outgoing flows of a medical treatment fluid and adapted to provide a selectable difference between ingoing and outgoing flows, the medical treatment cycler being configured to receive and interoperate with a predefined disposable tubing set with a first filter and fluid inlet and outlet connectors for a balanced medical treatment fluid;   providing a supplemental fluid management system having a second filter and connectable to the inlet and outlet connectors;   the supplemental fluid management system being configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector;   the supplemental fluid management system being configured to adapt automatically to the medical treatment cycler selecting, and altering in real time, a rate of fluid flow to and from, respectively, the outlet and inlet connectors, thereby providing automatic interoperability with the medical treatment cycler;   circulating an albumin solution in the medical treatment cycler predefined disposable tubing set; and   clearing solutes from the albumin solution using the supplemental fluid management system.   
     
     
         15 . The method of  claim 14 , wherein the medical treatment cycler is adapted for performing at least one of dialysis, hemofiltration, and hemodiafiltration. 
     
     
         16 . (canceled) 
     
     
         17 . The method of  claim 14 , wherein the medical treatment cycler is configured to generate a flow rate from the outlet port that is higher than a flow rate to the inlet port, the difference being selectable by a user, and the supplemental fluid management system being configured to adapt automatically to the medical treatment cycler selecting to these flow rates and changing selections thereof made by the medical treatment cycler. 
     
     
         18 . The method of  claim 14 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by pumping a larger or smaller quantity of electrolyte solution. 
     
     
         19 . The method of  claim 14 , wherein the supplemental fluid management system is configured to automatically detect an imbalance between rates of flow between the inlet and outlet connectors using a pressure sensor and compensate by pumping a larger or smaller quantity of electrolyte solution. 
     
     
         20 . The method of  claim 14 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by passively permitting a larger or smaller quantity of electrolyte solution to be drawn by the medical treatment cycler from a source of electrolyte provided by the supplemental fluid management system. 
     
     
         21 . The method of  claim 14 , wherein the supplemental fluid management system is configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector by performing diffusion-based clearance, convection-based clearance, or a combination of diffusion-based clearance and convection-based clearance. 
     
     
         22 - 23 . (canceled) 
     
     
         24 . The method of  claim 14 , wherein the supplemental fluid management system is configured to adapt automatically to the medical treatment cycler selecting, and altering in real time, a rate of flow of fluid flow to and from, respectively, the outlet and inlet connectors, by receiving control signals therefrom. 
     
     
         25 . (canceled) 
     
     
         26 . The method of  claim 14 , wherein the first filter is adapted to permit albumin-bound molecules in blood to exchange with albumin in the albumin solution circulating in the medical treatment cycler predefined tubing set without convective exchange of albumin. 
     
     
         27 . A device for adapting a blood treatment cycler for the simultaneous clearance of albumin-bound molecules and solutes from blood, comprising:
 a medical treatment cycler configured to balance ingoing and outgoing flows of a medical treatment fluid and adapted to provide a selectable difference between ingoing and outgoing flows, the medical treatment cycler being configured to receive and interoperate with a predefined disposable tubing set with a first filter and fluid inlet and outlet connectors for a balanced medical treatment fluid;   a supplemental fluid management system having a second filter and connectable to the inlet and outlet connectors;   the supplemental fluid management system being configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector;   the supplemental fluid management system being configured to permit replacement fluid to be drawn by the medical treatment cycler at a rate determined by the medical treatment cycler without the use of a pump, the supplemental fluid management system being further configured to prevent a siphoning of the replacement fluid in the event of a cessation of flow to the outlet connector.   
     
     
         28 . The device of  claim 27 , wherein the medical treatment cycler is adapted for performing at least one of dialysis, hemofiltration, and hemodiafiltration. 
     
     
         29 . (canceled) 
     
     
         30 . The device of  claim 27 , wherein the medical treatment cycler is configured to generate a flow rate from the outlet port that is higher than a flow rate to the inlet port, the difference being selectable by a user, and the supplemental fluid management system being configured to adapt automatically to the medical treatment cycler selecting to these flow rates and changing selections thereof made by the medical treatment cycler. 
     
     
         31 . The device of  claim 27 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by providing a larger or smaller quantity of electrolyte solution. 
     
     
         32 . The device of  claim 27 , wherein the supplemental fluid management system is configured to automatically respond to an imbalance between rates of flow between the inlet and outlet connectors by passively permitting a larger or smaller quantity of electrolyte solution to be drawn by the medical treatment cycler from a source of electrolyte provided by the supplemental fluid management system. 
     
     
         33 . The device of  claim 27 , wherein the supplemental fluid management system is configured to clear solutes from a solution received at the outlet connector and to supply solute-cleared fluid to the inlet connector by performing diffusion-based clearance, convection-based clearance, or combination of diffusion-based and convection-based clearance. 
     
     
         34 . (canceled) 
     
     
         35 . The device of  claim 27 , wherein the supplemental fluid management system includes an albumin filter that removes toxins from albumin. 
     
     
         36 . The device of  claim 35 , wherein the albumin filter includes an adsorbent. 
     
     
         37 . (canceled)