Ureteral and Bladder Catheters and Methods of Inducing Negative Pressure to Increase Renal Perfusion

Abstract

Ureteral catheters are provided including a drainage lumen including a distal portion configured to be positioned in a patient's kidney, renal pelvis and/or in the ureter adjacent to the renal pelvis for receiving fluid from a patient's kidney and a proximal portion for draining the fluid from the distal portion, the distal portion including a coiled retention portion including: at least a first coil having a first diameter; at least a second coil having a second diameter, the first diameter being less than the second diameter, the second coil being closer to an end of the distal portion of the drainage lumen than the first coil; and one or more perforations on a sidewall of the coiled retention portion of the distal portion of the drainage lumen for permitting fluid flow into the drainage lumen, wherein the proximal portion of the drainage lumen is essentially free of or free of perforations.

What is claimed is: 
     
         1 . A ureteral catheter, comprising:
 a drainage lumen comprising a distal portion configured to be positioned in a patient's kidney, renal pelvis and/or ureter and a proximal portion for draining fluid from the distal portion, the distal portion comprising a retention portion comprising at least two coils, each of the at least two coils comprising a radially inwardly facing side comprising at least one drainage port and an outwardly facing side which is essentially free or free of drainage ports.   
     
     
         2 . The ureteral catheter according to  claim 1 , wherein the at least two coils comprise a first coil and a second coil. 
     
     
         3 . The ureteral catheter according to  claim 2 , wherein the radially inwardly facing side of the first coil comprises a plurality of drainage ports. 
     
     
         4 . The ureteral catheter according to  claim 2 , wherein the radially inwardly facing side of the second coil comprises a plurality of drainage ports. 
     
     
         5 . The ureteral catheter according to  claim 2 , wherein a total surface area of drainage port(s) on the radially inwardly facing side of the first coil is greater than a total surface area of drainage port(s) on the outwardly facing side of the first coil. 
     
     
         6 . The ureteral catheter according to  claim 2 , wherein a total surface area of drainage port(s) on the radially inwardly facing side of the second coil is greater than a total surface area of drainage port(s) on the outwardly facing side of the second coil. 
     
     
         7 . The ureteral catheter according to  claim 1 , wherein the retention portion further comprises a third coil closer to an end of the distal portion of the drainage lumen than a second coil of the at least two coils. 
     
     
         8 . The ureteral catheter according to  claim 1 , wherein the drainage port(s) on the radially inwardly facing sides of the at least two coils of the drainage lumen permit fluid flow upon application of negative pressure through the catheter. 
     
     
         9 . The ureteral catheter according to  claim 1 , wherein the retention portion is configured to establish an outer periphery or protective surface area that inhibits mucosal tissue from occluding the at least one drainage port(s) upon application of negative pressure through the catheter. 
     
     
         10 . The ureteral catheter according to  claim 1 , wherein the retention portion of the drainage lumen further comprises an open distal end for permitting fluid flow into the drainage lumen. 
     
     
         11 . The ureteral catheter according to  claim 1 , wherein the diameter of the at least two coils increases toward a distal end of the drainage lumen, resulting in a helical structure having a tapered or partially tapered configuration. 
     
     
         12 . The ureteral catheter according to  claim 1 , wherein the diameter of each of the at least two coils is the same. 
     
     
         13 . The ureteral catheter according to  claim 1 , wherein one or more ports are circular. 
     
     
         14 . The ureteral catheter according to  claim 1 , wherein one or more ports are non-circular. 
     
     
         15 . A system for inducing negative pressure in a portion of a urinary tract of a patient, the system comprising:
 (a) at least one ureteral catheter of  claim 1 ; and   (b) a bladder catheter comprising a distal portion configured for insertion within the patient's bladder and a proximal portion configured to transmit negative pressure into the kidney, which in turn causes fluid from the kidney to be drawn into and through the ureteral catheter, then through the bladder catheter, and then outside of the patient's body.   
     
     
         16 . A system for inducing negative pressure in a portion of a urinary tract of a patient, the system comprising:
 a ureteral catheter of  claim 1 ; and   a negative pressure source for application of negative pressure through the ureteral catheter, which in turn causes fluid from the kidney to be drawn into the ureteral catheter, and then outside of the patient's body.   
     
     
         17 . The system according to  claim 16 , wherein the negative pressure source comprises a pump. 
     
     
         18 . The system according to  claim 16 , wherein the negative pressure source comprises a vacuum source external to the patient's body for application and regulation of the negative pressure. 
     
     
         19 . The system according to  claim 18 , wherein the vacuum source is selected from the group consisting of a wall suction source, vacuum bottle, and manual vacuum source. 
     
     
         20 . The system according to  claim 16 , further comprising one or more physiological sensors configured to detect at least one physical parameter of the patient. 
     
     
         21 . The system according to  claim 16 , wherein the at least one physical parameter comprises one or more of volume of urine collected, urine composition, urine protein concentration, blood composition or blood flow. 
     
     
         22 . The system according to  claim 20 , wherein the at least one physical parameter of blood composition comprises one or more of hematocrit ratio, analyte concentration, protein concentration, or creatinine concentration. 
     
     
         23 . The system according to  claim 20 , wherein the at least one physical parameter of blood flow comprises one or more of blood pressure or blood flow velocity. 
     
     
         24 . The system according to  claim 20 , wherein the one or more physiological sensors comprise one or more of pulse oximetry sensor(s), blood pressure sensor(s), heart rate sensor(s), respiration sensor(s), capnography sensor(s), glucose sensor(s), blood velocity sensor(s), hemoglobin sensor(s), hematocrit sensor(s), protein sensor(s), creatinine sensor(s), analyte sensor(s), capacitance sensor(s), optical spectroscopy sensor(s) or combinations thereof. 
     
     
         25 . A kit for inducing negative pressure in a portion of a urinary tract of a patient, the kit comprising:
 one or two ureteral catheters according to  claim 1 ; and   a pump external to the patient's body for application of negative pressure through the ureteral catheter, which in turn causes fluid from the kidney to be drawn into the ureteral catheter, through the ureteral catheter, and then outside the patient's body.   
     
     
         26 . A method for inducing negative pressure in a portion of a urinary tract of a patient, the method comprising:
 deploying a ureteral catheter according to  claim 1  into a kidney, renal pelvis and/or ureter of a patient; and   applying negative pressure to the proximal end of the ureteral catheter to induce negative pressure in a portion of the urinary tract of the patient to remove fluid from the patient.