Renal Failure Treatment System with Reduced Time between Treatments

Abstract

The renal failure treatment system (10) includes: a fresh dialysis fluid (which may be flexible) tube (72) having a connector (72a) for connection to a dialyzer (102); a used dialysis fluid (which may be flexible) tube (74) having a connector (74a) for connection to the dialyzer (102); a dialysis fluid circuit (30) including: a fresh dialysis fluid line (70), a used dialysis fluid line (56), at least one of (i) a first disinfection device (90a) positioned between the fresh dialysis fluid line (70) and the fresh dialysis fluid tube (72) or (ii) a second disinfection device (90c) positioned between the used dialysis fluid line (70) and the used dialysis fluid tube (74), and a recirculation circuit that extends to (i) a first machine connector (28a) for mating with the connector (72a) of the fresh dialysis fluid tube (72) during local disinfection and (ii) a second machine connector (28c) for mating with the connector (74a) of the used dialysis fluid tube (74) during local disinfection; and a control unit (20) configured to energize the first or second disinfection device (90a, 90b) during local disinfection.

Description

Technical Field

[0001] The present disclosure generally relates to medical fluid therapy and, more particularly, to systems employing a medical fluid therapy machine for treating multiple patients in a day. Background Art

[0002] Hemodialysis (“HD”) typically uses diffusion to remove waste from a patient's blood. Diffusion occurs across a semipermeable dialyzer between the blood and an electrolyte dialysis solution. Hemofiltration (“HF”) is an alternative renal replacement therapy that relies on the convective transport of toxins from the patient's blood. This treatment is achieved by adding replacement fluid or substitution fluid (typically ten to ninety liters of such fluid) to the extracorporeal circuit during the treatment. During an HF treatment, the replacement fluid and the fluid that accumulates in the patient during the treatment are ultrafiltered, providing a convective transport mechanism that is particularly beneficial in removing medium and large molecules (in hemodialysis, a small amount of waste is removed along with the fluid obtained between dialysis sessions; however, the solutes dragged out from the removal of this ultrafiltrate are typically not sufficient to provide convective clearance).

[0003] Hemodiafiltration (“HDF”) is a treatment modality that combines convective clearance and diffusive clearance. Similar to standard hemodialysis, HDF passes a dialysis fluid through a dialyzer, providing diffusive clearance. Additionally, a substitution solution is provided directly to the extracorporeal circuit, providing convective clearance.

[0004] The above modalities are provided by dialysis machines. These machines can be set up in a center or in the patient's home. Dialysis machines set up in a center are used multiple times a day for multiple patients and are thus disinfected between treatments. There are different processes for disinfecting dialysis machines using different cleaning agents and / or heat disinfection. These techniques for disinfecting the entire dialysis fluid circuit take a long time. Many dialysis clinics require a short time between treatments. When a dialysis machine is down between treatments, patients cannot be dialyzed. Additionally, downtime typically means nursing time. When dialysis treatment is running smoothly, nurses do not have to constantly monitor the machine and can leave to perform other tasks. Nursing time is also expensive.

[0005] Accordingly, there is a need for reducing downtime between treatments for renal failure therapies as much as possible. Summary of the Invention

[0006] The present disclosure provides renal failure treatment systems and methods that perform hemodialysis (“HD”), hemofiltration (“HF”), hemodiafiltration (“HDF”), isolated ultrafiltration (“UF”), slow continuous ultrafiltration (“SCUF”), continuous renal replacement therapy (“CRRT”), continuous venovenous hemodialysis (“CVVHD”), continuous venovenous hemofiltration (“CVVH”), and / or continuous venovenous hemodiafiltration (“CVVHDF”). Thus, as used herein “renal failure treatment” is intended to include any one or more or all of the above modalities.

[0007] The present disclosure includes multiple embodiments, each seeking to reduce the amount of downtime between renal failure treatment machine treatments in a center. Currently, the disinfection of the machine is the longest procedure that occurs between treatments. One reason for this is that the entire dialysis circuit is sterile. Embodiments of the present disclosure take advantage of the fact that only the flexible dialysis fluid tubes leading from the machine to the dialyzer must be disinfected between treatments. Although there are flexible tubes located within the machine, these tubes, along with the non-flexible tubes located within the machine, are isolated from the dialyzer enough such that they do not need to be disinfected between treatments. Embodiments presented herein include various solutions for performing local disinfection on such tubes that (i) consume less time and / or (ii) are performed during an ongoing treatment rather than after a treatment.

[0008] The various solutions include:

[0009] (i) placing disinfection equipment, such as UV disinfection equipment, at the ends of each flexible-to-dialyzer dialysis tube, (ii) providing heated dialysis tubes, e.g., via resistive heating elements positioned along and / or within the tubes, and (iii) providing two sets of dialysis tubes for parallel use, where one set is being disinfected while the second set is used for treatment.

[0010] A first embodiment of the present disclosure uses all three of the solutions listed above. Here, a first set of self-heating dialysis fluid tubes is provided for use during a first treatment, while a second set of self-heating dialysis fluid tubes is provided for use during a second treatment. Before the first treatment (e.g., at the end of a treatment day or at the start of the next treatment day), the first ends of all four self-heating dialysis fluid tubes are positioned through corresponding through ports of the dialysis machine and inserted into corresponding UV disinfection equipment. The second ends of the four dialysis fluid tubes are inserted into connectors at the dialysis machine to complete the entire disinfection circuit. Then, a water flow heated by the heater of the dialysis machine flows through the entire dialysis fluid circuit, including the four tubes of the first set of dialysis fluid tubes and the second set of dialysis fluid tubes, to disinfect both the first set of tubes and the second set of tubes. During this operation, the heating elements for the four self-heating tubes and the four UV disinfection equipment may be powered on or off.

[0011] During the first treatment of the day, the second end of the dialysis fluid tube of the first group is disconnected from the dialysis machine connector and inserted into the dialyzer to perform the first treatment, during which its heater is not powered on. The second group of dialysis fluid tubes remains inserted into the dialysis machine and has been disinfected, so its heater can be powered on or off.

[0012] The following paragraphs describe why "cleaning fluid" as used herein can be water, dialysis fluid or, if desired, a different dedicated cleaning fluid. Before removing the second end of the first group of tubes from its connector, the first group of tubes is perfused with dialysis fluid to prepare for the first treatment, such that the water used for disinfection is removed to the drain. During this time, the second group of tubes can also be perfused or not perfused with dialysis fluid, such that the water used for disinfecting the second group of tubes can be discarded or retained respectively.

[0013] Regarding the UV disinfection device, during the first treatment, any of the following possible scenarios can be set: no UV power on, UV disinfection device only for the first group, UV disinfection device only for the second group, or UV disinfection device for both the first and second groups. In a preferred embodiment, during the first treatment, both groups of UV disinfection devices are powered on.

[0014] During the second treatment of the day, (i) the second end of the dialysis fluid tube of the first group is disconnected from the dialyzer and inserted into the dialysis machine connector to complete the first disinfection path, and (ii) during the second treatment, the tube heater is powered on to disinfect the first group of tubes. It should be noted that it is not necessary to move the dialysis fluid inside the heated tube for disinfection, since disinfection occurs due to the heating of the static dialysis fluid inside the tube. The UV disinfection device for the dialysis fluid tube of the first group is powered on during disinfection.

[0015] If the tubes of the second group have not been perfused with dialysis fluid and still contain water, before the second treatment, the second group of tubes is perfused with dialysis fluid to prepare for the second treatment, and the disinfected water is sent to the drain. After perfusion (if necessary), the second end of the dialysis fluid tube of the second group is disconnected from the dialysis machine connector and inserted into the dialyzer to perform the second treatment, during which its heater is not powered on. During the treatment, the UV disinfection device for the dialysis fluid tube of the second group can be powered on or off. In a preferred embodiment, during the second first treatment, both groups of UV disinfection devices are powered on.

[0016] During the third treatment period, the movement of the first set of self-heating dialysis fluid tubes and the second set of self-heating dialysis fluid tubes and the operations associated with the first set of self-heating dialysis fluid tubes and the second set of self-heating dialysis fluid tubes are in the reverse order of that just described for the second treatment. Here, the second end of the dialysis fluid tubes of the second set is disconnected from the dialyzer and inserted into the dialysis machine connector to complete the second disinfection path.

[0017] The exchange of the first set of tubes and the second set of tubes (one set for treatment while the other set is disinfected for the next treatment) just described is repeated until the treatment day is completed. The delay between treatments due to disinfection can be effectively reduced to zero (assuming only dialysis fluid is used for disinfection and thus there is no perfusion or rinsing), i.e., reduced to the time required to replace the first set of tubes and the second set of tubes. In an embodiment, when the tubes are used for treatment, the UV disinfection device is powered on to help prevent bacteria from migrating upward into the tubes (even if such migration occurs against the flow direction and at a flow rate of 300 ml / min).

[0018] Consider setting a rinsing sequence in which each set of the dialysis fluid tubes is rinsed with purified water after being connected to the dialysis machine connector but before being disinfected during the subsequent treatment period, and each set of the dialysis fluid tubes has just been connected to the dialyzer for the previous treatment. For this purpose, in one embodiment, purified water is used to push the dialysis fluid to the discharge section. After the subsequent treatment, the set of water-containing tubes is perfused with fresh dialysis fluid for the next treatment.

[0019] In a second embodiment of the present disclosure, self-heating tubes are not used. However, a UV disinfection device and two sets of dialysis fluid tubes are used. Here, the fresh dialysis fluid pipeline and the used or spent dialysis fluid pipeline are each provided with a pipe that forms a fresh loop recirculation loop and a used loop recirculation loop, which allows each flexible dialysis fluid tube to become part of the recirculation loop. Each recirculation loop includes a recirculation pump that circulates a cleaning fluid dedicated to disinfection (e.g., water or dialysis fluid depending on the perfusion and / or rinsing disclosed above) through a UV disinfection device that is interchangeably connected to the flexible dialysis tube. The flow of water or dialysis fluid removes bacteria from the inner wall of the recirculation loop. The removed bacteria are killed when flowing through the UV disinfection device.

[0020] Similar to the first embodiment, the first dialysis fluid tubes and the second set of dialysis fluid tubes are exchanged or replaced, one set for treatment while the other set is connected to the fresh loop recirculation loop and the used loop recirculation loop and disinfected for the next treatment until the treatment day is completed. The delay between treatments due to disinfection can again be effectively reduced to zero (assuming only dialysis fluid is used for disinfection and thus there is no perfusion or rinsing), i.e., reduced to the time required to replace the first set of tubes and the second set of tubes.

[0021] In an alternative embodiment of the second embodiment, the fresh circuit recirculation loop and the used circuit recirculation loop are provided with small heaters. These small heaters help the UV disinfection device to disinfect the flexible dialysis tube. Any embodiment of the second embodiment may employ any of the perfusion variations discussed above and may or may not flush the dialysis fluid with purified water before disinfection.

[0022] Similar to the first embodiment, the UV disinfection device in the second embodiment can be powered on while the tube is being used for treatment to help prevent bacteria from migrating upward into the tube (even if such migration would occur against the flow direction and at a flow rate of 300 ml / min).

[0023] A third embodiment of the present disclosure uses a self-heating tube and a UV disinfection device, but does not provide or use two sets of flexible dialysis fluid tubes. Thus, disinfection in the third embodiment does not occur in parallel with treatment. Here, the fresh self-heating dialysis fluid tube and the used self-heating dialysis fluid tube are removed from the dialyzer after treatment and inserted into connectors located at the machine to complete a disinfection circuit that begins in the fresh dialysis fluid line, extends through the fresh self-heating tube, the used self-heating tube, and the used dialysis fluid line to the discharge section.

[0024] Once the disinfection circuit is completed, the heating elements for the fresh self-heating tube and the used self-heating tube and the UV disinfection device are powered on to provide local disinfection of the flexible dialysis fluid tube. The local disinfection greatly reduces the disinfection time such that the downtime due to disinfection after treatment is not the longest factor.

[0025] Similar to the first and second embodiments, the UV disinfection device in the third embodiment can be powered on while the tube is being used for treatment to help prevent bacteria from migrating upward into the tube (even if such migration would occur against the flow direction).

[0026] A fourth embodiment of the present disclosure is very similar to the third embodiment, but instead of using a self-heating tube, a small auxiliary heater is provided in the fresh dialysis fluid line upstream of the flexible fresh dialysis fluid tube. Disinfection in the fourth embodiment likewise does not occur in parallel with treatment. Here, the fresh self-heating dialysis fluid tube and the used self-heating dialysis fluid tube are removed from the dialyzer after treatment and inserted into connectors located at the machine to complete a disinfection circuit that begins in the fresh dialysis fluid line, extends through the flexible fresh tube, the used flexible tube, and the used dialysis fluid tube to the discharge section.

[0027] Once the disinfection circuit is completed, the local auxiliary heater and the UV disinfection device are powered on to provide local disinfection of the flexible dialysis fluid tube. The local disinfection greatly reduces the disinfection time such that the downtime due to disinfection after treatment is not the longest factor.

[0028] Similar to the first to third embodiments, the UV disinfection device of the fourth embodiment can be powered on when the tube is used for treatment to help prevent bacteria from migrating upward into the tube (even if such migration occurs against the flow direction).

[0029] In a first aspect, which can be combined with any other aspect (or part thereof) described herein, a renal failure treatment system includes: a fresh dialysis fluid tube having a connector for connecting to a dialyzer; a used dialysis fluid tube having a connector for connecting to a dialyzer; a dialysis fluid circuit including: a fresh dialysis fluid line, a used dialysis fluid line, at least one disinfection device of (i) a first disinfection device positioned between the fresh dialysis fluid line and the fresh dialysis fluid tube or (ii) a second disinfection device positioned between the used dialysis fluid line and the used dialysis fluid tube, and a recirculation circuit extending to (i) a first machine connector and (ii) a second machine connector, the first machine connector being configured to mate with the connector of the fresh dialysis fluid tube during local disinfection, and the second machine connector being configured to mate with the connector of the used dialysis fluid tube during local disinfection; and a control unit configured to power on at least one of the first disinfection devices or at least one of the second disinfection devices during local disinfection to create a barrier against bacterial transport.

[0030] In a second aspect, which can be combined with any other aspect (or part thereof) described herein, the control unit is further configured to power on at least one of the first disinfection devices or at least one of the second disinfection devices during treatment.

[0031] In a third aspect, which can be combined with any other aspect (or part thereof) described herein, the fresh dialysis fluid tube and the used dialysis fluid tube are self-heating tubes configured to be powered on during local disinfection.

[0032] In a fourth aspect, which can be combined with any other aspect (or part thereof) described herein, the fresh dialysis fluid tube and the used dialysis fluid tube form a first set of dialysis fluid tubes, and the renal failure treatment system includes a second set of dialysis fluid tubes, and wherein the control unit is further configured to enable (i) a first treatment run when: the first set of dialysis fluid tubes or the second set of dialysis fluid tubes is connected to the dialyzer while the other set of dialysis fluid tubes of the first set of dialysis fluid tubes or the second set of dialysis fluid tubes undergoes local disinfection, and (ii) a second treatment run when: the disinfected set of dialysis fluid tubes in (i) is connected to the dialyzer while the set of dialysis fluid tubes used in the first treatment run in (i) undergoes local disinfection.

[0033] In a fifth aspect, which can be combined with any other aspect (or part thereof) described herein, the recirculation loop also extends to (i) a third machine connector and (ii) a fourth machine connector, the third machine connector being for mating with a connector of the second fresh dialysis fluid tube during local disinfection, and the fourth machine connector being for mating with a connector of the second used dialysis fluid tube during local disinfection.

[0034] In a sixth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system includes a third disinfection device and a fourth disinfection device, the third disinfection device being for operating with the second fresh dialysis fluid tube, and the fourth disinfection device being for operating with the second used dialysis fluid tube.

[0035] In a seventh aspect, which can be combined with any other aspect (or part thereof) described herein, the dialysis fluid circuit includes (i) a first three-way valve or a first pair of two-way valves and (ii) a second three-way valve or a second pair of two-way valves, the first three-way valve or the first pair of two-way valves being positioned and arranged to direct fresh dialysis fluid to the first disinfection device or the third disinfection device, and the second three-way valve or the second pair of two-way valves being positioned and arranged to receive used dialysis fluid from the second disinfection device or the fourth disinfection device.

[0036] In an eighth aspect, which can be combined with any other aspect (or part thereof) described herein, (i) the closed passage of the first three-way valve (94a) or the closed two-way valve of the first pair of two-way valves forms an end of a first static disinfection path, wherein the first disinfection device or the third disinfection device is positioned along the first static disinfection path, and (ii) the closed passage of the second three-way valve or the closed two-way valve of the second pair of two-way valves forms an end of a second static disinfection path, wherein the second disinfection device or the fourth disinfection device is positioned along the second static disinfection path.

[0037] In a ninth aspect, which can be combined with any other aspect (or part thereof) described herein, (i) the closed passage of the first three-way valve or the closed two-way valve of the first pair contributes to defining a first recirculation disinfection path, wherein the first disinfection device or the third disinfection device is positioned along the first recirculation disinfection path, and (ii) the closed passage of the second three-way valve or the closed two-way valve of the second pair forms an end of a second recirculation disinfection path, wherein the second disinfection device or the fourth disinfection device is positioned along the second recirculation disinfection path.

[0038] In a tenth aspect, which can be combined with any other aspect (or part thereof) described herein, at least one of the first recirculation disinfection path or the second recirculation disinfection path is provided with a pump.

[0039] In an eleventh aspect, which can be combined with any other aspect (or part thereof) described herein, at least one of the first recirculation disinfection path or the second recirculation disinfection path is provided with a disinfection heater.

[0040] In a twelfth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system includes a local disinfection heater positioned to operate with a fresh dialysis fluid line adjacent to the first disinfection device.

[0041] In a thirteenth aspect, which can be combined with any other aspect (or part thereof) described herein, at least one of the disinfection devices is a UV disinfection device.

[0042] In a fourteenth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system includes at least one straight-through port for receiving one of the dialysis fluid tubes in the dialysis fluid tubes.

[0043] In a fifteenth aspect, which can be combined with any other aspect (or part thereof) described herein, a renal failure treatment system includes: a blood treatment unit; a first fresh dialysis fluid tube having a connector for connecting to the blood treatment unit, forming a first set with a first used dialysis fluid tube having a connector for connecting to the blood treatment unit, a second fresh dialysis fluid tube having a connector for connecting to the blood treatment unit, forming a second set with a second used dialysis fluid tube having a connector for connecting to the blood treatment unit; and a control unit configured to cause (i) a first treatment to operate when: a first set of dialysis fluid tubes or a second set of dialysis fluid tubes is connected to the blood treatment unit while the other set of dialysis fluid tubes in the first set of dialysis fluid tubes or the second set of dialysis fluid tubes is undergoing local disinfection, and (ii) a second treatment to operate when: the disinfected set of dialysis fluid tubes in (i) is connected to the blood treatment unit while the set of dialysis fluid tubes used in the first treatment in (i) is undergoing local disinfection.

[0044] In a sixteenth aspect, which can be combined with any other aspect (or part thereof) described herein, at least one of the sets of dialysis fluid tubes undergoing local disinfection transports dialysis fluid during local disinfection.

[0045] In a seventeenth aspect, which can be combined with any other aspect (or part thereof) described herein, at least one of the sets of dialysis fluid tubes undergoing local disinfection is rinsed with purified water before local disinfection.

[0046] In an eighteenth aspect, which can be combined with any other aspect (or part thereof) described herein, at least one set of the group of dialysis fluid tubes connected to the blood treatment unit is perfused with dialysis fluid before being connected to the blood treatment unit.

[0047] In a nineteenth aspect, which can be combined with any other aspect (or part thereof) described herein, the fresh dialysis fluid tube is a flexible tube and / or the used dialysis fluid tube is a flexible tube.

[0048] In a twentieth aspect, which can be combined with any other aspect (or part thereof) described herein, the recirculation circuit includes (i) a first machine connector for mating with the connector of the fresh dialysis fluid flexible tube during local disinfection, and (ii) a second machine connector for mating with the connector of the used dialysis fluid flexible tube during local disinfection.

[0049] In a twenty - first aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system further includes a first disinfection device and a second disinfection device.

[0050] In a twenty - second aspect, which can be combined with any other aspect (or part thereof) described herein, the control unit is configured to energize both the first disinfection device and the second disinfection device during local disinfection to create a barrier against bacterial transmission.

[0051] In a twenty - third aspect, which can be combined with any other aspect described herein, the fresh dialysis fluid line is provided with a fresh dialysis fluid pump, and the control unit is configured to drive the fresh dialysis fluid pump to pump fluid towards the fresh dialysis fluid tube.

[0052] In a twenty - fourth aspect, which can be combined with any other aspect (or part thereof) described herein, the used dialysis fluid line is provided with a used dialysis fluid pump, and the control unit is configured to drive the used dialysis fluid pump to pump fluid away from the used dialysis fluid tube.

[0053] In a twenty - fifth aspect, which can be combined with any other aspect described herein, the renal failure treatment system further includes a bypass line and at least one valve for selectively opening and closing the bypass line, the bypass line selectively connecting the fresh dialysis fluid line to the used dialysis fluid line.

[0054] In a twenty - sixth aspect, which can be combined with any other aspect described herein, the fresh dialysis fluid line is provided with a conductivity sensor or a concentration sensor, particularly a conductivity unit, to measure the characteristics of the fresh dialysis fluid flowing therein.

[0055] In a twenty-seventh aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system further includes an ultrafiltration ("UF") system to monitor the difference between the fresh dialysis fluid flowing in the fresh dialysis fluid line and the used dialysis fluid flowing in the used dialysis fluid line.

[0056] In a twenty-eighth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system further includes a housing, wherein the fresh dialysis fluid tube and / or the used dialysis fluid tube extend from the housing.

[0057] In a twenty-ninth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system further includes a blood treatment unit such as a dialyzer, during treatment, the connector of the fresh dialysis fluid tube is attached to the inlet port of the blood treatment unit, and the connector of the used dialysis fluid flexible tube is attached to the outlet port of the blood treatment unit.

[0058] In a thirtieth aspect, which can be combined with any other aspect (or part thereof) described herein, the first disinfection device and / or the second disinfection device includes a heater for heating the fresh and / or used dialysis fluid flexible tube during local disinfection.

[0059] In a thirty-first aspect, which can be combined with any other aspect (or part thereof) described herein, a first static disinfection path is included between the closed passage of the first three-way valve or the first pair of closed two-way valves and the closed passage of the second three-way valve or the second pair of closed two-way valves, and the fluid contained in the first static disinfection path is prevented from circulating.

[0060] In a thirty-second aspect, which can be combined with any other aspect (or part thereof) described herein, the first recirculation disinfection path is provided with an additional valve, the additional valve is configured to be open to allow fluid to recirculate along the first recirculation disinfection path, in particular, wherein the closed passage of the additional valve prevents fluid from recirculating in the first recirculation disinfection path.

[0061] In a thirty-third aspect, which can be combined with any other aspect (or part thereof) described herein, wherein the second recirculation disinfection path is provided with another valve, the another valve is configured to be open to allow fluid to recirculate along the second recirculation disinfection path, in particular, wherein the closed passage of the another valve prevents fluid from recirculating in the second recirculation disinfection path.

[0062] In a thirty-fourth aspect, which can be combined with any other aspect (or part thereof) described herein, the renal failure treatment system further includes a blood treatment unit having a blood chamber and a fluid chamber separated by a semipermeable membrane, the fluid chamber including an inlet port and an outlet port, wherein, during treatment, the inlet port is connected to a connector of a fresh dialysis fluid tube and the outlet port is connected to a connector of a used dialysis fluid tube.

[0063] In a thirty-fifth aspect, which can be combined with any other aspect (or part thereof) described herein, the blood treatment unit includes a dialyzer.

[0064] In a thirty-sixth aspect, which can be combined with any other aspect (or part thereof) described herein, the control unit is configured to cause (i) a first extracorporeal blood treatment to operate when a first set of dialysis fluid tubes or a second set of dialysis fluid tubes is connected to the blood treatment unit while the other set of the first set of dialysis fluid tubes or the second set of dialysis fluid tubes is undergoing local disinfection, and (ii) a second extracorporeal blood treatment to operate when the set of dialysis fluid tubes that has been disinfected in (i) is connected to the blood treatment unit while the set of dialysis fluid tubes used in the first treatment in (i) is undergoing local disinfection.

[0065] In a thirty-seventh aspect, Figures 1 to 10 any features, functions, and alternatives described in any one or more of Figures 1 to 10 can be combined with any features, functions, and alternatives described in any other drawing in

[0066] In view of the above aspects and the teachings herein, an advantage of the present disclosure is to provide hemodialysis, hemofiltration, or hemodiafiltration systems and methods that reduce machine downtime.

[0067] Another advantage of the present disclosure is to provide hemodialysis, hemofiltration, or hemodiafiltration systems and methods that provide local disinfection.

[0068] Another advantage of the present disclosure is to provide hemodialysis, hemofiltration, or hemodiafiltration systems and methods that help prevent the migration of bacteria.

[0069] Additional features and advantages are described in the Detailed Description section and the drawings that follow, and will be apparent from the Detailed Description section and the drawings. The features and advantages described herein are not all-inclusive, and in particular, given the drawings and description, many additional features and advantages will be apparent to those of ordinary skill in the art. Additionally, any particular embodiment need not have all of the advantages listed herein, and individual advantageous embodiments are expressly contemplated as being separately claimed. Further, it should be noted that the language used in the specification has been selected primarily for readability and guidance purposes, and thus does not limit the scope of the inventive subject matter. Description of the Drawings

[0070] Figure 1 is a schematic diagram of an embodiment of a kidney treatment system modified according to the local disinfection structure described herein.

[0071] Figure 2 is a front view of an embodiment of a hemodialysis blood set that can be used with Figure 1 the kidney treatment system and any local disinfection structure described herein.

[0072] Figure 3 is a schematic diagram of a portion of a dialysis fluid circuit according to a first local disinfection embodiment of the present disclosure in a first state.

[0073] Figure 4 is a cross-sectional view of an embodiment of a self-heating tube for the present disclosure.

[0074] Figure 5 is a schematic diagram of a portion of a dialysis fluid circuit according to a first local disinfection embodiment of the present disclosure in a second state.

[0075] Figure 6 is a schematic diagram of a portion of a dialysis fluid circuit according to a first local disinfection embodiment of the present disclosure in a third state.

[0076] Figure 7 is a schematic diagram of a portion of a dialysis fluid circuit according to a second local disinfection embodiment of the present disclosure.

[0077] Figure 8 is a schematic diagram of a portion of a dialysis fluid circuit according to a variant of a second local disinfection embodiment of the present disclosure.

[0078] Figure 9 is a schematic diagram of a portion of a dialysis fluid circuit according to a third local disinfection embodiment of the present disclosure.

[0079] Figure 10 is a schematic diagram of a portion of a dialysis fluid circuit according to a fourth local disinfection embodiment of the present disclosure. Detailed implementation manners

[0080] Now referring to the drawings, and in particular Figure 1 , system 10 shows a structure for use with an embodiment of local disinfection of the present disclosure. System 10 includes a machine 12 having a housing. Machine 12 houses a dialysis fluid circuit 30 described in detail below. Machine 12 also supports a user interface 14 that allows a nurse or other operator to interact with system 10. User interface 14 may have a monitor screen 15 that can be operated in combination with a touchscreen overlay, electromechanical buttons (e.g., membrane switches), or both. User interface 14 is in electrical communication with at least one processor 16 and at least one memory 18. At least one processor 16 and at least one memory 18 also electrically interact with the pumps, valves, and sensors described herein (e.g., the pumps, valves, and sensors of dialysis fluid circuit 30) and, where appropriate, control the pumps, valves, and sensors described herein (e.g., the pumps, valves, and sensors of dialysis fluid circuit 30). At least one processor 16 and at least one memory 18 are collectively referred to herein as control unit 20. The dashed lines extending from control unit 20 lead to pumps, valves, sensors, heaters, and other electrical devices, as indicated by similar dashed lines leading from pumps, valves, sensors, heaters, etc.

[0081] Dialysis fluid circuit 30 includes a purified water pipeline 32, an A concentrate pipeline 34, and a bicarbonate B concentrate pipeline 36. Purified water pipeline 32 receives purified water from a purified water device or source 22. Any one or more processes can be used to purify the water, such as reverse osmosis, carbon filtration, ultraviolet radiation, electrodeionization (“EDI”), and / or ultrafiltration. A suitable device or source 22 for purifying water is sold as a WRO300H TM water purification machine.

[0082] An A concentrate pump 38 (such as a peristaltic pump, piston pump, gear pump, or diaphragm pump) pumps A concentrate from an A concentrate source 24 (which can be a liquid source) into purified water pipeline 32 via A concentrate pipeline 34. Conductivity unit 40 measures the conductivity effect of the A concentrate on the purified water and sends a signal to control unit 20, which uses this signal to appropriately dispense the A concentrate by controlling A concentrate pump 38. The A conductivity signal is temperature compensated via a reading from temperature sensor 42.

[0083] The B concentrate pump 44 (such as a peristaltic pump, piston pump, gear pump, or membrane pump) pumps the B concentrate (e.g., a bicarbonate substance) from the B concentrate source 26 (which can be a dry powder concentrate source) via the B concentrate line 36 into the purified water line 32. The conductivity unit 46 measures the conductivity effect of the B concentrate on the purified water / A concentrate mixture and sends a signal to the control unit 20, which uses this signal to appropriately dispense the B concentrate by controlling the B concentrate pump 44. The B conductivity signal is also temperature compensated via readings from the temperature sensor 48.

[0084] The expansion tank 50 degasses the purified water before receiving the concentrate, removing air bubbles from the water that has been degassed in the chamber 51 by the degassing pump 53 located below the expansion tank 50. The heater 52, controlled by the control unit 20, heats the purified water to body temperature, e.g., 37 °C. Thus, the fluid leaving the conductivity unit 46 is freshly prepared dialysis fluid, appropriately degassed and heated, and suitable for delivery to the dialyzer for treatment. The fresh dialysis fluid pump 54 (such as a peristaltic pump, piston pump, gear pump, or membrane pump) delivers the fresh dialysis fluid to the dialyzer (see Figure 2 ). The control unit 20 controls the fresh dialysis fluid pump 54 to deliver the fresh dialysis fluid to the dialyzer at a specified flow rate.

[0085] The used or spent dialysis fluid pump 58, located along the drain line 56, pumps the used or spent dialysis fluid (including the patient's ultrafiltration fluid) from the dialyzer to the drain section 60. The control unit 20 controls the spent dialysis fluid pump 58 to withdraw the used dialysis fluid from the dialyzer at a specified flow rate. The pressure sensor 62 senses the pressure of the used dialysis fluid in the drain line 56 and sends a corresponding pressure signal to the control unit 20. The blood leak detector 64 (such as an optical detector) looks for the presence of blood in the drain line 56, e.g., to detect whether the dialyzer membrane has a tear or leak. The heat exchanger 66 recovers heat from the used dialysis fluid leaving the dialysis fluid circuit 30 to the drain section 60 and preheats the purified water traveling towards the heater 52 to save energy.

[0086] The UF system 96 monitors the fresh dialysis fluid flowing to the dialyzer ( Figure 2, and / or as replacement fluid flowing directly to the blood set) and the flow rate of the used fluid flowing out of the dialyzer. The UF system 96 includes a fresh flow sensor and a used flow sensor as part of the UF system control, which respectively send signals indicating the fresh dialysate flow rate and the used dialysate flow rate to the control unit 20. The control unit 20 uses the signals to set the used dialysate pump 58 to pump faster than the fresh dialysate pump 54 by a predetermined amount to remove a specified amount of ultrafiltration ("UF") from the patient during the treatment. A second set of fresh flow sensors and used flow sensors can be provided as part of the UF system protection, which are redundant sensors to ensure the normal operation of the UF system 96.

[0087] The bypass line 68 allows fresh dialysate to flow from the fresh dialysate line 70 to the drain line 56 without contacting the dialyzer. The fresh dialysate tube 72 extends from the housing of the machine 12 and carries fresh dialysate from the fresh dialysate line 70 to the dialyzer. The used dialysate tube 74 also extends from the housing of the machine 12 and carries the used dialysate from the dialyzer to the drain line 56.

[0088] Figure 1 The system 10 provides a plurality of valves 92 (collectively referred to as valves 92a to 92f) under the control of the control unit 20 to selectively control the pre-treatment filling procedure or perfusion procedure, the dialysis treatment, the disinfection sequence described herein, and other sequences and procedures involving the system 10. In particular, the valve 92a selectively opens and closes the fresh dialysate line 70, and the valve 92b selectively opens and closes the bypass line 68. The valve 92c selectively opens and closes the fresh disinfection recirculation line 76. The valve 92d selectively opens and closes the used disinfection recirculation line 78. The valve 92e selectively opens and closes the drain line 56 to the drain section 60. If necessary, a second drain valve 92 can be provided along the drain line 56 downstream of the recirculation line 78 distal . The valve 92f selectively opens and closes the purification water line 32 to the purification water source 22.

[0089] It should be understood that Figure 1 the dialysate circuit 30 is simplified and may include other structures and functions not shown. In addition, the dialysate circuit 30 shows the hemodialysis ("HD") path. It is specifically contemplated to provide one or more ultrafilters in the fresh dialysate line 70 to produce replacement fluid for hemofiltration ("HF"). It is also specifically contemplated to provide one or more ultrafilters in one or more lines branched from the fresh dialysate line 70 to produce replacement fluid in addition to the fresh dialysate in the line 70 for hemodiafiltration ("HDF").

[0090] Now refer toFigure 2 , blood set 100 illustrates an embodiment of a blood set that can be used with system 10 and any local disinfection embodiment of the present disclosure. Blood set 100 includes a dialyzer 102 having a plurality of hollow fiber semipermeable membranes 104 that divide the dialyzer 102 into a blood compartment and a dialysate fluid compartment. During treatment, the dialysate fluid compartment is placed in fluid communication with the distal end 72a of the fresh dialysate fluid tube 72 and the distal end 74a of the used or spent dialysate fluid tube 74. In the local disinfection embodiments discussed below, the distal ends 72a and 74a are alternately and sealingly inserted into communication with Figure 1 the disinfection recirculation lines 76 and 78. It should be understood that for HF, replacement fluid flows directly from a replacement line (not shown) to one or both of the arterial line 106 and the venous line 108 of the blood set 100, while the fresh dialysate fluid line 70 is blocked so that fresh dialysate fluid does not flow to the dialyzer 102. For HDF, replacement fluid flows directly from a replacement line (not shown) to one or both of the arterial line 106 and the venous line 108 of the blood set 100, while the fresh dialysate fluid line 70 is opened so that fresh dialysate fluid additionally flows to the dialyzer 102.

[0091] An arterial pressure pod 110 located upstream of the blood pump 120 enables the arterial line pressure to be measured, while the venous line 108 includes a venous pressure pod 112 that enables the venous line pressure to be measured. The pressure pods 110 and 112 are attached to corresponding blood pressure sensors (not shown) mounted on the housing of the machine 12, and these blood pressure sensors respectively send arterial pressure signals and venous pressure signals to the control unit 20. The venous line 108 includes a venous drip chamber 114 that collects air from the patient's blood before the blood returns to the patient 116.

[0092] The arterial line 106 of the blood set 100 includes a portion that can operate with the blood pump 120, and the blood pump pumps blood at a desired flow rate under the control of the control unit 20. System 10 also provides a plurality of blood-side electronic devices that send signals to and / or receive commands from the control unit 20. For example, the control unit 20 commands the spring pinchclamps 122a and 122b to selectively open or close the arterial line 106 and the venous line 108, respectively. A blood volume sensor (“BVS”) 124 is located along the arterial line 106 upstream of the blood pump 120. An air detector 126 looks for air in the venous blood line 108.

[0093] First partial disinfection embodiment

[0094] Now refer to Figures 3 to 6, showing a first partial disinfection embodiment of system 10. In Figure 3 , system 10 has many components that are the same as those described above, including conductivity unit 46, fresh dialysis fluid pump 54, used dialysis fluid or drain line 56, used dialysis fluid pump 58, bypass line 68, and fresh dialysis fluid line 70. All reusable components are housed within renal failure treatment fluid machine 12. Here, fresh dialysis fluid line 70 is divided into fresh dialysis fluid line segments 70a and 70b, which extend to partial disinfection devices 90a and 90b respectively. In one embodiment, the partial disinfection devices are UV disinfection devices. Fresh dialysis fluid line segments 70a and 70b branch from fresh dialysis fluid line 70 via first three-way valve 94a.

[0095] In Figure 3 , the used or spent dialysis fluid line 56 is divided into used dialysis fluid line segments 56a and 56b, which extend to partial disinfection devices 90c and 90d respectively. In embodiments, these partial disinfection devices are UV disinfection devices. Used dialysis fluid line segments 56a and 56b branch from used dialysis fluid line 56 via second three-way valve 94b. When describing the order in the four partial disinfection embodiments, the valves are opened to allow flow in the direction of the arrows provided in the figures.

[0096] In an embodiment, partial disinfection devices 90a to 90d are UV disinfection devices, which can be, for example, PearlAqua MicroUVT TM disinfection devices provided by Aquisenset Technologies, Erlanger, KY 41018, USA. Other types of partial disinfection devices can alternatively use heat sterilization. However, heat disinfection devices may need to operate at high temperatures to provide partial disinfection, which will present problems related to subsequent cooling of the heated fluid and its impact on the fluid pressure. The vertical dashed lines extending through partial disinfection devices 90a to 90d represent sterile barrier SB, which shows that the goal of partial disinfection devices 90a to 90d is to help prevent bacteria from migrating to Figure 3 the left side in

[0097] Figure 3Also shown is that the chassis or front wall of the machine 12 of the renal failure treatment system 10 has been attached to four quick-disconnect bulkhead connectors 28a to 28d and straight-through ports 98a to 98d. The bulkhead connectors 28a to 28d cooperate with internal check valves for preventing fluid from flowing back into the flexible dialysis fluid tubes, and the straight-through ports 98a to 98d are for allowing the flexible dialysis fluid tubes to extend through the machine 12 to be semi-permanently connected to the local disinfection devices 90a to 90d.

[0098] Figure 3 Also shown is that the system 10 includes fresh recirculation line segments 86a and 86b, and used recirculation line segments 88a and 88b. Each recirculation line segment 86a, 86b, 88a, and 88b extends to the recirculation manifold line 80.

[0099] Figure 3 Also shown in a first local disinfection embodiment of the system 10 are two sets of self-heating flexible dialysis tubes 72,130a, 74,130b, 72,130c, and 74,130d. Each fresh dialysis flexible-to-dialyzer tube 72 is fitted with a quick-disconnect distal connector 72a, while each used dialysis-to-dialyzer flexible tube 74 is fitted with a quick-disconnect distal connector 74a. Each quick-disconnect distal connector 72a and 74a is configured to quickly connect to and release from the corresponding bulkhead connectors 28a to 28d and dialysis fluid ports of the dialyzer 102 ( Figure 2 ). Note that the self-heating flexible dialysis tubes 72,130a, 74,130b, 72,130c, and 74,130d extend into the machine 12 and up to the IV disinfection devices 90a to 90d. The connectors 72a and 74a are also configured such that they can also be disinfected.

[0100] Figure 4 Shown in combination Figure 3 、 Figure 5 、 Figure 6 and Figure 9A possible construction of any self-heating tube used. Here, flexible dialysis tubes 72 and 74 are each inserted within reusable, closely fitting, flexible heating sleeves 130a through 130d. The flexible heating sleeves 130a through 130d include an outer flexible insulating layer 132 (e.g., fabric) for protecting the user from hot touch and for directing heat inwardly to the water or dialysis fluid flowing through the tubes. A flexible resistive heating layer 134 (e.g., resistive coils) is located between the insulating layer 132 and a flexible thermally conductive layer 136 (e.g., thin aluminum or copper strip) for evenly distributing heat around the flexible dialysis tubes 72 and 74. If desired, a flexible medical safety coil 138 (e.g., stainless steel coil) can be inserted within the flexible dialysis tubes 72 and 74 and also extend along the outer side of the tubes to contact the conductive layer 136 to assist in distributing heat within the tubes. Electrical leads providing voltage V+ and V- to the flexible resistive heating layer 134 can extend to a plug and be plugged into the machine 12 or elsewhere. The flexible heating sleeves 130a through 130d are configured to bring the water or dialysis fluid within the flexible dialysis tubes 72 and 74 to a desired disinfection temperature, e.g., 80°C, for disinfection.

[0101] Figure 3 Shown is that prior to a first treatment (e.g., at the end of a treatment day or at the start of the next treatment day), the first ends of all four self-heating dialysis fluid tubes 72,130a, 74,130b, 72,130c, and 74,130d are positioned to pass through respective through ports 98a through 98d of the renal failure treatment machine 12 and be inserted into respective UV disinfection devices. Although the self-heating dialysis fluid tubes can pass through ports 98a through 98d, the ports still provide restraint retention (e.g., spring-biased capture of the self-heating tubes) to prevent the tubes from being pulled out of the machine 12 and do not rely on the UV disinfection devices 90a through 90d for this pull-out restraint. The quick-disconnect ends 72a, 74a of the four dialysis fluid tubes are inserted into respective quick-disconnect connectors 28a through 28d at the dialysis machine 12 to complete the overall disinfection loop. Then, a water flow heated by the main heater 52 of the dialysis machine flows through the entire dialysis fluid loop 30 including the four tubes 72,130a, 74,130b, 72,130c, and 74,130d to disinfect both the first and second sets of tubes.

[0102] Figure 3 The recirculation flow path includes by the entire heater 52( Figure 1Heated water, as shown, flows through fresh line 70 and is separated by fresh sections 70a and 70b, flows from fresh sections 70a and 70b through flexible - dialyzer tubes 72,130a and 72,130c, through fresh disinfection sections 86a and 86b to disinfection manifold 80, flows from manifold 80 through used disinfection sections 88a and 88b, through flexible - dialyzer tubes 74,130b and 74,130d, through used sections 56a and 56b and discharge line 56 to discharge section 60( Figure 1 ). During this operation, the heating elements 134 for the four self - heating tubes and the four IV disinfection devices 90a to 90d may or may not be energized.

[0103] Figure 5 Shown is that for the first treatment of a day, the quick - disconnect ends 72a, 74a of the first - group dialysis fluid tubes 72,130a and 74,130b are disconnected from the quick - disconnect connectors 28a and 28c of the dialysis machine respectively and are inserted respectively into the fresh dialysis fluid connector and the used dialysis fluid connector of the dialyzer 102 to perform the first treatment. During this first treatment, when the dialysis fluid flows through tubes 72,130a and 74,130b, the heaters of these tubes are not energized. The second - group dialysis fluid tubes 72,130c and 74,130d remain inserted into the quick - disconnect connectors 28b and 28d and have been disinfected, so their heaters may or may not be energized. Regarding the disinfection devices 90a to 90d (e.g., UV disinfection devices), during the first treatment, any of the following combinations may be energized: no disinfection device, only disinfection devices 90a and 90c for the first group, only disinfection devices 90b and 90d for the second group, or disinfection devices 90a to 90d for both the first and second groups. In a preferred embodiment, during the first treatment, all disinfection devices 90a to 90d are energized.

[0104] Before removing the quick - disconnect ends 72a, 74a of the dialysis fluid tubes 72,130a and 74,130b of the first - group tubes from their quick - disconnect connectors 28a and 28c, the first - group tubes are perfused with dialysis fluid to prepare for the first treatment so that the water used for disinfection in the tubes is removed to the discharge section 60. To this end, the dialysis fluid is pumped through the first - group dialysis fluid tubes 72,130a and 74,130b via pumps 54 and 58 in order to push the disinfection water to the discharge section. During this time, the second - group tubes 72,130c and 74,130d may also be perfused or not perfused with dialysis fluid so that the water used for disinfecting the second - group tubes can be discarded or retained respectively.

[0105] Figure 6Shows the second treatment for a day, where (i) the quick-disconnect ends 72a and 74a of the dialysis fluid tubes 72, 130a and 74, 130b of the first group are disconnected from the dialyzer 102 and are respectively inserted into the quick-disconnect connectors 28a and 28c to complete the first disinfection path, and (ii) the tube heating elements 134 of the self-heating tubes 72, 130a and 74, 130b are energized to heat the dialysis fluid inside the tubes to disinfect the first group of tubes when performing the second treatment. It is noted that it is not necessary to move the dialysis fluid inside the heated tubes 72, 130a and 74, 130b for disinfection, because the disinfection occurs due to the self-heating of the static dialysis fluid inside the tubes. In one embodiment, during disinfection, the UV disinfection devices 90a and 90c for the dialysis fluid tubes 72, 130a and 74, 130b of the first group are energized.

[0106] During Figure 6 the second treatment of, the quick-disconnect ends 72a and 74a of the dialysis fluid tubes 72, 130c and 74, 130d of the second group are disconnected from the quick-disconnect machine connectors 28b and 28d and are inserted into the dialyzer 102 to perform the second treatment, during which the heaters are not energized when the dialysis fluid flows through the tubes 72, 130c and 74, 130d. If the dialysis fluid tubes 72, 130c and 74, 130d of the second group were perfused with dialysis fluid before the first treatment, then there is no need to perfuse the second group for the second treatment here. However, if the dialysis fluid tubes 72, 130c and 74, 130d of the second group were not perfused with dialysis fluid before the first treatment, then the second group needs to be perfused for the second treatment here. To this end, before the quick-disconnect ends 72a and 74a of the dialysis fluid tubes 72, 130c and 74, 130d of the second group are disconnected from the quick-disconnect machine connectors 28b and 28d, the dialysis fluid is pumped via pumps 54 and 58 so as to push the disinfection water to the discharge section.

[0107] In one embodiment, during treatment, the UV disinfection devices 90b and 90d for the dialysis fluid tubes 72, 130c and 74, 130d of the second group are energized. The UV disinfection devices prevent bacteria from moving through their barriers and are thus effective during treatment. Accordingly, when the machine 12 performs the first perfusion of the blood set 100 since the last full disinfection, the UV disinfection devices 90b and 90d in one embodiment are energized via the control unit 50. When the operator places the dialyzer line in its docking position ( Figure 3 72a and 74a in) after the final treatment of the day and initiates the full disinfection, the UV disinfection devices 90b and 90d can be deactivated at this time. Here, the control unit 50 is configured to deactivate all the UV disinfection devices when starting the full disinfection.

[0108] During the third treatment, the movement of the first set of self-heating dialysis fluid tubes and the second set of self-heating dialysis fluid tubes and the operations associated with the first set of self-heating dialysis fluid tubes and the second set of self-heating dialysis fluid tubes are in the reverse order of that just described for the second treatment back to Figure 6 the arrangement of Figure 5 . Here, (i) the quick-disconnect ends 72a and 74a of the dialysis fluid tubes 72, 130c and 74, 130d of the second set are disconnected from the dialyzer 102 and are respectively inserted into the quick-disconnect connectors 28b and 28d to complete the second disinfection path, and (ii) the tube heating elements 134 of the self-heating tubes 72, 130c and 74, 130d are energized to heat the dialysis fluid within the tubes, thereby disinfecting the second set of tubes during the third treatment. Again, note that it is not necessary to move the dialysis fluid within the heated tubes 72, 130c and 74, 130d for disinfection, as the disinfection occurs due to the self-heating of the static dialysis fluid within the tubes. In one embodiment, during disinfection, the UV disinfection devices 90b and 90d for the dialysis fluid tubes 72, 130c and 74, 130d of the second set are energized.

[0109] During the third treatment (back to Figure 5 ), the quick-disconnect ends 72a and 74a of the dialysis fluid tubes 72, 130a and 74, 130b of the first set are disconnected from the quick-disconnect machine connectors 28a and 28c and are inserted into the dialyzer 102 to perform the third treatment, during which the heaters for the tubes 72, 130a and 74, 130b are not energized while the dialysis fluid flows through the tubes 72, 130a and 74, 130b. For the reasons described above, in one embodiment, the UV disinfection devices 90a and 90c for the dialysis fluid tubes 72, 130a and 74, 130b of the first set are energized during treatment.

[0110] As described above, the dialysis fluid tubes 72, 130a and 74, 130b complete the first disinfection path, while the dialysis fluid tubes 72, 130c and 74, 130d of the second set complete the second disinfection path. These paths are defined by the states of the three-way valves 94a and 94b. The closed passages of the valves 94a and 94b together with the unconnected quick-disconnect machine connectors 28a to 28d form the ends of the respective disinfection paths.

[0111] The just-described exchange of the first and second sets of tubing (one set used for treatment while the other set is disinfected for the next treatment) is repeated until the treatment day is complete. The delay between treatments due to disinfection can be effectively reduced to zero (assuming only dialysis fluid is used for disinfection, and therefore no priming or flushing), i.e., reduced to the time required to exchange the first and second sets of tubing. In an embodiment, UV disinfection devices 90a to 90d are energized while their respective tubing is being used for treatment to help prevent bacteria from migrating up the tubing (even if such migration would occur against the direction of flow).

[0112] In an alternative embodiment to the first embodiment, before the next treatment begins, the set of dialysis fluid lines connected to the dialyzer 102 during the previous treatment is flushed with fresh dialysis fluid. To this end, when the previous treatment is completed, the user interface 14 instructs the operator to insert the dialysis fluid line connectors 72a and 74a into their respective quick-disconnect machine connectors 28a to 28d and confirm when completed (or when the machine can automatically detect the connection). The machine 12 then stops producing dialysis fluid and instead pumps purified water through the fresh line 70, three-way valve 94a, line 70a or 70b, flexible dialysis tubing 72, 130a or 72, 130c, line 86a or 86b, manifold line 80, line 88a or 88b, flexible dialysis tubing 74, 130b or 74, 130d, line 56a or 56b, three-way valve 94a, and drain line 58 to the drain 60 via pumps 54 and 58. The control unit 50 controls the flushing to be long enough to clear the flexible line of used or spent dialysis fluid as much as possible, for example, about several minutes (such as two minutes).

[0113] When the flush is complete, the operator enters "next patient composition" (or this occurs automatically), and the machine 12 begins preparing the next fluid composition for the next treatment. Upon detecting that the dialysis fluid has been prepared according to the specified composition, the control unit 50 causes the machine 12 to prime the flexible dialysis fluid tubing 72, 130a or 72, 130c for use in the subsequent treatment. To this end, the machine 12 pumps fresh dialysis fluid through the fresh line 70, the three-way valve 94a, the other of the lines 70a or 70b, the other of the flexible dialysis tubing 72, 130a or 72, 130c, the other of the lines 86a or 86b, the manifold line 80, the other of the lines 88a or 88b, the other of the flexible dialysis tubing 74, 130b or 74, 130d, the other of the lines 56a or 56b, the three-way valve 94a, and the drain line 58 to the drain 60 via the pumps 54 and 58. Here, the control unit 50 controls the priming to be long enough to clear as much purified water as possible from the flexible lines, for example, about several minutes (such as two minutes).

[0114] Accordingly, it is contemplated to use dialysate or purified water in the flexible tube being disinfected. Accordingly, the term "disinfection fluid" includes dialysate, purified water or even a disinfectant (such as a citric acid solution).

[0115] Second partial disinfection embodiment

[0116] Figure 7 A second partial disinfection embodiment is shown. Here, the quick-disconnect machine connectors 28a to 28d are installed to the machine 12 as described above, the through ports 98a to 98d are installed to the machine 12 as described above, and the first set of flexible dialysate tubes 72b and 74b and the second set of flexible dialysate tubes 72c and 74c are exchanged or replaced as described above between being connected to the dialyzer 102 for treatment and being connected to the quick-disconnect machine connectors 28a to 28d for disinfection. As described above, the flexible dialysate tubes 72b, 74b, 72c and 74c are also respectively connected to the disinfection devices 90a to 90d via the through ports 98a to 98d.

[0117] Figure 7 The difference between the second partial disinfection embodiment of Figures 3 to 6 and the first partial disinfection embodiment of Figure 7 is that the dialysate tubes 72b, 74b, 72c and 74c are not self-heating. Instead, only the disinfection devices 90a to 90d are used for disinfection. For this purpose,

[0118] The following recirculation hydraulic equipment is added to the system 10 of

[0119] Figure 7 The fresh dialysate line 70 is divided into branches 70a and 70b. The valve 92g is positioned along the fresh dialysate branch 70a, which extends between the disinfection device 90a and the recirculation manifold line 80. The valve 92h is positioned along the fresh dialysate branch 70b, which extends between the disinfection device 90b and the fresh dialysate branch 70a. The first recirculation pump 154 is positioned along the recirculation line 86, which extends between the manifold line 80 and the quick-disconnect connector 28b. The recirculation pump 154 can be a peristaltic pump, a piston pump, a gear pump or a membrane pump like the other pumps described above. The recirculation line 86, a part of the manifold line 80, the branches 70a and 70b, and the flexible dialysate tube 72b or 72c together form a first recirculation loop, in which the recirculation pump 154 continuously pumps the cleaning fluid dedicated to disinfection through one of the disinfection devices 90a or 90b during treatment. The flow of the cleaning fluid removes bacteria from the inner wall of the recirculation loop. The bacteria are killed when flowing through the disinfection device 90a or 90b.

[0119] Figure 7System 10 also adds the following recirculating hydraulic equipment. The used or spent dialysate line 56 is divided into branches 56a and 56b. Valve 92i is positioned along the spent dialysate branch 56a, which extends between the disinfection device 90c and the spent dialysate branch 56b. Valve 92j is positioned along the spent dialysate branch 56b, which extends between the disinfection device 90d and the recirculation manifold line 80. The second recirculation pump 158 is positioned along the recirculation line 88, which extends between the manifold 80 and the quick-disconnect connector 28c. The recirculation pump 158 can be a peristaltic pump, a piston pump, a gear pump, or a membrane pump like the other pumps described herein. The recirculation line 88, together with a portion of the manifold 80, branches 56a and 56b, and the flexible dialysate tubes 74b or 74c, forms a second recirculation loop in which the recirculation pump 158 continuously pumps a cleaning fluid dedicated to disinfection through one of the disinfection devices 90c or 90d during treatment.

[0120] Valve 92k is positioned in the manifold line 80 between the first and second recirculation loops to isolate these loops when needed. Figure 7 Valves 92g through 92k and Figure 3 , Figure 5 and Figure 6 the three-way valves 94a and 94b are under the control of the control unit 20. The flow of the cleaning fluid removes bacteria from the inner walls of the recirculation circuit. The bacteria are killed as they flow through the disinfection device 90c or 90d.

[0121] Similar to Figures 3 to 6 the first local disinfection embodiment, in Figure 7 the embodiment, the first set of flexible tubes 72b and 74b leading to the dialyzer and the second set of flexible tubes 72c and 74c leading to the dialyzer are exchanged or replaced, with one set being used for treatment through the dialyzer 102 while the other set is connected to the first and second recirculation loops and disinfected for the next treatment until the treatment day is completed. The delay between treatments due to disinfection can be effectively reduced to zero again (assuming only dialysate is used for disinfection and thus there is no priming or rinsing), i.e., reduced to the time required to replace the first and second sets of tubes. In the embodiment, when their respective tubes are used for treatment, the disinfection device is powered on to help prevent bacteria from migrating up the tubes (even though such migration may occur against the flow direction and at a flow rate of up to 300 ml / min).

[0122] Figure 7Shows a state where the flexible dialysis tubes 72b and 74b are connected to the dialyzer 102 for treatment and the flexible dialysis tubes 72c and 74c are being disinfected. The fresh dialysis fluid valve 92a and the used dialysis fluid valve 92e are opened so that fresh dialysis fluid can flow to the dialyzer 102, while the used dialysis fluid or the spent dialysis fluid can flow from the dialyzer 102 to the discharge section 60( Figure 1 ). With the valve 92g closed and the three-way valve 94a in the state according to the Figure 7 shown arrow, the fresh dialysis fluid flows through the fresh section 70a, the disinfection device 90a (energized in one embodiment), the flexible dialysis tube 72b to the dialyzer 102. When the flexible dialysis tube 72c is connected to the quick-disconnect connector 28b in the disinfection mode and the valve 92h is open and the valve 92k is closed, the cleaning fluid is recirculated through the recirculation line 86, the flexible dialysis tube 72c, the energized disinfection device 90b, the new section 70b, a small part of the fresh section 70a, and the upper half of the manifold 80 by the recirculation pump 154 and back to the recirculation line 86.

[0123] On Figure 7 the use side, the fresh dialysis fluid valve 92a and the used dialysis fluid valve 92e are opened again so that fresh dialysis fluid can flow to the dialyzer 102, while the spent dialysis fluid can flow from the dialyzer 102 to the discharge section 60( Figure 1 ] ). With the valve 92i closed and the three-way valve 94b in the state shown by the arrow in Figure 7 , the spent dialysis fluid flows from the dialyzer 102 through the flexible dialysis tube 74b, the disinfection device 90c (energized in one embodiment), a part of the used section 56a, and the discharge line 56 to the discharge section 60. When the flexible dialysis tube 74c is connected to the quick-disconnect connector 28d in the disinfection mode and the valve 92j is open and the valve 92k is closed, the recirculation pump 158 recirculates the cleaning fluid through the recirculation line 88, the flexible dialysis tube 74c, the energized disinfection device 90d, the used section 56b, and the lower half of the manifold 80 and back to the recirculation line 88.

[0124] When the flexible dialysis fluid line is exchanged or replaced, the flexible dialysis tubes 72c and 74c are changed to be connected to the dialyzer 102 for treatment while the flexible dialysis tubes 72b and 74b are being disinfected. Here, the fresh dialysis fluid valve 92a and the used dialysis fluid valve 92e remain open, and the manifold valve 92k remains closed. Under the control of the control unit 20, all the other valves marked in Figure 7 are switched to the state opposite to the state shown in Figure 7 . In one embodiment, all four disinfection devices 90a to 90d are energized.

[0125] Figure 8 illustrates Figure 7 a variation of the local disinfection embodiment of the system 10 in Figure 8 . In Figure 7 , the system 10 includes all the structures, functions, and alternatives of the system 10 in Figure 8 , including all dialysate tube exchanges, all valve states, and the operation of the disinfection devices 90a to 90d. The difference in Figure 8 is the addition of small heaters 152a and 152b respectively disposed in the disinfection recirculation pipelines 86 and 88. During treatment, heaters 152a and 152b are operated to heat the cleaning fluid to the disinfection temperature (e.g., 70 °C or higher, e.g., heated to 80 °C, at which A0 disinfection analysis is employed) to assist in disinfecting the inner surfaces of the flexible dialysate tubes 72b, 74b, 72c, and 74c. In one embodiment, the disinfection devices 90a to 90d are additionally used.

[0126] Any perfusion and flushing alternatives discussed above for the first embodiment of Figures 3 to 6 equally apply to the second embodiment of Figure 7 and Figure 8 .

[0127] Third partial disinfection implementation method

[0128] Figure 9 illustrates a third local disinfection embodiment for the system 10, which uses the self-heating tubes 72, 130 and 74, 130 discussed above for the first embodiment and the disinfection devices 90a and 90c discussed for each embodiment, but does not provide or use two sets of flexible dialysate fluid tubes. Thus, the disinfection of the third embodiment does not occur in parallel with the treatment. Here, the quick-disconnect distal connectors 72a and 74a of the corresponding fresh self-heating dialysate fluid tubes 72, 130 and the used self-heating dialysate fluid tubes 74, 130 are pulled out from the dialyzer 102 after treatment and inserted into the corresponding quick-disconnect connectors 28a and 28c located at the wall of the machine 12 to complete the disinfection circuit, which starts in the fresh dialysate fluid pipeline 70, extends through the fresh self-heating tubes 72, 130, through the disinfection pipeline 82, through the used self-heating tubes 74, 130, and through the used dialysate fluid pipeline 56 to the discharge section 60 ( Figure 1 ). Here, with the fresh dialysate fluid pipeline valve 92a and the used dialysate fluid pipeline valve 92e open, either or both of the fresh dialysate fluid pump 54 or the used dialysate fluid pump 58 can be used to pump the cleaning fluid dedicated to disinfection through the just-described disinfection circuit.

[0129] Once the disinfection circuit is completed, the heating elements 134 of the fresh self-heating tubes 72, 130 and the used self-heating tubes 74, 130, as well as the disinfection devices 90a and 90c, are energized to provide local disinfection of the flexible dialysis fluid tubes 72, 130 and 74, 130. The local disinfection greatly reduces the disinfection time, so that after treatment, the downtime due to disinfection is not the longest factor.

[0130] As with the first and second local disinfection embodiments of the system 10, the disinfection devices 90a and 90c of the third embodiment are energized while the self-heating tubes 72, 130 and 74, 130 are connected to the dialyzer 102 for treatment to help prevent bacteria from migrating upward into the tubes (even if such migration would occur against the flow direction).

[0131] Fourth partial disinfection embodiment

[0132] Figure 10 A fourth local disinfection embodiment of the system 10 is shown. The fourth local disinfection embodiment operates on the same principle as the third embodiment, which does not provide or use two sets of flexible dialysis fluid tubes. Therefore, the disinfection of the fourth embodiment does not occur in parallel with the treatment. The main difference between the local disinfection embodiments is that in Figure 10 , the self-heating dialysis fluid tubes 72, 130 and 74, 130 are not used. Instead, small local fluid heaters 152 are positioned along the fresh dialysis fluid line 70 near the disinfection device 90a.

[0133] In Figure 10 , the quick-disconnect distal connectors 72a and 74a of the corresponding fresh flexible dialysis fluid tube 72 and the used flexible dialysis fluid tube 74 are pulled out of the dialyzer 102 after treatment and inserted into the corresponding quick-disconnect connectors 28a and 28c located at the wall of the machine 12 to complete the disinfection circuit, which starts again in the fresh dialysis fluid line 70, extends through the fresh flexible tube 72, through the disinfection line 82, through the used flexible tube 74, and through the used or spent dialysis fluid line 56 to the discharge section 60 ( Figure 1 ). Here, with the fresh dialysis fluid line valve 92a and the used dialysis fluid line valve 92e open, either or both of the fresh dialysis fluid pump 54 or the used dialysis fluid pump 5 can be used to pump a cleaning fluid dedicated to disinfection through the disinfection circuit just described.

[0134] Once the disinfection circuit is completed, the small local disinfection heater 152 and the disinfection devices 90a and 90c are energized to provide local disinfection of the flexible dialysis fluid tubes 72, 130 and 74, 130. The local disinfection significantly reduces the disinfection time, such that after treatment, the downtime due to disinfection is not the longest factor. Assuming that thermal disinfection is fully effective, it may not be necessary to energize the disinfection devices 90a and 90c while the small local heater 152 is energized.

[0135] As with the first, second, and third local disinfection embodiments of the system 10, the disinfection devices 90a and 90c of the fourth embodiment are energized while the flexible tubes 72 and 74 are connected to the dialyzer 102 for treatment to help prevent bacteria from migrating upward into the tubes (even if such migration would occur against the flow direction).

[0136] It should be understood that various changes and modifications to the presently preferred embodiments described herein will be apparent to those skilled in the art. For example, any of the three-way valves described herein can be replaced by a pair of two-way valves. In another example, local heating can be combined with self-heating tubes to provide dual local heating. In another example, any of the embodiments described herein having any form of disinfection or heating other than the disinfection device can be provided without such a disinfection device. Such changes and modifications can be made without departing from the spirit and scope of the invention and without diminishing its intended advantages. Accordingly, these changes and modifications are intended to be covered by the appended claims.

Claims

1. A renal failure treatment system (10), comprising: A fresh dialysis fluid tube (72) having a connector (72a) for connection to a dialyzer (102); A used dialysis fluid tube (74) having a connector (74a) for connection to the dialyzer (102); wherein the fresh dialysis fluid tube (72) and the used dialysis fluid tube (74) form a first set of dialysis fluid tubes (72b, 74b); A second set of dialysis fluid tubes (72c, 74c); A dialysis fluid circuit (30), the dialysis fluid circuit comprising: A fresh dialysis fluid line (70), A used dialysis fluid line (56), (i) A first disinfection device (90a) positioned between the fresh dialysis fluid line (70) and the fresh dialysis fluid tube (72) or (ii) at least one of a second disinfection device (90c) positioned between the used dialysis fluid line (56) and the used dialysis fluid tube (74), and A recirculation circuit extending to (i) a first machine connector (28a) and (ii) a second machine connector (28c), the first machine connector (28a) being configured to cooperate with the connector (72a) of the fresh dialysis fluid tube (72) during local disinfection, and the second machine connector (28c) being configured to cooperate with the connector (74a) of the used dialysis fluid tube (74) during local disinfection; and A control unit (20), the control unit being configured to: Energize the at least one first disinfection device (90a) or at least one second disinfection device (90c) during the local disinfection to create a barrier against bacterial transport; Cause (i) a first treatment to operate when the first set of dialysis fluid tubes (72b, 74b) or the second set of dialysis fluid tubes (72c, 74c) is connected to the dialyzer (102), while the other of the first set of dialysis fluid tubes (72b, 74b) or the second set of dialysis fluid tubes (72c, 74c) undergoes local disinfection, and cause (ii) a second treatment to operate when one of the first set of dialysis fluid tubes (72b, 74b) and the second set of dialysis fluid tubes (72c, 74c) that has been disinfected in (i) is connected to the dialyzer (102), while the other of the first set of dialysis fluid tubes (72b, 74b) and the second set of dialysis fluid tubes (72c, 74c) undergoes local disinfection.

2. The renal failure treatment system (10) according to claim 1, wherein, The control unit (20) is further configured to energize the at least one first disinfection device (90a) or the at least one second disinfection device (90c) during treatment.

3. The renal failure treatment system (10) according to claim 1, wherein, The fresh dialysis fluid tube (72) and the used dialysis fluid tube (74) are self-heating tubes (72, 130, 74, 130), the self-heating tubes being configured to be energized during the local disinfection.

4. The renal failure treatment system (10) according to claim 1, wherein, The fresh dialysis fluid tube is a flexible tube and the used dialysis fluid tube is a flexible tube. The renal failure treatment system further includes a housing, wherein the fresh dialysis fluid tube and the used dialysis fluid tube extend from the housing.

5. The renal failure treatment system (10) according to any one of claims 1 to 4, wherein, The recirculation loop also extends to (i) a third machine connector (28b) and (ii) a fourth machine connector (28d). The third machine connector (28b) is for mating with a connector (72a) of a second fresh dialysis fluid tube (72c) during local disinfection, and the fourth machine connector (28d) is for mating with a connector (74a) of a second used dialysis fluid tube (74c) during local disinfection.

6. The renal failure treatment system (10) according to claim 5, the renal failure treatment system includes a third disinfection device (90b) and a fourth disinfection device (90d). The third disinfection device is for operating with the second fresh dialysis fluid tube (72c), and the fourth disinfection device is for operating with the second used dialysis fluid tube (74c).

7. The renal failure treatment system (10) according to claim 6, wherein, The dialysis fluid circuit (30) includes (i) a first three-way valve (94a) or a first pair of two-way valves and (ii) a second three-way valve (94b) or a second pair of two-way valves. The first three-way valve or the first pair of two-way valves are positioned and arranged to direct fresh dialysis fluid to the first disinfection device (90a) or the third disinfection device (90b), and the second three-way valve or the second pair of two-way valves are positioned and arranged to receive used dialysis fluid from the second disinfection device (90c) or the fourth disinfection device (90d).

8. The renal failure treatment system (10) according to claim 7, wherein, (i) The closed passage of the first three-way valve (94a) or the closed two-way valve of the first pair forms an end of a first static disinfection path, wherein the first disinfection device (90a) or the third disinfection device (90b) is positioned along the first static disinfection path, and (ii) the closed passage of the second three-way valve (94b) or the closed two-way valve of the second pair forms an end of a second static disinfection path, wherein the second disinfection device (90c) or the fourth disinfection device (90d) is positioned along the second static disinfection path.

9. The renal failure treatment system (10) according to claim 7, wherein, (i) The closed passage of the first three-way valve (94a) or the closed two-way valve of the first pair assists in defining a first recirculation disinfection path, wherein the first disinfection device (90a) or the third disinfection device (90b) is positioned along the first recirculation disinfection path, and (ii) the closed passage of the second three-way valve (94b) or the closed two-way valve of the second pair forms an end of a second recirculation disinfection path, wherein the second disinfection device (90c) or the fourth disinfection device (90d) is positioned along the second recirculation disinfection path.

10. The renal failure treatment system (10) according to claim 9, wherein, At least one of the first recirculation disinfection path or the second recirculation disinfection path is provided with a pump (154, 158).

11. The renal failure treatment system (10) according to claim 9, wherein, At least one of the first recirculation disinfection path or the second recirculation disinfection path is provided with a disinfection heater (152a, 152b).

12. The renal failure treatment system (10) according to any one of claims 1 to 4, the renal failure treatment system comprising a local disinfection heater positioned to operate with a fresh dialysis fluid line (70) adjacent to the first disinfection device (90a).

13. The renal failure treatment system (10) according to any one of claims 1 to 4, wherein, At least one of the disinfection devices (90a to 90d) is a UV disinfection device.

14. The renal failure treatment system (10) according to any one of claims 1 to 4, the renal failure treatment system comprising at least one through-port (98a to 98d) for receiving one of the dialysis fluid tubes (72b, 74b, 72c, 74c).

15. A renal failure treatment system (10), comprising: A blood treatment unit (102); A first fresh dialysis fluid tube (72b) having a connector (72a) for connection to the blood treatment unit (102), the first fresh dialysis fluid tube forming a first set with a first used dialysis fluid tube (74b) having a connector (74a) for connection to the blood treatment unit (102), A second fresh dialysis fluid tube (72c) having a connector (72a) for connection to the blood treatment unit (102), the second fresh dialysis fluid tube forming a second set with a second used dialysis fluid tube (74c) having a connector (74a) for connection to the blood treatment unit (102); And A control unit (20) configured to cause (i) a first treatment to operate when: the first set of dialysis fluid tubes (72b, 74b) or the second set of dialysis fluid tubes (72c, 74c) is connected to the blood treatment unit (102), while the other of the first set of dialysis fluid tubes (72b, 74b) or the second set of dialysis fluid tubes (72c, 74c) undergoes local disinfection, and to cause (ii) a second treatment to operate when: one of the first set of dialysis fluid tubes (72b, 74b) and the second set of dialysis fluid tubes (72c, 74c) that has been disinfected in (i) is connected to the blood treatment unit (102), while the other of the first set of dialysis fluid tubes (72b, 74b) and the second set of dialysis fluid tubes (72c, 74c) undergoes local disinfection.

16. The renal failure treatment system (10) according to claim 15, wherein, At least one of the sets of dialysis fluid tubes undergoing local disinfection carries dialysis fluid during the local disinfection.

17. The renal failure treatment system (10) according to claim 15, wherein, At least one of the sets of dialysis fluid tubes undergoing local disinfection is rinsed with purified water before the local disinfection.

18. The renal failure treatment system (10) according to any one of claims 15 to 17, wherein, At least one of the sets of dialysis fluid tubes connected to the blood treatment unit (102) is perfused with dialysis fluid before being connected to the blood treatment unit.

19. A renal failure treatment system (10), comprising: A housing, Fresh dialysis fluid flexible tube (72), said fresh dialysis fluid flexible tube having a connector (72a) for connection to a dialyzer (102); Used dialysis fluid flexible tube (74), said used dialysis fluid flexible tube having a connector (74a) for connection to said dialyzer (102); wherein, said fresh dialysis fluid flexible tube and said used dialysis fluid flexible tube extend from said housing, and said fresh dialysis fluid flexible tube (72) and said used dialysis fluid flexible tube (74) are self-heating tubes; Dialysis fluid circuit (30), said dialysis fluid circuit comprising Fresh dialysis fluid pipeline (70), Used dialysis fluid pipeline (56), A first disinfection device (90a), said first disinfection device being a UV disinfection device, positioned between said fresh dialysis fluid pipeline (70) and said fresh dialysis fluid flexible tube (72) and (ii) a second disinfection device (90c), said second disinfection device being a UV disinfection device, positioned between said used dialysis fluid pipeline (56) and said used dialysis fluid flexible tube (74), and A recirculation circuit that extends to (i) a first machine connector (28a) and (ii) a second machine connector (28c), said first machine connector (28a) being for mating with the connector (72a) of said fresh dialysis fluid flexible tube (72) during local disinfection, and said second machine connector (28c) being for mating with the connector (74a) of said used dialysis fluid flexible tube (74) during local disinfection; and A control unit (20), said control unit being configured to energize said first disinfection device (90a), said second disinfection device (90c), said fresh dialysis fluid flexible tube (72) and said used dialysis fluid flexible tube (74) during said local disinfection to create a barrier against bacterial transport.

20. The renal failure treatment system (10) according to claim 19, wherein, Said fresh dialysis fluid flexible tube (72) and said used dialysis fluid flexible tube (74) form a first group of dialysis fluid tubes (72b, 74b), and said renal failure treatment system includes a second group of dialysis fluid tubes (72c, 74c), and wherein, said control unit (20) is further configured to cause (i) a first treatment to operate when: either said first group of dialysis fluid tubes (72b, 74b) or said second group of dialysis fluid tubes (72c, 74c) is connected to said dialyzer (102), while the other group of dialysis fluid tubes in said first group of dialysis fluid tubes (72b, 74b) or said second group of dialysis fluid tubes (72c, 74c) undergoes local disinfection, and cause (ii) a second treatment to operate when: one of the disinfected first group of dialysis fluid tubes (72b, 74b) and the second group of dialysis fluid tubes (72c, 74c) in (i) is connected to said dialyzer (102), while the other group of the first group of dialysis fluid tubes (72b, 74b) and the second group of dialysis fluid tubes (72c, 74c) undergoes local disinfection.

21. The renal failure treatment system (10) according to claim 19, wherein, The control unit (20) is further configured to energize at least one first disinfection device (90a) or at least one second disinfection device (90c) during treatment.

22. The renal failure treatment system (10) according to any one of claims 19 to 20, the renal failure treatment system comprising at least one through-port (98a to 98d) for receiving one of the fresh dialysis fluid flexible tube (72) and the used dialysis fluid flexible tube (74).

23. The renal failure treatment system (10) according to any one of claims 19 to 20, wherein The first machine connector (28a) and the second machine connector (28c) are fitted with internal check valves for preventing fluid from flowing back into the fresh dialysis fluid flexible tube (72) and the used dialysis fluid flexible tube (74).

24. The renal failure treatment system (10) according to any one of claims 19 to 20, wherein The recirculation circuit begins in the fresh dialysis fluid line (70) and extends through the fresh dialysis fluid flexible tube (72), through the disinfection line (82), through the used dialysis fluid flexible tube (74) and through the used dialysis fluid line (56) to the discharge section (60).

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