Peritoneal dialysis patient line with disinfecting filter and drainage bypass

Abstract

The invention relates to a peritoneal dialysis patient line with a disinfecting filter and a drainage bypass. A medical fluid treatment system includes: a source of purified water; at least one concentrate for mixing with water from the water source to form a therapeutic fluid; a disposable kit includes a pumping portion, a concentrate line in fluid communication with a concentrate source and the pumping portion, and a patient line in fluid communication with the pumping portion, the patient line including a filter having a membrane configured to filter the treatment fluid, the filter is configured such that (i) fresh therapeutic fluid flowing from the pumping portion to the patient flows through the membrane, and (ii) used therapeutic fluid flowing from the patient through the filter to the pumping portion bypasses the membrane; and a medical fluid delivery machine comprising a pump actuator operable with the pumping portion of the disposable kit.

Description

[0001] This application is a divisional application of the Chinese application with application number 201980060481.6, application date September 18, 2019, and title “Peritoneal dialysis patient line with sterile filter and drainage bypass”. Related Applications

[0002] This application claims the benefit of and priority to U.S. Provisional Patent Application No. 62 / 732,782, filed on September 18, 2018, entitled “PERITONEAL DIALYSIS PATIENT LINE WITH STERILIZING FILTER AND DRAIN BYPASS,” which is incorporated herein by reference in its entirety. Technical Field

[0003] The present disclosure relates generally to medical fluid devices. More particularly, the present disclosure relates to medical fluid devices that mix fluids inline for treatment or receive fluids that are mixed inline for treatment. Background Art

[0004] For a variety of reasons, a person's kidney system may fail. Kidney failure produces several physiological disturbances. It is no longer possible to balance water and minerals or excrete the daily metabolic load. Toxic end products of metabolism, such as urea, creatinine, uric acid, etc., may accumulate in the patient's blood and tissues.

[0005] Reduced kidney function, especially kidney failure, is treated with dialysis. Dialysis removes waste products, toxins, and excess water from the body that would otherwise be removed by normally functioning kidneys. For many people, dialysis treatment to replace kidney function is vital because it can be life-saving.

[0006] One type of renal failure therapy is hemodialysis ("HD"), which typically uses diffusion to remove waste products from a patient's blood. A diffusion gradient occurs across a semipermeable dialyzer between the blood and an electrolyte solution called dialysate or dialysis fluid to cause diffusion.

[0007] Hemofiltration ("HF") is an alternative renal replacement therapy that relies on the convective transport of toxins from the patient's blood. HF is achieved by adding replacement or substitution fluid to the extracorporeal circulation during treatment. The replacement fluid and the patient's accumulated fluid between treatments are ultrafiltered during HF treatment, providing a convective transport mechanism that is particularly beneficial for the removal of medium and large molecules.

[0008] Hemodiafiltration ("HDF") is a treatment method that combines convective and diffusive clearance. HDF uses the dialysis fluid flowing through the dialyzer to provide diffusive clearance, similar to standard hemodialysis. In addition, a replacement solution is provided directly to the extracorporeal circulation, thereby providing convective clearance.

[0009] Most HD (HF, HDF) treatments are performed in-center. Today, there is a trend toward home hemodialysis ("HHD"), in part because HHD can be performed daily, which provides a therapeutic benefit compared to in-center hemodialysis treatments, which are typically performed every two or three weeks. Studies have shown that more frequent treatments remove more toxins and waste products than patients who receive less frequent but potentially longer treatments. Patients who receive more frequent treatments do not experience as much of a down cycle as in-center patients, who have two or three days of accumulated toxins prior to treatment. In some areas, the nearest dialysis center may be many miles from the patient's home, resulting in home treatment times consuming a large portion of the day. HHD can occur at night or during the day, when the patient is relaxing, working, or otherwise productive.

[0010] Another type of renal failure therapy is peritoneal dialysis ("PD"), which infuses a dialysis solution (also called dialysis fluid) into the patient's peritoneal cavity through a catheter. The dialysis fluid contacts the peritoneum of the peritoneal cavity. Waste products, toxins, and excess water pass from the patient's bloodstream through the peritoneum and into the dialysis fluid due to diffusion and osmosis, i.e., an osmotic gradient occurs across the membrane. The osmotic gradient is provided by an osmotic agent in the PD dialysis fluid. Used or consumed dialysis fluid is drained from the patient, thereby removing waste products, toxins, and excess water from the patient. This cycle is repeated, e.g., multiple times.

[0011] There are various types of peritoneal dialysis therapies, including continuous ambulatory peritoneal dialysis ("CAPD"), automated peritoneal dialysis ("APD"), tidal flow dialysis, and continuous flow peritoneal dialysis ("CFPD"). CAPD is a manual dialysis treatment. Here, the patient manually connects an implanted catheter to a drain to allow used or consumed dialysis fluid to drain from the peritoneal cavity. The patient then switches the fluid connection so that the patient's catheter is connected to a bag of fresh dialysis fluid to inject fresh dialysis fluid into the patient through the catheter. The patient disconnects the catheter from the bag of fresh dialysis fluid and allows the dialysis fluid to reside in the peritoneal cavity, where the transfer of waste, toxins, and excess water occurs. After a period of residence, the patient repeats the manual dialysis procedure, for example, four times a day. Manual peritoneal dialysis requires a lot of time and effort from the patient, leaving much room for improvement.

[0012] Automated peritoneal dialysis ("APD") is similar to CAPD in that dialysis treatment includes drain, fill, and dwell cycles. However, an APD machine automatically performs these cycles, typically while the patient sleeps. An APD machine relieves the patient from having to manually perform treatment cycles or transport supplies during the day. An APD machine is fluidly connected to an implanted catheter, a source or bag of fresh dialysis fluid, and a fluid drain port. The APD machine pumps fresh dialysis fluid from a source of dialysis fluid into the patient's peritoneal cavity through the catheter. The APD machine also allows the dialysis fluid to dwell in the peritoneal cavity and allow the transfer of waste, toxins, and excess water to occur. The source of fresh dialysis fluid can include multiple bags of sterile dialysis fluid solution.

[0013] The APD machine pumps used or spent dialysate from the peritoneal cavity through a catheter to a drain port. As with the manual process, several drain, fill, and dwell cycles occur during dialysis. The "final fill" may occur at the end of an APD treatment. The fluid may remain in the patient's peritoneal cavity until the next treatment begins, or it may be manually emptied at some point during the day.

[0014] In any of the above forms using automated machines, the therapeutic fluid may be prepared online or at the point of use (e.g., before and / or during treatment). It is important to properly purify the fluid before use in treatment or delivery to a patient. Therefore, there is a need for an improved online or at the point of use system that ensures that the prepared fluid is of sufficient quality. Summary of the invention

[0015] Examples described herein disclose automated systems and methods suitable for, for example, fluid delivery for peritoneal dialysis ("PD"), plasma exchange, hemodialysis ("HD"), hemofiltration ("HF"), hemodiafiltration ("HDF"), continuous renal replacement therapy ("CRRT"), apheresis, autologous blood transfusion, hemofiltration for sepsis, and extracorporeal membrane oxygenation ("ECMO") therapy. The systems and methods described herein may be applicable to any medical fluid delivery system in which a therapeutic fluid may be made in-line or at the point of use, e.g., just prior to and / or during treatment. These forms may be collectively or generally individually referred to herein as a medical fluid delivery system.

[0016] In addition, each of the systems and methods described herein can be used for clinical or home-based treatment. For example, the present systems and methods can be used with a PD, HD, HF, or HDF machine in a center that is running all day. Alternatively, the present systems and methods can be used with a home PD, HD, HF, or HDF machine that is typically run at the patient's convenience.

[0017] In one embodiment, a peritoneal dialysis system and method with point-of-use dialysis fluid production is provided. The system includes a cycler and a water purifier. The cycler includes a control unit having at least one processor and at least one memory. The cycler may also include a wired or wireless transceiver for sending information to and receiving information from the water purifier. The water purifier may also include a control unit having at least one processor and at least one memory and a wired or wireless transceiver for sending information to and receiving information from the control unit of the cycler.

[0018] The cycler includes a device programmed by its control unit to prepare fresh dialysis solution at the point of use, pump the freshly prepared dialysis fluid to the patient, allow the dialysis fluid to reside in the patient, and then pump the spent dialysis fluid to the drain. In one embodiment, the cycler includes a heater under the control of the control unit for heating the dialysis fluid as it mixes. The heater may be located, for example, on top of the housing of the cycler, such as beneath a heated cover.

[0019] The cycler (and the water purifier in one embodiment) is operated using a disposable kit. The disposable kit may include a disposable pumping box, which may be composed of a planar rigid plastic piece, one or both sides of which are covered by a flexible film to form a fluid pumping chamber and a valve chamber. The fluid pump chamber may operate with the pneumatic pump chamber of the cycler, and the fluid valve chamber may operate with the pneumatic valve chamber of the cycler.

[0020] The disposable kit may include (i) a patient line extending from the box to a patient line connector, (ii) a drain line extending from the box to a drain line connector (which can then be removably connected to a water purifier), (iii) a heater / mixing line extending from the pumping box to a heater / mixing bag of the present disclosure, (iv) an upstream water line segment extending from the water purifier to a water inlet of a water collector and a downstream water line segment extending from a water outlet of the water collector to the box, (v) a last bag or sample line extending from the box to a premixed last fill bag or sample bag or other sample collection container for dialysis fluid, (vi) a first (e.g., glucose) concentrate line extending from the box to a first (e.g., glucose) concentrate container, and / or (vii) a second (e.g., buffer) concentrate line extending from the box to a second (e.g., buffer) concentrate container.

[0021] In one embodiment, the patient line of the present disclosure is connected to a single lumen catheter that extends into the patient's peritoneal cavity. During treatment, fresh peritoneal dialysis fluid is infused into the patient's peritoneal cavity through the catheter and allowed to reside for a period of time, such as approximately 4 hours. During this period of time, toxins osmotically migrate through the peritoneal wall that defines the patient's peritoneal cavity into the dialysis fluid, thereby removing toxins from the patient's blood. The spent dialysis fluid (also known as effluent) is then drained back through the patient line and discarded. If the dialysis solution contains contaminants when it is infused, the patient may experience complications. When making tubing connections with disposable kits, a source of contaminants can occur, such as when the patient or caregiver touches the connection and / or the connector is not properly disinfected when disconnecting.

[0022] To combat the above contaminants, it is contemplated that a filter is placed in a patient line along a single lumen pathway, the filter filtering the dialysis solution prior to infusion into the patient. The filter is disposed in a housing that allows spent dialysis fluid or effluent drained from the patient through the same patient line to bypass the filter hydrophilic membrane of the filter to prevent (i) clogging of the filter and (ii) filtering of toxins or other substances from the effluent by the filter, whereby the toxins or other substances may be reinfused into the patient through the same patient line along with fresh dialysis fluid during the next infusion cycle.

[0023] In one embodiment, the filter housing is constructed so that parallel fluid pathways are formed within the housing. A fresh dialysis fluid pathway is provided through one or more membranes of the filter to deliver filtered fresh dialysis fluid to the patient. On the other hand, spent dialysis fluid flows through the filter housing via a different parallel pathway that bypasses the one or more membranes of the filter. In one embodiment, a pair of one-way valves or check valves (e.g., duckbill check valves) are used to assist the parallel pathways. A first one-way valve is placed at a fresh dialysis fluid outlet end of a fresh dialysis fluid pathway of the housing. The first check valve is oriented to block incoming spent dialysis fluid and allow fresh dialysis fluid to flow through the fresh dialysis fluid pathway to leave the filter housing and flow to the patient. A second one-way valve is placed at a spent dialysis fluid outlet end of a spent dialysis fluid pathway of the housing. The second one-way valve is oriented to block incoming fresh dialysis fluid and allow spent dialysis fluid to flow through the spent dialysis fluid pathway to leave the filter housing and flow to a pumping cassette of a disposable kit, from which spent dialysis fluid is pumped to a drain port.

[0024] In one embodiment, fresh dialysis fluid flowing through the fresh dialysis fluid passage flows through an in-line membrane housing. The membrane housing may include a spacer having a rectangular passage grid extending vertically from the upper outer membrane surface and the lower outer membrane surface into a rectangular gap passage located near the grid, wherein the gap leads to an outlet passage of the filter housing. In one embodiment, the filter hydrophilic membrane is a hydrophilic material having micropores that allow purified fluid to pass through but capture contaminants. When the hydrophilic filter hydrophilic membrane is wetted, the membrane blocks air from passing through.

[0025] In one embodiment, two rectangular filter hydrophilic membranes are sealed to form the upper and lower surfaces of the membrane housing, respectively. Fresh fluid enters the filter and is then divided into two fresh dialysis fluid flows or branches, one flow or branch flows on the top of the upper membrane, and the other flow or branch flows under the bottom of the lower filter hydrophilic membrane. The upper flow flows downward into the spacer grid through the upper membrane, then flows out of the outlet passage of the filter housing, passes through the one-way valve to reach the patient. The lower flow flows upward into the spacer grid of the membrane housing through the lower membrane, then flows out of the outlet passage of the filter, passes through the fresh dialysis fluid one-way valve to reach the patient. The same fresh fluid check valve is oriented to prevent the used dialysis fluid leaving the patient from flowing back through the filter hydrophilic membrane in another way. Instead, the used dialysis fluid passage completely bypasses the membrane housing.

[0026] At the end of the patient dwell phase, the dialyzer or cycler supplies negative pressure along the patient line to draw out the spent dialysis fluid from the patient. Likewise, a check valve at the end of the fresh dialysis fluid pathway prevents the effluent from flowing into the interior area of ​​the membrane housing and out through the membrane. Instead, the one-way valve diverts the effluent to bypass the filter hydrophilic membrane and instead flow along a spent dialysis fluid pathway formed in the filter housing that extends alongside the membrane housing. As described above, the effluent stream is directed to a pumping cassette.

[0027] The filter structure just described results in a filtration method that includes preparing a medical solution, such as a dialysis solution for treatment, delivering the treatment fluid to a patient along a patient line through a filter hydrophilic membrane, and returning the spent solution through the same patient line, but bypassing the filter hydrophilic membrane. In this method, bypassing the filter hydrophilic membrane may include bypassing the filter hydrophilic membrane while still causing the spent solution to flow through the entire housing of the filter.

[0028] There are many advantages to placing the sterilizing filter within the patient line. First, the location is just before the medical fluid reaches the patient, so any contaminants remaining in the disposable set (e.g., due to set conditions) will be removed from the medical fluid, except for contaminants located in a short section of tubing leading from the filter to the patient. Second, the filter is located after mixing, so the filter will remove any contaminants provided via one or more concentrates used to produce the online medical fluid. Third, there may be a clean, unobstructed section of the patient line extending from the pumping section or pressure section providing the disposable set to the filter, making it readily available to pressure test the filter hydrophilic membrane prior to delivery to the patient.

[0029] It should be understood that although the subject matter of the present disclosure is described in conjunction with peritoneal dialysis, the present disclosure may be applied to other medical fluid applications where it is desirable to render the infusion or treatment solution as free of contaminants as possible, such as other types of dialysis applications, replacement fluid applications, or intravenous ("IV") infusion pump applications.

[0030] According to the disclosure herein and without limiting the present disclosure in any way, in a first aspect of the present disclosure, which first aspect can be combined with any other aspect listed herein, unless otherwise specified, a dialysis system includes: a medical fluid treatment system, which includes: a water source of purified water; at least one concentrate, which is used to mix with water from the water source to form a treatment fluid; a disposable kit, which includes a pumping part, a concentrate line connected to the concentrate source and the pumping part fluid, and a patient line connected to the pumping part fluid, the patient line including a filter, the filter having a membrane configured to filter the treatment fluid, the filter being configured so that (i) fresh treatment fluid flowing from the pumping part to the patient flows through the membrane, and (ii) used treatment fluid flowing from the patient flow filter to the pumping part bypasses the membrane; and a medical fluid delivery machine, which includes a pump actuator operable together with the pumping part of the disposable kit.

[0031] In a second aspect of the present disclosure, which second aspect may be combined with any other aspect listed herein unless otherwise stated, wherein the therapeutic fluid is a peritoneal dialysis therapeutic fluid.

[0032] In a third aspect of the present disclosure, which third aspect may be combined with any other aspect listed herein, unless otherwise stated, the filter comprises a fresh treatment fluid pathway and a used treatment fluid pathway arranged in parallel with the fresh treatment fluid pathway, the membrane being positioned along the fresh fluid pathway, the used treatment fluid pathway enabling used treatment fluid flowing through the filter to bypass the membrane.

[0033] In a fourth aspect of the present disclosure, which fourth aspect may be combined with the third aspect in combination with any other aspect listed herein, unless otherwise stated, a one-way valve is located at the outlet end of the fresh treatment fluid pathway, the one-way valve being positioned and arranged to prevent spent treatment fluid returning from the patient from reaching the membrane.

[0034] In a fifth aspect of the present disclosure, which fifth aspect may be combined with the third aspect in combination with any other aspect listed herein, unless otherwise stated, a one-way valve is located at the outlet end of the used treatment fluid pathway, the one-way valve being positioned and arranged to prevent fresh treatment fluid from flowing through the filter via the used treatment fluid pathway.

[0035] In a sixth aspect of the present disclosure, which sixth aspect may be combined with the third aspect in combination with any other aspect listed herein, unless otherwise stated, the membrane is contained in a membrane housing positioned along a fresh fluid passage, and wherein the filter is constructed to allow fresh therapeutic fluid to flow from the outside of the membrane housing, through the membrane, and into an interior area of ​​the membrane housing.

[0036] In a seventh aspect of the present invention, which seventh aspect may be combined with the third aspect in combination with any other aspect listed herein, unless otherwise stated, the filter comprises a housing having a first port and a second port, the first port leading to a first end of the filter housing and the second port leading to a second end of the filter housing, the first end of the filter housing forming a first end of a fresh treatment fluid pathway and a used treatment fluid pathway, and the second end of the filter housing forming a second end of a fresh treatment fluid pathway and a used treatment fluid pathway.

[0037] In an eighth aspect of the present disclosure, which eighth aspect may be combined with the seventh aspect in combination with any other aspect listed herein, unless otherwise stated, a first end of the fresh fluid treatment pathway at the first end of the filter housing comprises a first one-way valve, and wherein a second end of the spent fluid treatment pathway at the second end of the filter housing comprises a second one-way valve.

[0038] In a ninth aspect of the present disclosure, which ninth aspect may be combined with any other aspect listed herein, unless otherwise stated, the membrane is housed in a membrane housing, and wherein fresh therapeutic fluid entering the filter flows to the outside of the membrane housing, and fresh therapeutic fluid leaving the filter flows out from the inside of the membrane housing.

[0039] In the tenth aspect of the present disclosure, which can be combined with any other aspect listed herein, unless otherwise stated, the membrane is a first membrane, and wherein the filter includes a second membrane, wherein the first membrane and the second membrane are accommodated in a membrane housing, and wherein fresh therapeutic fluid entering the filter is divided into a first branch flowing to the outside of the first membrane and a second branch flowing to the outside of the second membrane.

[0040] In an eleventh aspect of the present disclosure, which eleventh aspect may be combined with the tenth aspect in combination with any other aspect listed herein unless otherwise stated, the membrane housing comprises a passage grid located between the first membrane and the second membrane.

[0041] In the twelfth aspect of the present disclosure, the twelfth aspect may be combined with the tenth aspect in combination with any other aspect listed herein, unless otherwise stated, the first membrane and the second membrane are respectively located on opposite sides of the membrane shell, the first branch extends to the first side of the shell, and the second branch extends to the second side of the shell.

[0042] In the thirteenth aspect of the present disclosure, the thirteenth aspect can be combined with any other aspect listed herein, unless otherwise stated, (i) the pump actuator operable with the pumping part of the medical fluid delivery machine includes a pneumatic pump actuator, and the pumping part of the disposable kit includes a pumping membrane, or (ii) the pump actuator operable with the pumping part of the medical fluid delivery machine includes a peristaltic pump actuator, and the pumping part of the disposable kit includes a peristaltic pumping tube.

[0043] In a fourteenth aspect of the present disclosure, which fourteenth aspect may be combined with any other aspect listed herein unless otherwise stated, the medical fluid treatment system comprises at least one hydrophobic vent for removing air from the filter.

[0044] In a fifteenth aspect of the present disclosure, which fifteenth aspect can be combined with any other aspect listed herein, unless otherwise stated, a disposable kit for a medical fluid treatment system comprises: a pumping portion; a concentrate line connected to the pumping portion fluid; and a patient line connected to the pumping portion fluid, the patient line comprising a filter having a membrane constructed to filter the therapeutic fluid, the filter being constructed so that (i) fresh therapeutic fluid flowing from the pumping portion to the patient flows through the membrane, and (ii) used therapeutic fluid flowing from the patient through the filter to the pumping portion bypasses the membrane via a one-way valve, the one-way valve being positioned and arranged to open under fresh therapeutic fluid pressure and close under used therapeutic fluid pressure.

[0045] In a sixteenth aspect of the present disclosure, which sixteenth aspect may be combined with the fifteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the one-way valve comprises a duckbill check valve.

[0046] In a seventeenth aspect of the present disclosure, which seventeenth aspect may be combined with the fifteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the one-way valve is a first one-way valve, and the disposable kit includes a second one-way valve located at a second end of the filter, the second end of the filter being opposite to the first end of the filter, the first one-way valve being positioned at the first end of the filter, and the second one-way valve being positioned and arranged to open under a used treatment fluid pressure and to close under a fresh treatment fluid pressure.

[0047] In the eighteenth aspect of the present disclosure, which can be combined with any other aspect listed herein, unless otherwise stated, a filter is provided in which a fluid is intended to flow in a first direction and a second direction, wherein the filter is constructed to filter the fluid flowing in the first direction without filtering the fluid flowing in the second direction, the filter comprising: a shell; a first fluid passage provided by the shell for allowing the fluid to flow in the first direction; a second fluid passage provided by the shell for allowing the fluid to flow in the second direction; a membrane positioned to filter the fluid flowing in the first direction; and a one-way valve located at the outlet end of the first fluid passage, the one-way valve being positioned and arranged to prevent the fluid flowing in the second direction from reaching the membrane.

[0048] In a nineteenth aspect of the present disclosure, which nineteenth aspect may be combined with the eighteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the filter is part of a disposable kit comprising a fluid line connected to the filter and a pumping portion for operating with a pump actuator, the pumping portion being in fluid communication with the fluid line.

[0049] In a twentieth aspect of the present disclosure, which may be combined with the nineteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the pumping portion is part of a disposable cassette of the disposable kit, and the fluid line extends from the disposable cassette to the filter.

[0050] In a twenty-first aspect of the present disclosure, which may be combined with the nineteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the filter is configured to fluidly connect the fluid line to the first fluid passage and the second fluid passage of the filter at different times.

[0051] In the twenty-second aspect of the present disclosure, the twenty-second aspect can be combined with the nineteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the fluid line is a first fluid line, and wherein the disposable kit includes a second fluid line connected to the filter, the second fluid line extending to a fluid delivery destination.

[0052] In the twenty-third aspect of the present disclosure, the twenty-third aspect may be combined with the eighteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the one-way valve is a first one-way valve, and the filter includes a second one-way valve located at the outlet end of the second fluid passage, the second one-way valve being positioned and arranged to prevent fluid flowing in the first direction from flowing through the second fluid passage.

[0053] In the twenty-fourth aspect of the present disclosure, which can be combined with the twenty-third aspect in combination with any other aspect listed herein, unless otherwise stated, the shell includes (i) a first port located downstream of the first one-way valve and connected to the fluid of the second fluid passage, and (ii) a second port located downstream of the second one-way valve and connected to the fluid of the first fluid passage.

[0054] In the twenty-fifth aspect of the present disclosure, which can be combined with the eighteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the membrane is contained in a membrane housing located within the filter housing and along a first fluid path, and wherein the filter housing is constructed so that a fluid flowing in a first direction flows from the outside of the membrane housing through the membrane and flows into an internal area of ​​the membrane housing.

[0055] In the twenty-sixth aspect of the present disclosure, which can be combined with the twenty-fifth aspect in combination with any other aspect listed herein, unless otherwise stated, the fluid flowing in the first direction leaves the filter from the interior area of ​​the membrane housing, and the fluid flowing in the second direction bypasses the membrane housing via the second fluid passage.

[0056] In the twenty-seventh aspect of the present disclosure, the twenty-seventh aspect can be combined with the twenty-fifth aspect in combination with any other aspects listed herein, unless otherwise stated, the membrane is a first membrane and the filter includes a second membrane, wherein the first membrane and the second membrane are accommodated in a membrane housing, and wherein a fluid flowing in a first direction is divided into a first branch flowing to the outside of the first membrane and a second branch flowing to the outside of the second membrane.

[0057] In a twenty-eighth aspect of the present disclosure, which may be combined with the twenty-seventh aspect in combination with any other aspect listed herein unless otherwise stated, the membrane housing comprises a passage grid located between the first membrane and the second membrane.

[0058] In the twenty-ninth aspect of the present disclosure, the twenty-ninth aspect can be combined with the twenty-seventh aspect in combination with any other aspect listed herein, unless otherwise stated, the first membrane and the second membrane are respectively located on opposite sides of the membrane shell, the first branch extends to the first side of the membrane shell, and the second branch extends to the second side of the membrane shell.

[0059] In a thirtieth aspect of the present disclosure, which may be combined with the eighteenth aspect in combination with any other aspect listed herein, unless otherwise stated, the housing includes a hydrophobic vent for removing air.

[0060] In the thirty-first aspect of the present disclosure, which thirty-first aspect can be combined with any other aspect listed herein, unless otherwise stated, a medical fluid processing method includes: enabling medical fluid to be prepared at the point of use for treatment; enabling the medical fluid to be transported to the patient along a patient line through a filter hydrophilic membrane; and enabling used medical fluid to be returned through the same patient line, wherein the filter hydrophilic membrane is bypassed.

[0061] In a thirty-second aspect of the present disclosure, which thirty-second aspect may be combined with the thirty-first aspect in combination with any other aspect listed herein, unless otherwise stated, the filter hydrophilic membrane and the bypassing occurs within a filter housing the filter hydrophilic membrane.

[0062] In a thirty-third aspect of the present disclosure, which thirty-third aspect may be combined with the thirty-first aspect in combination with any other aspect listed herein unless otherwise stated, the medical fluid prepared for treatment at the point of use is a peritoneal dialysis fluid.

[0063] In the thirty-fourth aspect of the present disclosure, which can be combined with any other aspect listed herein, unless otherwise stated, the fluid filtering method includes: enabling the fluid flowing from the first port of the filter to the second port of the filter to be filtered; and enabling the fluid flowing from the second port of the filter to the first port of the filter to avoid filtration.

[0064] In the thirty-fifth aspect of the present disclosure, the thirty-fifth aspect may be combined with the thirty-fourth aspect in combination with any other aspect listed herein, unless otherwise stated, causing the fluid flowing from the second port of the filter to the first port of the filter to avoid filtration includes diverting the fluid flowing from the second port of the filter to the first port away from the filtering mechanism.

[0065] In the thirty-sixth aspect of the present disclosure, which thirty-sixth aspect may be combined with the thirty-fourth aspect in combination with any other aspect listed herein, unless otherwise stated, the method further includes enabling fluid flowing from a first port of the filter to a second port of the filter to bypass a fluid passage used by fluid flowing from the second port of the filter to the first port of the filter.

[0066] In the thirty-seventh aspect of the present disclosure, in combination Figures 1 to 6 Any structure, function and alternative disclosed may be combined with Figures 1 to 6 Any other structures, functions and alternatives disclosed may be combined.

[0067]

[0013] According to the present disclosure and the above aspects, an advantage of the present disclosure is therefore to provide an improved medical fluid delivery system.

[0068] Another advantage of the present disclosure is to provide an improved medical fluid delivery system that prepares therapeutic fluids in-line or at the point of use.

[0069] Yet another advantage of the present invention is to provide an improved medical fluid delivery system having a sterile disinfection grade filter in the patient line.

[0070] Yet another advantage of the present disclosure is to provide an improved medical fluid delivery system having a sterile disinfecting grade filter for filtering mixed in-line therapeutic fluids.

[0071] Yet another advantage of the present invention is to provide an improved medical fluid delivery system having a sterilizing grade filter that is easily purged of air and primed with fluid.

[0072] The advantages discussed herein may be found in one or some, and perhaps not all, of the embodiments disclosed herein.Additional features and advantages are described herein and will become apparent from the following detailed description and drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0073] Figure 1 is a front elevation view of one embodiment of a medical fluid delivery system having point-of-use dialysis fluid production of the present disclosure.

[0074] Figure 2 is with Figure 1 A front view of one embodiment of a disposable kit for use with the system is shown.

[0075] Figure 3 It is available with Figure 2 An elevational cross-sectional view of one embodiment of a patient line filter for use with a disposable kit.

[0076] Figure 4 It is available with Figure 2 A perspective cross-sectional view of one embodiment of a patient line filter for use with a disposable kit.

[0077] Figure 5 It is available with Figure 2 A perspective cross-sectional view of one embodiment of a patient line filter for use with a disposable kit wherein the filter housing has been removed to better show an embodiment of a filter hydrophilic membrane.

[0078] Figure 6 It is available with Figure 2A perspective cross-sectional view of one embodiment of a patient line filter for use with a disposable kit of the invention, wherein the filter housing and filter hydrophilic membranes have been removed to better show an embodiment of a spacer grid located between the filter hydrophilic membranes. DETAILED DESCRIPTION Systematic review

[0079] The examples described herein can be applied to any medical fluid treatment system that delivers medical fluids that can be mixed at the point of use, before treatment and / or during treatment, such as dialysis fluids, replacement fluids, or intravenous drugs. These examples are particularly suitable for renal failure therapies, such as all forms of peritoneal dialysis ("PD"), hemodialysis ("HD"), hemofiltration ("HF"), hemodiafiltration ("HDF"), and continuous renal replacement therapy ("CRRT"), which are collectively or generally referred to as renal failure therapies in this article. In addition, the machine described herein can be used in a clinical or home environment. For example, the machine and related methods can be used to be adopted in a PD or HD machine in a center, which actually runs continuously throughout the day. Alternatively, the machine and method can be used in a home PD or HD machine, for example, a home PD or HD machine can run at night when the patient is sleeping. The machine and method discussed herein can also be applied to medical delivery applications. The following examples will be described in the context of a peritoneal dialysis system with point-of-use dialysis fluid production, but these examples can be used to form point-of-use treatment fluids for any of the above forms.

[0080] Referring now to the drawings, in particular Figure 1 , one embodiment of a peritoneal dialysis system with point-of-use dialysis fluid production of the present disclosure is illustrated by system 10. System 10 includes a cycler 20 and a water purifier 210. Suitable cyclers for cycler 20 include, for example, Amia® or HomeChoice® cyclers sold by Baxter International, Inc., and it should be understood that these cyclers are provided with updated programs to execute and use point-of-use dialysis fluid produced according to system 10. To this end, cycler 20 includes a control unit 22, which has at least one processor and at least one memory. Control unit 22 also includes a wired or wireless transceiver for sending information to and receiving information from water purifier 210. Water purifier 210 also includes a control unit 212, which has at least one processor and at least one memory. Control unit 212 also includes a wired or wireless transceiver for sending information to and receiving information from control unit 22 of cycler 20. For example, wired communication can be performed via an Ethernet connection. Wireless communication can be performed via Bluetooth TM , WiFi TM, Zigbee®, Z-Wave®, wireless Universal Serial Bus (“USB”), or infrared protocols, or through any other suitable wireless communication technology.

[0081] The cycler 20 includes a housing 24 that houses a device programmed by a control unit 22 to prepare fresh dialysis solution at the point of use, pump the freshly prepared dialysis fluid to the patient P, allow the dialysis fluid to reside in the patient P, and then pump the spent dialysis fluid to a drain. In the illustrated embodiment, the water purifier 210 includes a drain line 214 leading to a drain 216, which may be a residential sewer or a drain container. In an embodiment, the device programmed by the control unit 22 to prepare fresh dialysis solution at the point of use includes a device for a pneumatic pumping system, including but not limited to (i) one or more positive pressure reservoirs, (ii) one or more negative pressure reservoirs, (iii) a compressor and a vacuum pump each under the control of the control unit 22, or a single pump that generates positive and negative pressures under the control of the control unit 22 to provide the positive and negative pressures to be stored at the one or more positive and negative pressure reservoirs, (iv) a plurality of pneumatic valve chambers for delivering the positive and negative pressures to a plurality of fluid valve chambers, and (v) a plurality of pneumatic pump chambers for transferring the positive and negative pressures to a plurality of fluid valve chambers. negative pressure is delivered to a plurality of fluid pump chambers, (vi) a plurality of electrically actuated on / off pneumatic solenoid valves under the control of the control unit 22, which are located between the plurality of pneumatic valve chambers and the plurality of fluid valve chambers, (vii) a plurality of electrically actuated variable orifice pneumatic valves under the control of the control unit 22, which are located between the plurality of pneumatic pump chambers and the plurality of fluid pump chambers, (viii) in one embodiment, a heater under the control of the control unit 22 for heating the dialysis fluid when the dialysis fluid is mixed, and (ix) an occluder 26 under the control of the control unit 22 for closing the patient line and the drain line in the event of an alarm and other situations.

[0082] In one embodiment, the plurality of pneumatic valve chambers and the plurality of pneumatic pump chambers are located on the front face or front surface of the housing 24 of the cycler 20. The heater is located within the housing 24 and, in one embodiment, comprises a heating coil that contacts a heating plate or tray that is located on a heating cover ( Figure 1 1 and 12. The top of the housing 24 is positioned below the housing 24 (not shown).

[0083] In the illustrated embodiment, the cycler 20 includes a user interface 30. In an embodiment, the control unit 22 includes a video controller, which may have its own processing and memory, for interacting with the main control processing and memory of the control unit 22. The user interface 30 includes a video monitor 32, which may be operated using a touch screen overlay placed on the video monitor 32 for inputting commands into the control unit 22 through the user interface 30. The user interface 30 may also include one or more electromechanical input devices, such as membrane switches or other buttons. The control unit 22 may also include an audio controller for playing sound files, such as voice activated commands, at one or more speakers 34.

[0084] In the illustrated embodiment, the water purifier 210 also includes a user interface 220. In an embodiment, the control unit 212 of the water purifier 210 includes a video controller, which may have its own processing and memory for interacting with the main control processing and memory of the control unit 212. The user interface 220 includes a video monitor 222, which may also be operated using a touch screen overlay placed on the video monitor 222 for inputting commands into the control unit 212. The user interface 220 may also include one or more electromechanical input devices, such as a membrane switch or other buttons. The control unit 212 may also include an audio controller for playing sound files, such as alarms or warning sounds, at one or more speakers 224 of the water purifier 210.

[0085] Additional references Figure 2 , shows an embodiment of a disposable kit 40. The disposable kit 40 is also Figure 1 4, which cooperates with the cycler 20 to move fluid within the disposable set 40, for example, as described herein, to mix the dialysis fluid. In the illustrated embodiment, the disposable set 40 includes a disposable cassette 42, which may include a planar rigid plastic piece covered on one or both sides by a flexible membrane. The membrane pressed against the housing 24 of the cycler 20 forms a pumping and valve membrane. Figure 2 The disposable cassette 42 is shown to include a fluid pump chamber 44 that operates in conjunction with a pneumatic pump chamber located at the housing 24 of the cycler 20 and a fluid valve chamber 46 that operates in conjunction with a pneumatic valve chamber located at the housing 24 of the cycler 20 .

[0086] Figure 1 and Figure 2 The disposable set 40 is shown to include a patient line 50 extending from a patient line port of the cassette 42 and terminating in a patient line connector 52 . Figure 1The patient line connector 52 is shown connected to a patient transfer kit 54, which in turn is connected to an indwelling catheter located in the peritoneal cavity of the patient P. The patient line 50 also includes a sterilization grade filter 100 discussed in detail below. The disposable kit 40 includes a drain line 56 extending from a drain line port of the cassette 42 and terminating in a drain line connector 58. Figure 1 The drainage line connector 58 is shown removably connected to the drainage connector 218 of the water purifier 210 .

[0087] Figure 1 and Figure 2 The disposable kit 40 is further shown to include a heater / mixing line 60 that extends from a heater / mixing line port of the cassette 42 and terminates in a heater / mixing bag 62, which will be discussed in more detail below. The disposable kit 40 includes an upstream water line segment 64a that extends to a water inlet 66a of a water collector 66. A downstream water line segment 64b extends from a water outlet 66b of the water collector 66 to the cassette 42. In the illustrated embodiment, the upstream water line segment 64a begins at a water line connector 68 and is located upstream of the water collector 66. Figure 1 The water line connector 68 is shown removably connected to the water outlet connector 228 of the water purifier 210 .

[0088] The output water of the water purifier 210 may also be suitable for water for peritoneal dialysis ("WFPD"). The sterile disinfection grade filter 100 in the patient line 50 ensures that any contaminants in the water leaving the water purifier 210 are removed. In addition to the sterile patient line disinfection grade filter 100, the system 10 can but does not have to provide one or more sterile disinfection grade filters in one or more water lines. In the illustrated embodiment, the sterile disinfection grade filter 90a is placed upstream of the downstream sterile disinfection grade filter 90b accordingly. Filters 90a and 90b can be placed in the water line segment 64a upstream of the water collector 66. Sterile disinfection grade filters 100, 90a and 90b can be straight-through filters without waste lines. For example, the pore size of the filter membrane of the filter 100, 90a and 90b can be less than 1 micron, such as 0.1 or 0.2 microns. The assignee of the present disclosure can provide suitable sterile disinfection grade filters 100, 90a and 90b. In embodiments, only one of the upstream or downstream sterilizing filters 90a and 90b is required to produce a WFPD, however, in the embodiment shown, two sterilizing grade filters 90a and 90b may be provided in case one fails.

[0089] Figure 2It is further shown that a final bag or sample line 72 may be provided extending from a final bag or sample port of the cassette 42. The final bag or sample line 72 terminates in a connector 74 that may be connected to a matching connector of a premixed final fill bag of dialysis fluid, or to a sample bag or other sample collection container. The final bag or sample line 72 and connector 74 may alternatively be used for a third type of concentrate if desired.

[0090] Figure 1 and Figure 2 The disposable set 40 is shown to include a first (e.g., glucose) concentrate line 76 extending from a first concentrate port of the cassette 42 and terminating in a first (e.g., glucose) cassette concentrate connector 80a. A second (e.g., buffer) concentrate line 78 extends from a second concentrate port of the cassette 42 and terminates in a second (e.g., buffer) cassette concentrate connector 82a.

[0091] Figure 1 A first concentrate container 84a is shown containing a first (e.g., glucose) concentrate which is pumped from the first concentrate container 84a through a container line 86 to a first container concentrate connector 80b which mates with the first cartridge concentrate connector 80a. A second concentrate container 84b contains a second (e.g., buffer) concentrate which is pumped from the second concentrate container 84b through a container line 88 to a second container concentrate connector 82b which mates with the second cartridge concentrate connector 82a.

[0092] In an embodiment, to begin treatment, the patient P loads the cassette 42 into the cycler 20 and, in a random or specified order, (i) places the heater / mixing bag 62 onto the cycler 20, (ii) connects the upstream water line segment 64a to the water outlet connector 228 of the water purifier 210, (iii) connects the drain line 56 to the drain connector 218 of the water purifier 210, (iv) connects the first cassette concentrate connector 80a to the first container concentrate connector 80b, and (v) connects the second cassette concentrate connector 82a to the second container concentrate connector 82b. At this point, the patient connector 52 remains capped. Once fresh dialysis fluid is prepared and verified, the fresh dialysis fluid is injected into the patient line 50 including the sterilizing grade filter 100, after which the patient P can connect the patient line connector 52 to the transfer kit 54 for treatment. Each of the above steps can be graphically shown on the video monitor 32 and / or provided through voice guidance from the speaker 34.

[0093] For the disposable kit 40, the rigid portion of the box 42 can be made, for example, of amorphous thermal olefin polymer ("TOPAS") cyclic olefin copolymer ("coc"). The flexible membrane of the box 42 can be made, for example, of copolyether ("PCCE") and can have one or more layers. Any pipe or line can be made, for example, of polyvinyl chloride ("PVC"). Any connector can be made, for example, of acrylonitrile-butadiene-styrene ("ABS", such as the connector 70 of the heater / mixing bag or container 62 and / or the concentrate connectors 80a, 80b, 82a, 82b discussed below), acrylic resin (such as for the drainage line connector 58) or PVC (such as for the water line connector water line connector 68). Any bag or container, such as the heater / mixing bag or container 62 discussed below, can be made of PVC. The materials used for any of the above components may change over time. The housing of the sterile disinfection grade filter 100 can be made of any of the materials listed above.

[0094] The control unit 22 may be programmed to cause the cycler 20 to perform one or more mixing actions to help properly and evenly mix the dialysis fluid for treatment. For example, any fluid pump chamber 44 may be caused to draw a certain amount of mixed fluid (e.g., made of one or both of the first and second concentrates and purified water) from the heater / mixing bag 62 into the pump chamber, and return this mixture to the heater / mixing bag 62, and repeat this process multiple times (which is described herein as a mixing sequence or "stirring"). In particular, to perform a mixing sequence, in an embodiment, the control unit 22 causes the cycler 20 to close all fluid valve chambers 46 at the cassette 42 except for the fluid valve chambers 46 leading to the heater / mixing line 60 and the heater / mixing bag 62. The fluid pump chambers 44 operate sequentially and repeatedly to (i) pull a fluid composition of purified water and concentrate that may not be mixed from the heater / mixing bag 62 into the pump chamber, and then (ii) push the mixed purified water and concentrate from the pump chamber back to the heater / mixing bag 62, and (iii) repeat (i) and (ii) at least once. The control unit 22 can be programmed to operate the fluid pump chambers 44 and associated valves 46 together so that they pull and push simultaneously, or alternatively, so that one pump chamber 44 pulls from the heater / mixing bag 62 while the other pump chamber 44 pushes to the heater / mixing bag 62, thereby creating turbulence in the heater / mixing line 60.

[0095] Providing a container or bag 62 operable with the cassette 42 and the heater / mixing line 60 allows the purified water from the water collector 66 and the concentrates from the first concentrate container 84a and the second concentrate container 84b to at least partially mix before entering the container or bag. However, even if a cassette 42 is not provided, the purified water and at least one concentrate will still be partially mixed in the heater / mixing line 60 before reaching the container or bag. Patient Line Filters

[0096] Reference now Figure 3 , a schematic diagram of an embodiment of a patient line sterilizing grade filter 100 is shown, showing the flow paths presented by fresh dialysis fluid mixed online to the patient at the point of use and by spent dialysis fluid returned from the patient. In an embodiment, the control unit 22 of the cycler 20 causes the fluid pump chamber 44 and the fluid valve chamber 46 of the disposable cassette 42 to move fresh dialysis fluid under positive pressure in the patient line. Figure 3 The control unit 22 of the cycler 20 causes the fluid pump chamber 44 and the fluid valve chamber 46 of the disposable cassette 42 to pump the used dialysis fluid from right to left in the dialysis chamber 42 to the patient P. Figure 3 The pumping is from left to right in the middle and from the patient P to the box 42.

[0097] The patient line sterilization grade filter 100 includes a filter housing 102, any one or more of which may be made of any of the materials listed above, and the filter housing 102 may be made of one or more molded parts (e.g., injection molded parts). In the illustrated embodiment, the housing 102 includes an elongated enclosure 104 sealed at both ends by a first port cover 106 and a second port cover 112. The first port cover 106 includes a first port 108 and defines a first manifold or opening area 110, while the second port cover 112 includes a second port 114 and defines a second manifold or opening area 116. The first port 108 and the second port 112 may be configured to be sealedly connected to a line segment of the patient line 50 by a compression fitting (the port has a compression connector), a hose barb fitting (the port has a hose barb), a Luer connection (the port has a male or female Luer connector), a stretch of a patient line fitting (the outer diameter of the port is greater than the inner diameter of the line segment of the patient line 50), or a combination of the above.

[0098] Figure 3The filter housing 102 in one embodiment is shown to form a spent dialysis fluid passage 118 and to accommodate a fresh dialysis fluid passage 120. The first manifold or opening area 110 and the second manifold or opening area 116 are capable of receiving fresh dialysis fluid and spent dialysis fluid. The lines with arrows pointing to the right represent the spent dialysis fluid flowing through the spent dialysis fluid passage 118, while the lines with arrows pointing to the left represent the fresh dialysis fluid flowing through the fresh dialysis fluid passage 120. The fresh dialysis fluid passage 120 is shown to be divided into a first upper branch 122 and a second lower branch 124. As described in more detail below, the fresh dialysis fluid flows downward from the first upper branch 122 through a plurality of substantially parallel passages formed by the first filter hydrophilic membrane and the internal grid into an interior region 126 of the fresh dialysis fluid passage 120. Similarly, the fresh dialysis fluid flows upward from the second lower branch 124 through a plurality of substantially parallel passages formed by the second filter hydrophilic membrane and the internal grid into an interior region 126 of the fresh dialysis fluid passage 120.

[0099] The first port cap 106 houses a first one-way valve 150a that seals to a structure forming a fresh dialysis fluid pathway 120. The second port cap 112 houses a second one-way valve 150b that seals to an elongated enclosure 104 of the filter housing 102 that, in the illustrated embodiment, forms a spent dialysis fluid pathway 118. The first one-way valve 150a and the second one-way valve 150b may be made of a medically safe rubber or plastic, such as silicone or any of the flexible materials listed above. The first one-way valve 150a and the second one-way valve 150b may be, for example, duckbill check valves.

[0100] like Figure 3 As shown, the first one-way valve 150a is oriented such that the first one-way valve 150a opens under the positive pressure of fresh dialysis fluid delivered by the pumping cassette 42 through the fresh dialysis fluid pathway 120. Fresh dialysis fluid exiting the one-way valve 150a flows through the first port 108 of the first port cap 106 and a section of the patient line 50 to the patient P. However, the orientation of the one-way valve 150a is such that the valve 150a closes under negative pressure from the pumping cassette 42, thereby drawing spent dialysis fluid through the first port 108 of the first port cap 106 into the filter 100. In this manner, spent dialysis fluid is prevented from entering the fresh dialysis fluid pathway 120 and contacting the filter hydrophilic membrane, which is desirable because filtering the spent dialysis fluid may remove contaminants from the spent dialysis fluid, clog the filter hydrophilic membrane, and reintroduce the contaminants into the next cycle of fresh fluid.

[0101] like Figure 3As further shown in FIG. 1 , the second one-way valve 150b is oriented so that it opens under negative pressure of spent dialysis fluid pulled through the spent dialysis fluid pathway 118 by the pumping cassette 42. The spent dialysis fluid exiting the one-way valve 150b flows through the second port 114 of the second port cap 112 and a section of the patient line 50 to the disposable cassette 42. However, the orientation of the one-way valve 150b is such that the valve 150b closes under positive pressure from the pumping cassette 42, thereby pushing fresh dialysis fluid through the second port 114 of the second port cap 112 and into the filter 100. In this manner, all of the fresh dialysis fluid is forced to travel through the fresh dialysis fluid pathway 120, including its filter membrane.

[0102] Reference now Figure 4 , the patient line sterilizing grade filter 100 is shown in more detail. Here, a section is taken through the patient line 50, the filter housing 102, the spent dialysis fluid passage 118, the fresh dialysis fluid passage 120, the first port cover 106, the second port cover 112, and the one-way valves 150a and 150b. As described above, in one embodiment, the filter housing 102 defines the spent dialysis fluid passage 118 and retains the one-way valve 150b. Figure 4 In the embodiment, the second port cover 112 can also be formed with the filter housing 102, or sealed to the filter housing 102. As used herein, "sealed to" can but does not necessarily mean adhered to, ultrasonically welded to, solvent bonded to, mechanically sealed to, or any combination of the above.

[0103] Figure 4 In one embodiment, the filter hydrophilic membrane and the one-way valve 150a are shown to be held by a membrane housing 130 located within and sealed to the filter housing 102. The membrane housing 130 can be made of any material described herein, can be molded (e.g., injection molded) into one or more pieces, and can be sealed to the filter housing 102 and the first port cap 106 by any technique described herein. In the embodiment shown, the first port cap 106 is sealed to the membrane housing 130. In an alternative embodiment, the port cap 106 can be formed together with the membrane housing 130.

[0104] exist Figure 4In the illustrated embodiment, both the filter housing 102 and the membrane housing 130 participate in forming the fresh dialysis fluid passage 120. The upper branch 122 of the fresh dialysis fluid passage 120 is located between the upper wall 128a of the filter housing 102 and the upper wall of the membrane housing 130 (which accommodates the upper filter hydrophilic membrane, as shown below). The lower branch 124 of the fresh dialysis fluid passage 120 is located between the partition wall 128b of the filter housing 102 and the lower wall of the membrane housing 130 (which accommodates the lower filter hydrophilic membrane, as shown below). The interior area 126 of the fresh dialysis fluid passage 120 is located within the membrane housing 130.

[0105] Figure 4 The structure and orientation of the one-way valves 150a and 150b are better shown. The one-way valve 150a can be sealed to (e.g., adhered to) the membrane housing 130 and / or clamped between the membrane housing 130 and the first port cover 106. In the illustrated embodiment, the one-way valve 150a is a duckbill check valve with a slit duckbill angled toward the patient P so that the positive fresh dialysis fluid pressure provided by the pumping cassette 42 opens the slit from the inside of the check valve, and so that the negative pressure from the cassette 42 pumping the spent dialysis fluid cannot open the slit. As shown, the one-way valve 150b can be sealed to (e.g., adhered to) the filter housing 102 and / or clamped between the filter housing 102 and the second port cover 114. In the illustrated embodiment, the one-way valve 150b is also a duckbill check valve with a slitted duckbill angled oppositely toward the pumping cassette 42 so that negative pressure of spent dialysis fluid provided by the pumping cassette 42 opens the slit from outside the check valve and so that positive pressure from the cassette 42 pumping fresh dialysis fluid cannot open the slit.

[0106] Figure 4 Also shown is that the elongated enclosure 104 of the filter housing can include (e.g., sealed to) one or more hydrophobic (air passes but liquid stays) vents 152. The hydrophobic vents 152 allow air to escape from the sterile disinfection filter 100, such as during infusion and prior to treatment. Removing air from the sterile disinfection filter 100 helps prevent air from reaching the patient P. Removing air also helps protect the filter hydrophilic membranes 140 and 142.

[0107] Reference now Figure 5 , the membrane housing 130 is shown in more detail, with the filter housing 102 cut away. The membrane housing 130 includes a mounting arm 132 that is sized and arranged to seal to the filter housing 102 and the first port cover 106 by any of the techniques described above. The mounting arm 132 is also sized and arranged to seal (e.g., adhere) to the check valve 150a. The mounting arm 132 extends to the grille housing 134, which is combined with the following Figure 6The grille housing 134 is shown in greater detail. Importantly, Figure 5 , the grid housing 134 is shown sealed to upper and lower (first and second) filter hydrophilic membranes 140 and 142. The first upper membrane 140 filters fresh dialysis fluid flowing downward through the first upper branch 122, while the second lower membrane 142 filters fresh dialysis fluid flowing upward through the second lower branch 124.

[0108] In one embodiment, each of the filter hydrophilic membranes 140 and 142 is a hydrophilic membrane. A hydrophilic membrane generally allows liquid water to flow from one side of the membrane to the other side, and when properly moistened, prevents air from passing through in this manner. The pore size of the filter hydrophilic membranes 140 and 142 can be, for example, less than one micron, such as 0.1 or 0.2 microns. This pore size helps remove residual contaminants or impurities from any of the following substances from the fresh dialysis fluid: purified water used to prepare the fresh dialysis fluid, concentrate used to prepare the fresh dialysis fluid, and / or any portion of the disposable set that delivers purified water or concentrate to the patient P.

[0109] Reference now Figure 6 , combined with Figure 5 The membrane housing 130 discussed is shown in more detail, with the filter hydrophilic membranes 140 and 142 removed so that the interior region 126 of the fresh dialysis fluid passage 120 within the membrane housing 130 can be seen. Specifically, the grid housing 134 is shown in more detail. The grid housing 134 can be made of any suitable material discussed herein (e.g., injection molded). In the illustrated embodiment, the grid housing 134 extends from the mounting arms 132 of the membrane housing 130. The grid housing 134 includes a plurality of baffles 136 that extend across the grid housing 134 and separate the filtered dialysis fluid that has flowed through the filter hydrophilic membranes 140 and 142 into a plurality of fluid channels 144 that form the interior region 126 of the fresh dialysis fluid passage 120. The baffles 136 help support the thinner filter hydrophilic membranes 140 and 142 and space the filter hydrophilic membranes a desired distance apart.

[0110] In order to maintain the baffles 136 in their illustrated spaced-apart and generally parallel relationship, a plurality of cross braces 138 may be provided. The cross braces 138 are sized (narrowed) so that filtered dialysis fluid can flow through the cross braces along the channels 144 defined by the baffles 136 to the collection channels 146. The collection channels 146 in turn funnel the filtered dialysis fluid to the first one-way valve 150a, after which the filtered dialysis fluid exits the filter 100 into a downstream segment of the patient line 50, as described herein.

[0111] 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. Such changes and modifications may be made without departing from the spirit and scope of the present subject matter and without diminishing the intended advantages of the present subject matter. Therefore, it is intended that the appended claims cover such changes and modifications. For example, the fluid pump chamber 44 may be a pneumatically actuated pump chamber or a section of peristaltic pumping tubing. Similarly, the valve chamber 46 may be pneumatically actuated, such as volcano valves, or a section of tubing operated by a pinch valve. Likewise, the pump and valve actuators may be pneumatic actuators or electromechanical actuators, such as a peristaltic pump actuator and a pinch valve, respectively.

Claims

1. A peritoneal dialysis system, comprising: a cycler configured to pump peritoneal dialysis fluid; and a disposable set configured to receive peritoneal dialysis fluid pumped by the cycler, the disposable set comprising a filter having a membrane configured to filter the peritoneal dialysis fluid, the filter configured such that (i) fresh peritoneal dialysis fluid flowing from the cycler to the patient flows through the membrane via a passage having an outlet end located downstream of a flow of fresh peritoneal dialysis fluid flowing through the membrane, and (ii) spent peritoneal dialysis fluid flowing from the patient through the filter to the cycler bypasses the membrane.

2. The peritoneal dialysis system of claim 1, wherein the disposable set includes tubing extending from the filter to a connector configured to connect to a patient transfer set.

3. The peritoneal dialysis system of claim 1, wherein the disposable kit further comprises a disposable drainage line.

4. The peritoneal dialysis system of claim 1, wherein the filter is connected to a patient line extending from the cycler.

5. The peritoneal dialysis system of claim 1 , wherein the passage is a fresh peritoneal dialysis fluid passage, and wherein the filter further comprises a spent peritoneal dialysis fluid passage disposed in parallel with the fresh peritoneal dialysis fluid passage, the membrane being positioned along the fresh peritoneal dialysis fluid passage, the spent peritoneal dialysis fluid passage being configured to enable spent peritoneal dialysis fluid flowing through the filter to bypass the membrane.

6. The peritoneal dialysis system of claim 5, wherein a one-way valve is located at or near the outlet end of the fresh peritoneal dialysis fluid pathway, the one-way valve being positioned and arranged to prevent spent peritoneal dialysis fluid returning from the patient from reaching the membrane.

7. The peritoneal dialysis system of claim 5, wherein a one-way valve is located at an outlet end of the spent peritoneal dialysis fluid pathway, the one-way valve being positioned and arranged to prevent fresh peritoneal dialysis fluid from flowing through the filter via the spent peritoneal dialysis fluid pathway.

8. The peritoneal dialysis system of claim 5, wherein the membrane is housed in a membrane housing positioned along the fresh fluid passage, and wherein the filter is configured to allow fresh peritoneal dialysis fluid to flow from outside the membrane housing through the membrane and into an interior region of the membrane housing.

9. The peritoneal dialysis system of claim 5, wherein the filter comprises a housing having a first port and a second port, the first port leading to a first end of the filter housing, the second port leading to a second end of the filter housing, the first end of the filter housing forming a first end of the fresh peritoneal dialysis fluid passage and a spent peritoneal dialysis fluid passage, and the second end of the filter housing forming a second end of the fresh peritoneal dialysis fluid passage and a spent peritoneal dialysis fluid passage.

10. The peritoneal dialysis system of claim 9, wherein the first end of the fresh fluid handling pathway at the first end of the filter housing comprises a first one-way valve, and wherein the second end of the spent fluid handling pathway at the second end of the filter housing comprises a second one-way valve.

11. The peritoneal dialysis system of claim 1 , wherein the membrane is housed in a membrane housing, and fresh peritoneal dialysis fluid entering the filter flows to the outside of the membrane housing, and fresh filtered peritoneal dialysis fluid leaving the filter flows out from the inside of the membrane housing.

12. The peritoneal dialysis system of claim 1 , wherein the membrane is a first membrane, wherein the filter includes a second membrane, wherein the first membrane and the second membrane are accommodated in a membrane housing, and fresh peritoneal dialysis fluid entering the filter is divided into a first branch flowing to the outside of the first membrane and a second branch flowing to the outside of the second membrane.

13. The peritoneal dialysis system of claim 12, wherein the membrane housing comprises a passage grid located between the first membrane and the second membrane.

14. The peritoneal dialysis system of claim 12, wherein the first membrane and the second membrane are located at opposite sides of the membrane housing, respectively, the first branch extends to the first side of the housing, and the second branch extends to the second side of the housing.

15. The peritoneal dialysis system of claim 1, comprising at least one hydrophobic vent for removing air from the filter.

16. A peritoneal dialysis system, comprising: a cycler configured to pump peritoneal dialysis fluid; and a disposable kit configured to receive peritoneal dialysis fluid pumped by the cycler, the disposable kit comprising a filter in which the peritoneal dialysis fluid is intended to flow in first and second directions, wherein the filter is configured to filter the peritoneal dialysis fluid flowing in the first direction and not filter the peritoneal dialysis fluid flowing in the second direction, the filter comprising: Filter housing, a first fluid passage provided by the filter housing for causing the peritoneal dialysis fluid to flow in the first direction, a second fluid passage provided by the filter housing for causing peritoneal dialysis fluid to flow in the second direction, and A membrane is positioned to filter peritoneal dialysis fluid flowing in the first direction, and wherein the outlet end of the first fluid pathway is located downstream of the flow of peritoneal dialysis fluid through the membrane.

17. The peritoneal dialysis system of claim 16, wherein the membrane is contained in a membrane housing located within the filter housing and along the fresh fluid passage, and wherein the filter is configured such that fresh peritoneal dialysis fluid flows from outside the membrane housing through the membrane and into an interior region of the membrane housing.

18. The peritoneal dialysis system of claim 16, wherein the filter housing comprises a first port and a second port, the first port leading to a first end of the filter housing, the second port leading to a second end of the filter housing, the first end of the filter housing forming a first end of the fresh peritoneal dialysis fluid passage and a spent peritoneal dialysis fluid passage, and the second end of the filter housing forming a second end of the fresh peritoneal dialysis fluid passage and a spent peritoneal dialysis fluid passage.

19. The peritoneal dialysis system of claim 16, wherein the membrane is housed in a membrane housing located within the filter housing, and wherein fresh peritoneal dialysis fluid entering the filter flows to the exterior of the membrane housing, and fresh, filtered peritoneal dialysis fluid exiting the filter flows out of the interior of the membrane housing.

20. The peritoneal dialysis system of claim 16, wherein the membrane is a first membrane, and wherein the filter comprises a second membrane, wherein the first membrane and the second membrane are housed in a membrane housing located within the filter housing, and wherein fresh peritoneal dialysis fluid entering the filter is divided into a first branch flowing to the outside of the first membrane and a second branch flowing to the outside of the second membrane.

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