Peritoneal dialysis whole course management method and related equipment

Abstract

The invention discloses a peritoneal dialysis whole disease course management method and related equipment. The method comprises the following steps: acquiring residual renal function RRF, recent week Kt / V and total duration of single treatment of a patient, and evaluating disease course stages of the patient; dynamically setting an ultrafiltration amount threshold value of the patient based on the disease course stages; and calculating the actual ultrafiltration amount of the patient, and triggering an ultrafiltration alarm under the condition that the actual ultrafiltration amount exceeds the ultrafiltration amount threshold range. The problems of osmotic gradient loss, membrane failure, liquid leakage or mechanical blockage and the like possibly existing in over-low UF or even negative UF can be solved, the net ultrafiltration amount needs to be concerned due to the fact that abnormal over-high UF has potential dehydration living hypotension risk, but although an existing system records dialysis data, a static early warning threshold value is adopted, such as a unified ultrafiltration amount alarm interval, and therefore the problem that the existing system cannot give an alarm is solved. And the situation of false alarm or missing alarm is easy to generate is solved.

Description

Technical Field

[0001] The embodiments of this application relate to the field of smart healthcare, and more specifically, the present invention relates to a method and related equipment for the whole course of peritoneal dialysis management. Background Technology

[0002] Peritoneal dialysis is a renal replacement therapy for patients with end-stage renal disease and some acute kidney injury. It utilizes the patient's own peritoneum as a semipermeable membrane, establishing solute diffusion and water transmembrane transport between the peritoneal cavity and the blood, achieving toxin removal and water-sodium management. Dialysis fluid is injected into the peritoneal cavity through a peritoneal catheter, remains there for a period of time, and then is drained. Net ultrafiltration volume (UF) is usually defined as: drained fluid volume - injected fluid volume. APD devices calculate UF at the end of each cycle or at the end of a treatment course and judge it according to the expected range. Too low a UF or even a negative UF may indicate problems such as loss of osmotic gradient, membrane failure, leakage, or mechanical blockage. Abnormally high UF poses a potential risk of dehydration or hypotension. Therefore, net ultrafiltration volume needs to be monitored. However, while existing systems record dialysis data, they use static warning thresholds. Without a unified ultrafiltration volume alarm range, false alarms or missed alarms are prone to occur. Summary of the Invention

[0003] The summary section introduces a series of simplified concepts, which will be further explained in detail in the detailed description section. The summary section of this invention is not intended to limit the key features and essential technical features of the claimed technical solution, nor is it intended to determine the scope of protection of the claimed technical solution.

[0004] To address the potential problems of loss of osmotic gradient, membrane failure, leakage, or mechanical blockage caused by excessively low or even negative ultrafiltration (UF), and the potential risks of dehydration and hypotension associated with abnormally high UF, it is necessary to monitor net ultrafiltration volume. However, while existing systems record dialysis data, they use static warning thresholds, such as a unified ultrafiltration volume alarm range, which can easily lead to false alarms or missed alarms. Therefore, this invention proposes a method for managing the entire course of peritoneal dialysis, comprising:

[0005] Obtain the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment session to assess the patient's disease stage;

[0006] The ultrafiltration threshold for the patient is dynamically set based on the disease stage.

[0007] Calculate the patient's actual ultrafiltration volume, and trigger an ultrafiltration alarm if the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range.

[0008] Optionally, dynamically setting the ultrafiltration threshold for the patient based on the disease stage includes:

[0009] If the assessed disease stage is determined to be early, an upper limit threshold for ultrafiltration volume is set for the patient.

[0010] If the assessed disease stage is determined to be advanced, a lower limit threshold for ultrafiltration volume is set for the patient.

[0011] Optional, also includes:

[0012] Obtain the patient's residual renal function (RRF), serum creatinine (Scr), blood pressure, and weight change rate over a pre-defined period;

[0013] The target ultrafiltration center value for each treatment is determined based on the patient's residual renal function (RRF), serum creatinine (Scr), blood pressure, and the rate of weight change over a preset period. The upper and lower limits are then set according to a preset ratio to obtain the optimal ultrafiltration range for that treatment.

[0014] Optional, also includes:

[0015] Calculate the deviation between the patient's actual ultrafiltration volume and the optimal ultrafiltration range for that session;

[0016] Based on the deviation amount, hierarchical management is implemented, with different response measures corresponding to different deviation levels.

[0017] Optional, also includes:

[0018] When the patient's disease stage is early, the lower limit threshold of the early free water ratio is determined based on the statistical baseline of the patient's history when the body fluid status is stable. The early free water ratio is used to indicate the proportion of net ultrafiltration volume within a limited time window after the start of finger retention relative to the total net ultrafiltration volume of the current cycle.

[0019] An ultrafiltration alarm is triggered even when the patient's actual ultrafiltration volume does not exceed the ultrafiltration volume threshold range, but the patient's actual early free water percentage is lower than the early free water percentage lower limit threshold, and this decrease occurs for at least two consecutive nights.

[0020] Optionally, calculating the patient's actual ultrafiltration volume includes:

[0021] During the drainage phase, the tilt angle parameters and catheter height difference parameters related to the patient's position are obtained, and the siphon pressure caused by the superposition of the water column height difference is calculated.

[0022] Based on the siphon pressure, head compensation is performed on the symmetric weight and flow rate measurement results, and the actual ultrafiltration volume of the patient is obtained by correcting the symmetric weight and flow rate measurement results.

[0023] Optionally, calculating the patient's actual ultrafiltration volume includes:

[0024] During the dialysate inlet stage, the temperature value of the dialysate in the tubing or inside the machine is obtained, and the actual viscosity and density of the dialysate are predicted based on a preset temperature-viscosity comparison relationship to obtain a temperature correction factor.

[0025] When using a flow sensor to calculate the influent volume, the original flow rate value is divided by a temperature correction factor to obtain the corrected flow rate, which is then used to correct the measured influent volume of the dialysate.

[0026] When using the influent volume calculation with a weight sensor, the original flow rate value is divided by a temperature correction factor to obtain the corrected flow rate, which is used to correct the measured influent volume of the dialysate.

[0027] The patient's actual ultrafiltration volume is calculated based on the corrected dialysate influent volume.

[0028] Secondly, the present invention also proposes a peritoneal dialysis full-course management device, comprising:

[0029] The acquisition unit is used to acquire the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment, and to assess the patient's disease stage.

[0030] The setting unit is used to dynamically set the ultrafiltration threshold of the patient based on the disease stage;

[0031] The management unit is used to calculate the patient's actual ultrafiltration volume and trigger an ultrafiltration alarm if the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range.

[0032] Thirdly, an electronic device includes: a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the computer program stored in the memory to implement the steps of the peritoneal dialysis full-course management method as described in any of the first aspects above.

[0033] Fourthly, the present invention also proposes a computer-readable storage medium having a computer program stored thereon, wherein the computer program, when executed by a processor, implements the peritoneal dialysis full-course management method of any of the above claims in the first aspect.

[0034] In summary, the peritoneal dialysis full-course management method proposed in this application assesses the patient's disease stage by acquiring residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment session; dynamically sets the ultrafiltration volume threshold based on the disease stage; calculates the patient's actual ultrafiltration volume, and triggers an ultrafiltration alarm when the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range. This upgrades the net ultrafiltration volume management of peritoneal dialysis from a traditional static, uniform standard to an individualized, dynamically adjusted full-course management plan. By using disease course indicators to reveal the patient's baseline fluid balance and dynamically adjusting the threshold based on individual historical data, individualized safety management is achieved. It significantly reduces false alarms and false negatives, improving alarm reliability. It detects potential problems such as membrane failure, leakage, or mechanical obstruction early. It avoids excessive dehydration or volume overload, improving patient safety and quality of life; and tiered intervention improves the efficiency of medical resource utilization, making clinical management more refined. In early-stage patients, this method can accurately identify the potential risk of hypotension caused by excessively high UF; in late-stage patients, it can sensitively detect volume overload problems caused by low UF, both of which are superior to traditional uniform threshold schemes.

[0035] The peritoneal dialysis whole-course management method of the present invention, other advantages, objectives and features of the present invention will be apparent in part from the following description, and in part will be understood by those skilled in the art through study and practice of the present invention. Attached Figure Description

[0036] Various other advantages and benefits will become apparent to those skilled in the art upon reading the following detailed description of preferred embodiments. The accompanying drawings are for illustrative purposes only and are not intended to limit this specification. Furthermore, the same reference numerals denote the same parts throughout the drawings. In the drawings:

[0037] Figure 1 A schematic diagram of a peritoneal dialysis full-course management method provided in this application embodiment;

[0038] Figure 1a A schematic diagram of the patient data recording interface in an application system for a peritoneal dialysis full-course management method provided in this application embodiment;

[0039] Figure 1b A schematic diagram of the patient's disease staging assessment interface in a peritoneal dialysis full-course management method application system provided in this application embodiment;

[0040] Figure 1c A schematic diagram of the patient's ultrafiltration threshold setting interface in a peritoneal dialysis full-course management method application system provided in this application embodiment;

[0041] Figure 2A schematic diagram of a peritoneal dialysis full-course management device provided in this application embodiment;

[0042] Figure 3 A schematic diagram of an electronic device for managing the entire course of peritoneal dialysis provided in this application embodiment;

[0043] Figure 4 This is a schematic diagram of a hierarchical management interface in the whole process management of peritoneal dialysis, provided as an embodiment of this application. Detailed Implementation

[0044] The terms "first," "second," "third," "fourth," etc. (if present) in the specification, claims, and accompanying drawings of this application are used to distinguish similar objects and are not necessarily used to describe a specific order or sequence. It should be understood that such data can be interchanged where appropriate so that the embodiments described herein can be implemented in orders other than those illustrated or described herein. Furthermore, the terms "comprising" and "having," and any variations thereof, are intended to cover non-exclusive inclusion; for example, a process, method, system, product, or apparatus that comprises a series of steps or units is not necessarily limited to those steps or units explicitly listed, but may include other steps or units not explicitly listed or inherent to such processes, methods, products, or apparatus. The technical solutions of the embodiments of this application will now be clearly and completely described in conjunction with the accompanying drawings. Obviously, the described embodiments are only a part of the embodiments of this application, and not all of them.

[0045] To address the potential problems of loss of osmotic gradient, membrane failure, leakage, or mechanical blockage caused by excessively low or even negative ultrafiltration (UF), and the potential risks of dehydration and hypotension associated with abnormally high UF, it is necessary to monitor net ultrafiltration volume. However, while existing systems record dialysis data, they use static warning thresholds. For example, a unified ultrafiltration volume alarm range can easily lead to false alarms or missed alarms. Please refer to [link / reference needed]. Figure 1 This is a schematic diagram of a peritoneal dialysis full-course management method provided in an embodiment of this application, which may specifically include steps S110 to S130.

[0046] S110, obtain the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment, and assess the patient's disease stage.

[0047] S120, dynamically set the ultrafiltration threshold for the patient based on the disease stage.

[0048] S130, calculate the patient's actual ultrafiltration volume, and trigger an ultrafiltration alarm if the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range.

[0049] For example, the system can first obtain three key indicators from the patient's routine follow-up and dialysis data: residual renal function (RRF), recent weekly Kt / V value, and total duration of a single treatment session. RRF represents the patient's own renal clearance capacity and is an important basis for determining the patient's disease stage; Kt / V is an indicator of dialysis adequacy, reflecting the overall level of solute clearance; and the duration of a single treatment session reflects the prescription intensity and dialysis load. By comprehensively evaluating these three indicators, the system can output the patient's disease stage, such as early, middle, or late. Patients with higher RRF and more adequate Kt / V have better overall clearance capacity and are often in the early stage of the disease; while patients with severely decreased RRF and difficulty in achieving target Kt / V often enter the late stage of the disease. In this way, disease staging not only has a clear physiological basis but also provides a prerequisite for subsequent individualized setting of ultrafiltration thresholds. This avoids lumping all patients together, thus making subsequent threshold determination more accurate.

[0050] For example, after staging is determined, the system can dynamically generate individualized ultrafiltration threshold ranges based on the risk characteristics of different stages. Early-stage patients still have relatively good residual renal function; excessive ultrafiltration can easily lead to excessive fluid loss, resulting in hypotension or even dehydration. Therefore, the focus in the early stages is to tighten the upper limit of ultrafiltration. Late-stage patients have significant renal failure; insufficient ultrafiltration can easily lead to volume overload, inducing heart failure and hypertension. Therefore, the focus in the late stages is to raise the lower limit of ultrafiltration. Mid-stage patients are relatively balanced, with attention paid to both the upper and lower limits. The system can provide differentiated upper and lower thresholds for different stages based on statistical results of historical dialysis data, such as mean and dispersion, or based on empirical rules. For example, in the early stages, the system can set the upper limit to the historical mean plus a small deviation, while keeping the lower limit lenient; in the late stages, the opposite adjustment is made. This stage-driven dynamic threshold ensures safety while adapting to the patient's condition development, avoiding false alarms and missed alarms caused by overly rigid static thresholds. During dialysis, the system collects the volume difference between the influent and effluent in real time and calculates it as the actual net ultrafiltration volume for that cycle and overnight. This actual ultrafiltration volume is then compared to the aforementioned dynamic threshold range. If the actual ultrafiltration volume exceeds the upper limit, the system determines there is a risk of over-dehydration; if the actual ultrafiltration volume is below the lower limit, the system determines there is a risk of volume overload. Net ultrafiltration volume directly reflects water transmembrane transport, and its abnormality is often an early sign of membrane function decline, loss of osmotic gradient, or mechanical blockage. By comparing it with an individualized range, early warnings can be issued before serious consequences arise. This avoids mismatches between absolute values ​​and individual suitable ranges, improving the sensitivity and accuracy of identification. When the actual ultrafiltration volume exceeds the dynamic threshold range, the system will trigger an alarm and handle the situation according to the magnitude of the deviation. For example, when the deviation from the threshold is 10%–20%, the system only alerts the patient via SMS or app push notification; when the deviation is 20%–30%, the system automatically generates prescription adjustment suggestions and prompts the nurse to follow up by phone; when the deviation exceeds 30%, a red alert is triggered directly, requiring the patient to return for a follow-up visit as soon as possible. Through tiered management, abnormalities of different severity are mapped to different levels of intervention, achieving rational allocation of resources. This ensures that serious problems are addressed promptly while avoiding over-treatment or excessive disruption due to minor fluctuations, thus balancing sensitivity and practicality.

[0051] In summary, the peritoneal dialysis full-course management method provided in this application assesses the patient's disease stage by acquiring the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment session; dynamically sets the ultrafiltration volume threshold based on the disease stage; calculates the patient's actual ultrafiltration volume; and triggers an ultrafiltration alarm when the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range. This upgrades the net ultrafiltration volume management of peritoneal dialysis from a traditional static, uniform standard to an individualized, dynamically adjusted full-course management plan. By using disease course indicators to reveal the patient's baseline fluid balance and dynamically adjusting the threshold based on individual historical data, individualized safety management is achieved. It significantly reduces false alarms and false negatives, improving alarm reliability. It detects potential problems such as membrane failure, leakage, or mechanical obstruction early. It avoids excessive dehydration or volume overload, improving patient safety and quality of life; and tiered intervention improves the efficiency of medical resource utilization, making clinical management more refined. In early-stage patients, this method can accurately identify the potential risk of hypotension caused by excessively high UF; in late-stage patients, it can sensitively detect volume overload problems caused by low UF, both of which are superior to traditional uniform threshold schemes.

[0052] In some examples, dynamically setting the ultrafiltration threshold for the patient based on the disease stage includes:

[0053] If the assessed disease stage is determined to be early, an upper limit threshold for ultrafiltration volume is set for the patient.

[0054] If the assessed disease stage is determined to be advanced, a lower limit threshold for ultrafiltration volume is set for the patient.

[0055] For example, dynamically setting the ultrafiltration volume threshold for the patient based on the disease stage includes: when the assessed disease stage is early, the system sets an upper limit threshold for the ultrafiltration volume to prevent excessive water loss due to an excessively strong dialysate osmotic gradient, thus avoiding adverse events such as hypotension, dizziness, or dehydration; when the assessed disease stage is late, the system sets a lower limit threshold for the ultrafiltration volume to ensure that the patient can obtain sufficient ultrafiltration volume through dialysis to maintain fluid balance and prevent the risk of heart failure or hypertension due to excessive volume overload; when the assessed disease stage is mid-stage, the system can simultaneously set both the upper and lower limits for the ultrafiltration volume to ensure that the patient does not experience excessive dehydration or volume retention during dialysis, thereby achieving targeted safety management for different disease stages.

[0056] In some examples, it also includes:

[0057] Obtain the patient's residual renal function (RRF), serum creatinine (Scr), blood pressure, and weight change rate over a pre-defined period;

[0058] The target ultrafiltration center value for each treatment is determined based on the patient's residual renal function (RRF), serum creatinine (Scr), blood pressure, and the rate of weight change over a preset period. The upper and lower limits are then set according to a preset ratio to obtain the optimal ultrafiltration range for that treatment.

[0059] For example, during the dynamic setting of ultrafiltration thresholds, the system further acquires the patient's residual renal function (RRF), serum creatinine (Scr), blood pressure, and weight change rate within a preset cycle. RRF reflects the patient's water clearance capacity, serum creatinine, as a metabolic product concentration, reflects solute retention levels, blood pressure reflects the circulatory system's volumetric load, and weight change rate reflects recent fluid balance. Based on these multi-dimensional parameters, the system comprehensively evaluates the target ultrafiltration center value for the current treatment and weights each parameter using clinical experience or preset weights to obtain the target ultrafiltration level best suited to the patient's current condition. Subsequently, the system determines upper and lower thresholds based on the target ultrafiltration center value according to a preset proportional range, thus forming the optimal ultrafiltration range for the current treatment course. In this way, a more individualized ultrafiltration threshold range can be set for the patient before each treatment, making subsequent comparisons of actual ultrafiltration volumes and alarm triggering more targeted. By introducing multiple physiological and metabolic indicators to achieve dynamic modeling, misjudgments caused by relying on only a single parameter are avoided, thereby improving the accuracy of abnormality identification and the clinical reference value of early warnings.

[0060] In some examples, it also includes:

[0061] Calculate the deviation between the patient's actual ultrafiltration volume and the optimal ultrafiltration range for that session;

[0062] Based on the deviation amount, hierarchical management is implemented, with different response measures corresponding to different deviation levels.

[0063] For example, after determining the optimal ultrafiltration range for the current treatment, the system calculates in real time during treatment the deviation between the patient's actual ultrafiltration volume and the optimal ultrafiltration range. This deviation can be either an absolute value (difference between the actual value and the upper / lower limits) or a relative percentage (difference from the target center value). Based on this deviation, the system manages the ultrafiltration results of the current treatment in a tiered manner: when the deviation is within the first threshold range, the system automatically pushes reminders or educational content to guide the patient to pay attention to diet and fluid intake; when the deviation is within the second threshold range, the system provides feedback on the deviation to nursing staff and generates a suggested prescription adjustment plan; when the deviation exceeds the third threshold range, the system triggers a high-level alarm, prompting the patient to return for a follow-up visit and a comprehensive evaluation by a doctor. By quantifying the difference between the actual ultrafiltration volume and the ideal range, risks of different severity levels can be finely stratified, thus avoiding over-intervention or under-reaction caused by fixed-threshold alarms. This achieves tiered and individualized alarms, ensuring that minor fluctuations only trigger reminders, while serious abnormalities receive timely intervention, improving monitoring sensitivity while also considering the system's clinical usability and patient compliance.

[0064] For example, such as Figure 4 As shown, medical staff can see the information and deviation of the patients under their jurisdiction. The figure shows the deviation as a percentage. When the deviation exceeds the preset value, an alarm is generated and medical staff can intervene in a timely manner.

[0065] In some examples, it also includes:

[0066] When the patient's disease stage is early, the lower limit threshold of the early free water ratio is determined based on the statistical baseline of the patient's history when the body fluid status is stable. The early free water ratio is used to indicate the proportion of net ultrafiltration volume within a limited time window after the start of finger retention relative to the total net ultrafiltration volume of the current cycle.

[0067] An ultrafiltration alarm is triggered even when the patient's actual ultrafiltration volume does not exceed the ultrafiltration volume threshold range, but the patient's actual early free water percentage is lower than the early free water percentage lower limit threshold, and this decrease occurs for at least two consecutive nights.

[0068] For example, when the patient's disease stage is early, the system determines the lower limit threshold for the early free water ratio based on statistical data from multiple treatment cycles when the patient's fluid status is stable. The early free water ratio indicates the proportion of net ultrafiltration volume within a defined time window (e.g., 30 to 45 minutes) after the start of the dialysis session relative to the total net ultrafiltration volume of the current cycle, reflecting whether the free water pathway (AQP) function is normal at the beginning of dialysis. Subsequently, during the current dialysis session, the system compares the patient's actual ultrafiltration volume with the dynamic ultrafiltration volume threshold range, and calculates the patient's actual early free water ratio, comparing it with the lower limit threshold. If the system detects that the patient's actual ultrafiltration volume does not exceed the ultrafiltration volume threshold range, but the actual early free water ratio is lower than the lower limit threshold, and this abnormality shows a decreasing trend for at least two consecutive nights, the system still triggers an ultrafiltration alarm and outputs a prompt message.

[0069] Understandably, even if the total ultrafiltration rate is within the normal range, an abnormal decrease in the early free water percentage may indicate impaired peritoneal free water channel function, commonly seen in latent inflammation or early membrane function changes. Relying solely on the total ultrafiltration rate threshold can easily miss such potential risks. By adding the monitoring dimension of the early free water percentage and setting individualized thresholds, early identification of pathological changes can be achieved. The system can provide early warnings before patients show obvious ultrafiltration insufficiency, helping medical staff to intervene early and reduce the risk of serious complications caused by membrane function deterioration.

[0070] Suppose Mr. Zhang, a 55-year-old patient, is in the early stages of peritoneal dialysis, with a residual renal function (RRF) of 5.2 mL / min, a recent weekly Kt / V ratio of 1.7, and a single dialysis session duration of 9 hours. Based on staging, Mr. Zhang is classified as an early-stage patient. During multiple treatment sessions in his stable state, the system statistically determined the baseline early free water percentage to be approximately 42%, with a lower limit threshold set at 35%. On the first day of the dialysis session, the system calculated Mr. Zhang's actual total ultrafiltration volume for that evening to be 480 mL, falling within the dynamic threshold range [400–550 mL], and therefore, according to standard procedures, no alarm would be triggered. However, further analysis of the ultrafiltration volume during the first 30–45 minutes of the session showed that it accounted for only 32% of the total UF for that session, below the lower limit threshold of 35%. The system recorded this as an abnormal early free water percentage. On the second day, Mr. Zhang's total ultrafiltration volume was 500 mL, still within the threshold range. However, the calculated early free water percentage was 30%, lower than the previous day, again below the lower limit threshold. The system identified a downward trend for two consecutive nights. After the second day of dialysis, the system triggered an early warning of decreased free water function, alerting nursing staff to the possibility of weakened free water channel (AQP) function or early signs of latent inflammation / fibrosis. The system also provided suggestions, such as checking for signs of mild peritonitis; considering minor adjustments to the prescribed dialysate concentration and residence time; and strengthening patient education, advising the patient to seek medical attention promptly for symptoms such as abdominal pain or cloudy fluid. This mechanism can trigger an early warning 1–3 nights earlier than total UF abnormalities, before complete membrane failure or significant ultrafiltration, allowing for early intervention and reducing the risk of serious complications.

[0071] In some examples, calculating the patient's actual ultrafiltration volume includes:

[0072] During the drainage phase, the tilt angle parameters and catheter height difference parameters related to the patient's position are obtained, and the siphon pressure caused by the superposition of the water column height difference is calculated.

[0073] Based on the siphon pressure, head compensation is performed on the symmetric weight and flow rate measurement results, and the actual ultrafiltration volume of the patient is obtained by correcting the symmetric weight and flow rate measurement results.

[0074] For example, calculating the patient's actual ultrafiltration volume includes: during the drainage phase of dialysis treatment, the system first acquires the tilt angle parameter related to the patient's position and the height difference parameter between the catheter outlet and the abdominal cavity, thereby calculating the siphon pressure generated by the superposition of the water column height difference; wherein, the tilt angle parameter can be acquired by the inertial measurement unit built into the machine, and the height difference parameter can be obtained through the calibration information of the catheter installation position. Subsequently, the system performs head compensation on the weighing and flow measurement results during the drainage process based on the siphon pressure, thereby correcting the measurement deviation caused by changes in patient position or catheter height difference, and finally obtaining the corrected actual ultrafiltration volume.

[0075] Understandably, when a patient is in a sitting or semi-recumbent position during the drainage phase, the height difference between the two ends of the catheter alters the static pressure difference between the abdominal cavity and the drainage bag, creating an additional siphon effect. This causes the drainage volume detected by the weighing and flow sensors to be higher than initially thought, potentially leading to a misjudgment of overfiltration. By incorporating position and height difference parameters to calculate and compensate for the siphon pressure, systematic errors caused by positional differences can be effectively eliminated. This significantly improves the measurement accuracy of the actual ultrafiltration volume, avoids false alarms of spurious ultrafiltration, and ensures the reliability of subsequent threshold comparisons and abnormal alarms. Furthermore, combined with a dynamic compensation mechanism, it enhances applicability and robustness in home settings, reduces interference from arbitrary changes in patient position, and strengthens the system's clinical reference value.

[0076] Suppose a patient is undergoing automated peritoneal dialysis at home, and at the end of dialysis, enters the drainage phase. At this time, the patient is not lying flat, but rather semi-reclining in bed watching television. The dialysis machine is equipped with a weighing sensor and a flow sensor, and also has a built-in inertial measurement unit (IMU) to collect the patient's tilt angle. The IMU detects that the patient's current tilt angle is 45° semi-reclining. The system, combined with the catheter's preset calibration data, calculates that the height difference between the catheter outlet and the peritoneal fluid level in this position is 25 cm. Based on this height difference, the system calculates an additional hydrostatic pressure of approximately 2.5 kPa, equivalent to 25 cm of water column. This pressure creates a siphon effect, causing the drainage rate and total drainage volume to be overestimated. The weighing sensor shows an increase of 2200 mL in the drainage bag weight, and the flow sensor shows a cumulative volume of approximately 2180 mL. If this data is used directly, the calculated net ultrafiltration volume for this session is 650 mL. The system uses the calculated siphon pressure to compensate and correct the weighing and flow data. After correction, the actual discharge volume is 2050 mL and the influent volume is 1500 mL, therefore the corrected net ultrafiltration volume is 550 mL. If not corrected, the system would compare 650 mL with the threshold range, which might falsely report a risk of over-dehydration; the corrected 550 mL falls within the individualized threshold range, so no alarm will be triggered.

[0077] According to some embodiments, calculating the patient's actual ultrafiltration volume includes:

[0078] During the dialysate inlet stage, the temperature value of the dialysate in the tubing or inside the machine is obtained, and the actual viscosity and density of the dialysate are predicted based on a preset temperature-viscosity comparison relationship to obtain a temperature correction factor.

[0079] When using a flow sensor to calculate the influent volume, the original flow rate value is divided by a temperature correction factor to obtain the corrected flow rate, which is then used to correct the measured influent volume of the dialysate.

[0080] When using the influent volume calculation with a weight sensor, the original flow rate value is divided by a temperature correction factor to obtain the corrected flow rate, which is used to correct the measured influent volume of the dialysate.

[0081] The patient's actual ultrafiltration volume is calculated based on the corrected dialysate influent volume.

[0082] For example, calculating the patient's actual ultrafiltration volume includes: during the fluid infusion stage, the system first acquires the dialysate temperature value collected by a temperature sensor placed in the tubing or body, and predicts the actual viscosity and density of the current dialysate based on a stored temperature-viscosity correlation, thereby obtaining a temperature correction factor. The temperature correction factor reflects the changes in the physical properties of the liquid at different temperatures. When using a flow sensor to calculate the infusion volume, the system divides the originally detected flow rate value by the temperature correction factor to obtain a corrected flow rate value, and uses this to correct the measured dialysate infusion volume. This avoids the problem of underestimating the flow rate due to increased viscosity caused by excessively low dialysate temperature or insufficient heating. When using a weight sensor to calculate the infusion volume, the system also uses the temperature correction factor to correct the volume conversion. Specifically, by combining the corrected liquid density parameter, the weight sensor's detection result is converted into an infusion volume closer to the actual situation, thereby eliminating measurement errors caused by fluctuations in liquid density with temperature. Finally, based on the corrected dialysate inflow volume and the outflow volume data, the system calculates the corrected actual ultrafiltration volume.

[0083] Understandably, the viscosity and density of dialysate change at room temperature or in winter when it is not heated, directly affecting the measurement accuracy of the flow and weight sensors. Without temperature compensation, the calculated ultrafiltration volume will have systematic errors, potentially leading to misjudgments of insufficient or excessive ultrafiltration. By introducing a temperature correction factor, the influent volume can be dynamically corrected, improving the overall accuracy of the ultrafiltration volume calculation. This ensures that the calculated ultrafiltration volume is more stable and reliable regardless of the season or operating environment, avoiding false alarms caused by liquid temperature factors, thereby enhancing the clinical reference value of the warning system and patient safety.

[0084] Suppose a patient is undergoing automated peritoneal dialysis at home during winter. That evening, the dialysate bag is at approximately 15°C, not sufficiently heated. The dialysis machine is equipped with a flow sensor and a temperature sensor. The temperature sensor detects the actual temperature of the dialysate during the infusion phase as 15°C. After reading this temperature, the system retrieves a stored temperature-viscosity / density lookup table. The table shows that at 15°C, the dialysate viscosity is approximately 20% higher than at 37°C, and the density is approximately 2% higher than the standard value. Based on this, the system generates a temperature correction factor to reflect the changes in the liquid's properties at that temperature. The flow sensor detects an initial flow rate of 150 mL / min during infusion. Due to the low temperature causing a lower flow rate, the system divides the initial flow rate by the correction factor of approximately 1.2, obtaining a corrected flow rate of approximately 180 mL / min, and calculates the infusion volume accordingly. If a weight sensor is also used, the system will utilize the corrected density parameter to convert the weighing data into a volume closer to the true value. For example, if the weight is 2000g, it is converted to 2000mL according to the standard density at 37℃. However, at 15℃, it should be corrected to approximately 1960mL to avoid error accumulation. After the drainage is completed, the system combines the corrected difference between the influent and drainage volumes to obtain the actual net ultrafiltration volume for this treatment course. If the calculated result before correction is 550mL and the actual result after correction is 450mL, the system will use 450mL as the final UF value for threshold comparison.

[0085] In some implementations, the system also acquires additional information related to the patient's menstrual cycle in the management of female patients. Patients record the start and end dates of their menstrual cycle in a mobile application, and the system automatically calculates their current follicular phase, luteal phase, or menstrual period, allowing patients to correct or confirm the data. Simultaneously, the system can access heart rate variability (HRV) data recorded by wearable devices or chest patches to help determine fluid retention status. During the luteal phase, due to hormonal effects, fluid retention and a slight increase in weight are common, leading to a decrease in the baseline net ultrafiltration (UF). By taking physiological cycle fluctuations into account, the system avoids misidentifying naturally low UF levels as abnormal. When generating individualized ultrafiltration thresholds, the system not only considers the upper and lower limits determined by the disease stage but also adjusts the thresholds based on the patient's current menstrual cycle stage. During the luteal phase, the system moderately lowers the lower threshold based on the historical stable UF distribution baseline, or, if necessary, suggests using a slightly higher concentration of dialysate or extending the residence time to compensate for the effects of physiological retention. During the follicular phase or menstruation, the normal threshold setting is restored. Periodic fluid fluctuations are treated as an individualized bias, dynamically adjusting the threshold range. This reduces periodic false alarms and makes the system more closely reflect the patient's true physiological state. During dialysis, the system collects the influent and exfluent volumes in real time, calculates the actual net ultrafiltration volume, and compares this result with the periodically adjusted individualized ultrafiltration threshold range. If it exceeds the upper or lower limit, it is considered abnormal; if it remains within the adjusted threshold, it is considered normal fluctuation. By comparing the actual dynamic UF threshold, natural fluctuations are distinguished from true pathological abnormalities. This avoids false alarms triggered by periodic fluid retention and reduces unnecessary interventions. When the actual ultrafiltration volume is outside the adjusted threshold range, the system triggers an ultrafiltration alarm and outputs corresponding tiered intervention measures. For mild abnormalities, reminders can be sent to patients, prompting them to pay attention to fluid intake and salt intake. For significant abnormalities, suggestions for follow-up visits or re-examinations are generated. Especially during the luteal phase, if UF is low but does not exceed the corrected threshold, the system will not trigger an alarm, but instead will send educational messages indicating that the patient is currently in a periodic fluid retention phase and that the stay can be appropriately extended or the dialysate concentration adjusted. Linking periodic factors with prescription adjustment suggestions avoids underreporting of true risks and enhances patients' understanding and adherence to their own fluid fluctuations. By introducing the female menstrual cycle and HRV to assist in prediction on the basis of routine disease stage management, it is possible to identify and differentiate between physiological fluid fluctuations and pathological ultrafiltration insufficiency at an early stage. This reduces periodic false alarms, improves the accuracy and usability of the system, achieves dynamic threshold adaptation, makes ultrafiltration management more individualized, provides periodic health education, helps patients understand and cope with fluid fluctuations, and enhances adherence and safety.

[0086] According to some embodiments, during the dialysis drainage stage, the system uses pressure and flow sensors to collect pressure changes and flow curves in real time during the drainage process and performs dynamic analysis. When the catheter orifice is partially adhered to by the membrane or fibrin, the flow and pressure signals will exhibit periodic sawtooth fluctuations, i.e., the flow rate drops briefly and then recovers rapidly, forming a sawtooth pattern, while the pressure signal is accompanied by short-period fluctuations. It is understandable that when blockage and release occur alternately, the tubing resistance and intraluminal pressure constantly change, forming high-frequency abnormal components. Signal monitoring can identify the difference between normal drainage and soft blockage, providing a basis for subsequent treatment. The system extracts features from the pressure and flow signals to identify the presence of obvious high-frequency components and periodic sawtooth fluctuations. When the sawtooth feature exceeds a preset threshold, the system determines that soft blockage is caused by membrane adhesion or fibrin deposition at the catheter end. A normal drainage process should present a relatively smooth flow curve and a monotonically decreasing pressure curve, while sawtooth fluctuations are a direct signal of alternating mechanical resistance. Therefore, potential mechanical drainage obstacles can be detected in advance before the total net ultrafiltration volume becomes significantly abnormal, thereby improving the early detection rate. When a risk of soft blockage is detected, the system automatically triggers a micro-pulse anti-blockage algorithm. This algorithm controls the dialysis machine's pump system to output multiple small backflush pulses, each with a volume of 10–20 mL and a duration of less than 5 seconds, keeping the entire process within safe limits. This small-volume backflush gently breaks up the retina or fibrin layer, restoring catheter patency; the volume and time limitations prevent excessive pressure changes that could cause discomfort or risk to the patient. This achieves non-invasive catheter recanalization, eliminating the need for manual flushing or catheter replacement, significantly improving ease of use and safety. After micro-pulse backflush, the system continues to monitor the pressure and flow curves and recalculates for significant sawtooth fluctuations. If the sawtooth pattern disappears or significantly weakens, the system determines that the anti-blockage was successful and resumes normal drainage; if the sawtooth pattern persists, the system prompts the patient or caregiver to adjust their position, such as alternating between supine and lateral positions for drainage, to further eliminate soft blockage factors. Backflush addresses some adhesion issues, and positional adjustments change the relative position of the catheter and abdominal structures, helping to relieve residual obstruction. By monitoring flow and pressure signals during the drainage phase and identifying unique sawtooth wave characteristics, combined with micropulse anti-blockage and positional assistance strategies, catheter soft blockage can be effectively resolved without increasing invasive procedures. Utilizing mechanical wave characteristics as a diagnostic basis reduces the frequency of catheter changes and emergency flushing, improving patient safety and experience in home dialysis settings, while ensuring the accuracy of ultrafiltration monitoring and alarms.

[0087] Please see Figure 2 One embodiment of the peritoneal dialysis full-course management device in this application may include:

[0088] Acquisition unit 21 is used to acquire the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment, and to assess the patient's disease stage;

[0089] Setting unit 22 is used to dynamically set the ultrafiltration volume threshold of the patient based on the disease stage;

[0090] The management unit 23 is used to calculate the patient's actual ultrafiltration volume and trigger an ultrafiltration alarm if the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range.

[0091] In summary, the peritoneal dialysis full-course management device provided in this application assesses the patient's disease stage by acquiring the patient's residual renal function (RRF), recent weekly Kt / V, and total duration of a single treatment session; dynamically sets the ultrafiltration volume threshold based on the disease stage; calculates the patient's actual ultrafiltration volume; and triggers an ultrafiltration alarm when the actual ultrafiltration volume exceeds the ultrafiltration volume threshold range. Thus, the net ultrafiltration volume management of peritoneal dialysis is upgraded from a traditional static, uniform standard to an individualized, dynamically adjusted full-course management solution. By using disease course indicators to reveal the patient's baseline fluid balance and dynamically adjusting the threshold based on individual historical data, individualized safety management is achieved. It significantly reduces false alarms and false negatives, improving alarm reliability. It detects potential problems such as membrane failure, leakage, or mechanical obstruction early. It avoids excessive dehydration or volume overload, improving patient safety and quality of life; and tiered intervention improves the efficiency of medical resource utilization, making clinical management more refined. In early-stage patients, this method can accurately identify the potential risk of hypotension caused by excessively high UF; in late-stage patients, it can sensitively detect volume overload problems caused by low UF, both of which are superior to traditional uniform threshold schemes.

[0092] like Figure 3 As shown, this application embodiment also provides an electronic device 300, including a memory 310, a processor 320, and a computer program 311 stored in the memory 310 and executable on the processor. When the processor 320 executes the computer program 311, it implements the steps of any of the above-mentioned methods for peritoneal dialysis full-course management.

[0093] Since the electronic device described in this embodiment is the device used to implement the peritoneal dialysis full-course management device in the embodiments of this application, those skilled in the art can understand the specific implementation method and various variations of the electronic device in this embodiment based on the method described in the embodiments of this application. Therefore, how the electronic device implements the method in the embodiments of this application will not be described in detail here. Any device used by those skilled in the art to implement the method in the embodiments of this application falls within the scope of protection of this application.

[0094] In practical implementation, when the computer program 311 is executed by the processor, it can achieve the following: Figure 1 Any of the corresponding implementation methods in the embodiments.

[0095] It should be noted that the descriptions of each embodiment in the above embodiments have different focuses. For parts that are not described in detail in a certain embodiment, please refer to the relevant descriptions in other embodiments.

[0096] Those skilled in the art will understand that embodiments of this application can be provided as methods, systems, or computer program products. Therefore, this application can take the form of a completely hardware embodiment, a completely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, this application can take the form of a computer program product embodied on one or more computer-usable storage media (including but not limited to disk storage, CD-ROM, optical storage, etc.) containing computer-usable program code.

[0097] This application is described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of this application. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, special-purpose computer, embedded computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create a machine for implementing the flowchart illustrations. Figure 1 One or more processes and / or boxes Figure 1 A device that provides the functions specified in one or more boxes.

[0098] These computer program instructions may also be stored in a computer-readable storage medium that can direct a computer or other programmable data processing device to function in a particular manner, such that the instructions stored in the computer-readable storage medium produce an article of manufacture including instruction means, which are implemented in a process Figure 1 One or more processes and / or boxes Figure 1 The function specified in one or more boxes.

[0099] These computer program instructions may also be loaded onto a computer or other programmable data processing equipment to cause a series of operational steps to be performed on the computer or other programmable equipment to produce a computer-implemented process, thereby providing instructions that execute on the computer or other programmable equipment for implementing the process. Figure 1 One or more processes and / or boxes Figure 1 The steps of the function specified in one or more boxes.

[0100] This application also provides a computer program product, which includes computer software instructions that, when executed on a processing device, cause the processing device to perform actions such as... Figure 1 The corresponding embodiment describes the process of peritoneal dialysis management throughout the entire course of the disease.

[0101] A computer program product includes one or more computer instructions. When the computer program instructions are loaded and executed on a computer, all or part of the flow or function according to the embodiments of this application is generated. The computer may be a general-purpose computer, a special-purpose computer, a computer network, or other programmable device. The computer instructions may be stored in a computer-readable storage medium or transmitted from one computer-readable storage medium to another. For example, computer instructions may be transmitted from one website, computer, server, or data center to another website, computer, server, or data center via wired (e.g., coaxial cable, fiber optic, digital subscriber line (DSL)) or wireless (e.g., infrared, wireless, microwave, etc.) means. The computer-readable storage medium may be any available medium that a computer can store or a data storage device such as a server or data center that integrates one or more available media. The available medium may be a magnetic medium (e.g., floppy disk, hard disk, magnetic tape), an optical medium (e.g., DVD), or a semiconductor medium (e.g., solid-state disk (SSD)).

[0102] Those skilled in the art will clearly understand that, for the sake of convenience and brevity, the specific working processes of the systems, devices, and units described above can be referred to the corresponding processes in the foregoing method embodiments, and will not be repeated here.

[0103] In the several embodiments provided in this application, it should be understood that the disclosed systems, apparatuses, and methods can be implemented in other ways. For example, the apparatus embodiments described above are merely illustrative; for instance, the division of units is only a logical functional division, and in actual implementation, there may be other division methods. For example, multiple units or components may be combined or integrated into another system, or some features may be ignored or not executed. Furthermore, the coupling or direct coupling or communication connection shown or discussed may be through some interfaces, or indirect coupling or communication connection between apparatuses or units, and may be electrical, mechanical, or other forms.

[0104] The units described as separate components may or may not be physically separate. The components shown as units may or may not be physical units; that is, they may be located in one place or distributed across multiple network units. Some or all of the units can be selected to achieve the purpose of this embodiment according to actual needs.

[0105] Furthermore, the functional units in the various embodiments of this application can be integrated into one processing unit, or each unit can exist physically separately, or two or more units can be integrated into one unit. The integrated unit can be implemented in hardware or as a software functional unit.

[0106] If the integrated unit is implemented as a software functional unit and sold or used as an independent product, it can be stored in a computer-readable storage medium. Based on this understanding, the technical solution of this application, in essence, or the part that contributes to the prior art, or all or part of the technical solution, can be embodied in the form of a software product. This computer software product is stored in a storage medium and includes several instructions to cause a computer device (which may be a personal computer, server, or network device, etc.) to execute all or part of the steps of the methods of the various embodiments of this application. The aforementioned storage medium includes various media capable of storing program code, such as USB flash drives, portable hard drives, read-only memory (ROM), random access memory (RAM), magnetic disks, or optical disks.

[0107] The above embodiments are only used to illustrate the technical solutions of this application, and are not intended to limit them. Although this application has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features. Such modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of this application.

Claims

1. A peritoneal dialysis continuum of care method, characterized in that, The method comprises the following steps: acquiring residual renal function RRF, recent week Kt / V and total treatment time of a patient, and evaluating a course stage of the patient; dynamically setting an ultrafiltration threshold of the patient based on the course stage; calculating an actual ultrafiltration amount of the patient, and triggering an ultrafiltration alarm if the actual ultrafiltration amount exceeds the ultrafiltration threshold range.

2. The method of claim 1, wherein, The step of dynamically setting the ultrafiltration threshold of the patient based on the course stage comprises: setting an upper limit threshold of the ultrafiltration amount of the patient if the evaluated course stage is early stage; setting a lower limit threshold of the ultrafiltration amount of the patient if the evaluated course stage is late stage.

3. The method of claim 1, wherein, The method further comprises the following steps: acquiring residual renal function RRF, serum creatinine Scr, blood pressure and weight change rate of a patient in a preset period; determining a target ultrafiltration center value of a current treatment of the patient based on the residual renal function RRF, the serum creatinine Scr, the blood pressure and the weight change rate of the patient in the preset period, and forming upper and lower limits according to a preset proportion to obtain an optimal ultrafiltration range of the current treatment.

4. The method of claim 3, wherein, The method further comprises the following steps: calculating a deviation amount of the actual ultrafiltration amount of the patient from the optimal ultrafiltration range of the current treatment; performing hierarchical management based on the deviation amount, and the response measures corresponding to different deviation levels are different.

5. The method of claim 2, wherein, The method further comprises the following steps: if the course stage of the patient is early stage, determining a lower limit threshold of early stage free water proportion of the patient based on the statistics of a baseline when the patient's body fluid state is stable, and the early stage free water proportion is used to indicate the proportion of net ultrafiltration amount within a limited time window after the start of dwell to the total net ultrafiltration amount of the current cycle; if the actual ultrafiltration amount of the patient does not exceed the ultrafiltration threshold range, but the actual early stage free water proportion of the patient is lower than the lower limit threshold of the early stage free water proportion, and the actual early stage free water proportion of the patient has decreased for at least two consecutive nights, an ultrafiltration alarm is still triggered.

6. The method of any one of claims 1 to 5, wherein, The step of calculating the actual ultrafiltration amount of the patient comprises the following steps: in a drainage stage, acquiring an inclination angle parameter and a catheter height difference parameter related to the body position of the patient, and calculating a siphon pressure caused by the superposition of water column height difference; performing water head compensation on the weighing and flow measurement results based on the siphon pressure, so as to correct the weighing and flow measurement results to obtain the actual ultrafiltration amount of the patient.

7. The method of any one of claims 1 to 5, wherein, The step of calculating the actual ultrafiltration amount of the patient comprises the following steps: in a fluid infusion stage, acquiring a temperature value of the dialysis fluid in the pipeline or the body, and predicting the actual viscosity and density of the dialysis fluid based on a preset temperature-viscosity reference relationship to obtain a temperature correction factor; in the case of using a flow sensor to calculate the fluid infusion volume, the original flow rate value is divided by the temperature correction factor to obtain a corrected flow rate, so as to correct the measured fluid infusion volume of the dialysis fluid; in the case of using a weight sensor to calculate the fluid infusion volume, the original flow rate value is divided by the temperature correction factor to obtain a corrected flow rate, so as to correct the measured fluid infusion volume of the dialysis fluid; the actual ultrafiltration amount of the patient is calculated based on the corrected fluid infusion volume of the dialysis fluid.

8. A peritoneal dialysis continuum of care device, characterized in that, The method comprises the following steps: an acquiring unit is configured to acquire residual renal function RRF, recent week Kt / V and total treatment time of a patient, and evaluate a course stage of the patient; The setting unit is configured to dynamically set a threshold of ultrafiltration amount of the patient based on the disease course stage; The management unit is configured to calculate an actual ultrafiltration amount of the patient, and trigger an ultrafiltration alarm if the actual ultrafiltration amount exceeds the threshold of ultrafiltration amount.

9. An electronic device comprising: A memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor is configured to implement the steps of the peritoneal dialysis whole-disease-course management method according to any one of claims 1-7 when executing the computer program stored in the memory.

10. A computer readable storage medium having stored thereon a computer program, characterized in that: The computer program is executable on the processor to implement the peritoneal dialysis whole-disease-course management method according to any one of claims 1-7.

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