Dialysis treatment and dialysis machine

Abstract

The present disclosure relates to a method comprising: determining a dialysis treatment time of a patient; receiving a dialysate flow rate from at least one sensor of the dialysis machine, the dialysate comprising bicarbonate pumped from a bicarbonate source, the bicarbonate source having an initial bicarbonate amount; and predicting that the amount of bicarbonate remaining in the bicarbonate source does not exceed a threshold at the end of the dialysis treatment; and in response, determining that the clearance value during the treatment is currently above or will be above the clearance threshold; and sending instructions to a balancing system to reduce the dialysate flow rate to a reduced flow rate capable of reducing the rate at which bicarbonate is pumped out of the bicarbonate source while maintaining the clearance value of the treatment not below the clearance threshold.

Description

Cross-references to related applications

[0001] This application is a continuation-in-part application claiming priority to U.S. Patent Application No. 18 / 349,522, filed July 10, 2023, and U.S. Patent Application No. 18 / 456,237, filed August 25, 2023, the entire contents of which are incorporated herein by reference. Technical Field

[0002] This disclosure relates to dialysis machines and dialysis methods. Specifically, this disclosure covers methods for maintaining one or more dialysis sources (e.g., bicarbonate sources) within a specific threshold throughout the treatment process. Background Technology

[0003] For patients who cannot properly purify their blood through their own renal system (such as the kidneys), a dialysis prescription is usually given.

[0004] The two main dialysis methods are hemodialysis and peritoneal dialysis. During hemodialysis (“HD”), the patient’s blood flows through the dialyzer of a dialysis machine, while dialysate flows through the dialyzer simultaneously. A semipermeable membrane within the dialyzer separates the blood from the dialysate, allowing diffusion and osmotic exchange between the two fluids. These transmembrane exchanges remove waste products from the blood, including solutes such as urea and creatinine, and regulate the levels of other substances in the blood, such as sodium and water. Thus, the dialysis machine acts as an artificial kidney to purify the blood.

[0005] During peritoneal dialysis (“PD”), dialysate is periodically infused into the patient’s peritoneal cavity. The membranous lining of the patient’s peritoneum acts as a natural semipermeable membrane, allowing diffusion and osmotic exchange between the dialysate and the blood. These transperitoneal exchanges remove waste products from the blood, including solutes such as urea and creatinine, and regulate the levels of other substances in the blood, such as sodium and water. In hemodialysis treatment, the patient is connected to an extracorporeal blood circulation loop by inserting venous and arterial tubing to remove toxic blood from the body and return purified blood to the body. The dialysis machine receives blood from the arterial tubing, allowing the blood to flow through a semipermeable membrane or filter that allows toxins and fluids to pass through. On the other side of the filter, the dialysate flows in the opposite direction. The dialysate consists of acids, water, and other chemicals, the most important of which is bicarbonate. The treatment duration and the concentration of chemicals in the dialysate are prescribed by the physician and infused into the dialysis machine before dialysis begins. The prescription includes bicarbonate concentration, flow rate, treatment duration, and other parameters and concentration indicators. Typically, dialysate is prepared by mixing liquids pre-dissolved with specific substances. For example, bicarbonate solution is prepared by mixing a liquid with a concentration of bicarbonate powder, which can then be mixed with other solutions to prepare dialysate.

[0006] Dialysis machines prepare solutions for a single substance by inserting a container into the machine and entering all relevant information, including container size, prescription, and other patient data. Larger capacity containers support longer treatment durations and / or higher flow rates. After initial connection to the machine, the machine injects water into the container to dissolve bicarbonate powder, creating a bicarbonate solution. The machine then delivers the dissolved bicarbonate solution to the chamber, where it is mixed with acid and other substances to prepare dialysate. As some solution is withdrawn from the container, additional bicarbonate solution is generated, thus preparing more dialysate. Containers are considered depleted when bicarbonate or acid concentrate is exhausted. Current machines detect bicarbonate depletion using conductivity sensors. To determine the appropriate container capacity, the patient or operator consults a table in the manual that provides approximate depletion times based on the prescribed flow rate and bicarbonate concentration. An alarm or other form of user notification is issued when bicarbonate or acid levels fall below, for example, 20%. At this point, treatment will be paused, and the operator will need to replace one or two containers to continue treatment. Ideally, it should be ensured that the bicarbonate or acid can sustain the entire treatment process to avoid interruption.

[0007] In practice, operators need to prepare the dialysis machine and patient before starting treatment, a process that can be time-consuming, including disinfecting the machine, patient, and all equipment that comes into contact with the machine or patient. If the dialysis machine is equipped with relevant detection functions, errors during setup may not become apparent until an alarm is triggered during dialysis. Summary of the Invention

[0008] This disclosure provides techniques for adjusting the flow rate of substances obtained from a dialysis source (e.g., bicarbonate, acid concentrate, etc.) to extend treatment run time and avoid the need for mid-treatment supplementation. The techniques include: determining or predicting that a specific treatment source connected to the dialysis machine will fall below a specific threshold before the end of treatment, and making appropriate adjustments to extend treatment run time while utilizing the existing source. The techniques ensure that changing the flow rate does not result in an unacceptable decrease in treatment clearance. For example, the techniques include predicting clearance throughout the treatment process and ensuring that the clearance does not fall below a specific clearance threshold.

[0009] Details of one or more embodiments are set forth in the accompanying drawings and the following description. Other aspects, features, and advantages of this disclosure will become apparent from the description, the drawings, and the claims.

[0010] Some implementations include a computer-implemented method executable by a processor of a dialysis machine, the method comprising: determining a treatment time for dialysis treatment of a patient based on a prescription received from an external source; receiving a dialysate flow rate of dialysate flowing through the machine from at least one first sensor of the dialysis machine, the dialysate comprising bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial amount of bicarbonate before the start of dialysis treatment; and predicting, based on (i) the treatment time, (ii) the initial amount of bicarbonate, and (iii) the dialysate flow rate, that at the end of dialysis treatment, the amount of remaining bicarbonate in the bicarbonate source will not exceed a specific threshold. In response, the method may include: determining that a clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and sending an instruction to a balancing system receiving the dialysate to change a switching rate, reducing the dialysate flow rate to a reduced flow rate, the balancing system being part of the dialysis machine, wherein the reduced flow rate reduces the rate at which bicarbonate is pumped from the bicarbonate source while maintaining a clearance value not below the clearance threshold.

[0011] Implementations may include one or any combination of two or more of the following features: The determined clearance value is or is based on the current clearance value of the treatment, and the method further includes determining the current clearance value by receiving corresponding conductivity measurements of dialysate flowing into or out of the dialyzer from multiple sensors, and calculating the current clearance value based on the received conductivity values.

[0012] The determined clearance value is a future clearance value, and the method further includes predicting the future clearance value by: calculating multiple clearance values ​​for a certain time period during treatment, each of the multiple clearance values ​​being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within the time period; and predicting the future clearance value at a certain time point before the end of treatment based on the trend of the multiple clearance values ​​and the current clearance value.

[0013] The method includes generating instructions to the balancing system based on predicted future clearance values, wherein the instructions include a reduction in the switching rate, the reduction depending on the difference between the predicted future clearance value and a specific clearance threshold, with a larger difference resulting in a larger reduction.

[0014] The instruction is a first instruction, and the method further includes: determining that the predicted future clearance value is less than a specific clearance threshold, and in response, sending a second instruction to the balancing system to increase the dialysate flow rate, thereby increasing the clearance value of the treatment, wherein the second instruction is sent after the first instruction is sent.

[0015] The method includes sending the predicted future clear value to a display for presentation.

[0016] Instructions to change the switching rate include the amount by which the switching rate is reduced.

[0017] The method includes determining that treatment has ended and the machine has been disconnected from the patient, and in response, sending a post-treatment instruction to the balancing system to reduce the dialysate flow rate.

[0018] Post-treatment instructions include reducing the dialysate flow rate to less than half of its original value.

[0019] Some embodiments include a dialysis system comprising: a dialyzer; a fluid line for delivering dialysate from a bicarbonate source to a balancing system; a sensor configured to measure the dialysate flow rate through the fluid line, the dialysate comprising bicarbonate pumped from the bicarbonate source; a balancing system configured to deliver purified dialysate from the fluid line to the dialyzer and discharge used dialysate from the dialyzer to a discharge device, wherein the balancing system includes a switching switch whose state changes with a switching rate, the change in the switching rate causing a change in the dialysate flow rate through the fluid line; and a processor configured to perform operations. The operation includes: determining a treatment time for dialysis treatment of a patient based on a prescription received from an external source; receiving a dialysate flow rate from a sensor, wherein the bicarbonate source has an initial bicarbonate amount before the start of dialysis treatment; predicting, based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, that the amount of remaining bicarbonate in the bicarbonate source at the end of dialysis treatment will not exceed a specific threshold; and, in response, determining that the clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and sending a command to a balancing system to change the switching rate, reducing the dialysate flow rate to a reduced flow rate, wherein the reduced flow rate reduces the rate at which bicarbonate is pumped out of the bicarbonate source while maintaining the clearance value not below the clearance threshold.

[0020] Implementations may include one or any combination of two or more of the following features: The dialysis system includes multiple sensors operatively connected to the fluid lines of the dialysis machine, the sensors being configured to measure the corresponding conductivity values ​​of the dialysate flowing into or out of the dialyzer.

[0021] The determined clearance value is or is based on the current clearance value of the treatment, and the operation further includes determining the current clearance value by receiving corresponding conductivity values ​​from multiple sensors and calculating the current clearance value based on the received conductivity values.

[0022] The determined clearance value is a future clearance value, and the operation further includes predicting the future clearance value by: calculating multiple clearance values ​​for a certain time period during treatment, each of the multiple clearance values ​​being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within that time period; and predicting the future clearance value at a certain time point before the end of treatment based on the trend of the multiple clearance values ​​and the current clearance value.

[0023] The operation also includes generating instructions based on predicted values, wherein the instructions include a reduction in the switching rate, the reduction depending on the difference between the predicted future clearance value and a specific clearance threshold, with a larger difference resulting in a larger reduction.

[0024] The instruction is a first instruction, and the operation further includes: determining that the predicted future clearance value is less than a specific clearance threshold, and in response, sending a second instruction to the balancing system to increase the dialysate flow rate, thereby increasing the clearance value of the treatment, wherein the second instruction is sent after the first instruction is sent.

[0025] The operation includes sending the predicted future clear value to a display for presentation.

[0026] Instructions to change the switching rate include the amount by which the switching rate is reduced.

[0027] Some implementations include one or more computer-readable media storing instructions executable by a processing device, which, when executed, cause the processing device to perform the following operations: determining a treatment time for dialysis treatment of a patient based on a patient prescription received from an external source; receiving, from at least one sensor of the dialysis machine, a dialysate flow rate through the machine containing bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial amount of bicarbonate prior to the start of treatment; and based on (i) the treatment time, (ii) the initial amount of bicarbonate... The amount of bicarbonate and (iii) the dialysate flow rate are used to predict that at the end of dialysis treatment, the amount of bicarbonate remaining in the bicarbonate source will not exceed a specific threshold; and in response, to determine that the clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and to send an instruction to a balancing system receiving the dialysate to change the switching rate, reducing the dialysate flow rate to a reduced flow rate, the balancing system being part of the dialysis machine, wherein the reduced flow rate reduces the rate at which bicarbonate is pumped out of the bicarbonate source while maintaining the clearance value of treatment not below the clearance threshold.

[0028] Implementations may include one or any combination of two or more of the following features: The determined clearance value is a future clearance value, and the operation further includes predicting the future clearance value by: calculating multiple clearance values ​​for a certain time period during treatment, each of the multiple clearance values ​​being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within that time period; and predicting the future clearance value at a certain time point before the end of treatment based on the trend of the multiple clearance values ​​and the current clearance value.

[0029] The operation also includes generating instructions based on predicted values, wherein the instructions include a reduction in the switching rate, the reduction depending on the difference between the predicted future clearance value and a specific clearance threshold, with a larger difference resulting in a larger reduction.

[0030] Some implementations include a computer-implemented method executable by a processor of a dialysis machine, the method comprising: determining a treatment time for dialysis treatment of a patient based on a prescription received from an external source; receiving a dialysate flow rate of dialysate flowing through the dialysis machine from at least one sensor of the dialysis machine, the dialysate comprising bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial bicarbonate amount before the start of dialysis treatment; and predicting, based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, that at the end of dialysis treatment, the amount of remaining bicarbonate in the bicarbonate source will not exceed a specific threshold. The method may further include: determining, in response to the prediction that the amount of remaining bicarbonate in the bicarbonate source will not exceed the specific threshold at the end of dialysis treatment, that a clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and sending an instruction to a balancing system receiving the dialysate to change the switching rate, reducing the dialysate flow rate to a reduced flow rate, the balancing system being part of the dialysis machine. The reduced flow rate can decrease the rate at which bicarbonate is pumped out of the bicarbonate source, while maintaining the clearance value of the treatment at no less than the clearance threshold.

[0031] Some embodiments include a dialysis system comprising: a dialyzer; a fluid line for delivering dialysate from a bicarbonate source to a balancing system; a sensor configured to measure the dialysate flow rate through the fluid line, the dialysate comprising bicarbonate pumped from the bicarbonate source; a balancing system configured to deliver purified dialysate from the fluid line to the dialyzer and discharge used dialysate from the dialyzer to a discharge device, wherein the balancing system includes a switching switch whose state changes with a switching rate, the change in the switching rate causing a change in the dialysate flow rate through the fluid line; and a processor. The processor is configured to perform the following operations: determine the treatment time for dialysis treatment of a patient based on a prescription received from an external source; receive the dialysate flow rate from a sensor, wherein the bicarbonate source has an initial bicarbonate amount before the start of dialysis treatment; predict, based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, that the amount of remaining bicarbonate in the bicarbonate source at the end of dialysis treatment will not exceed a specific threshold; and, in response, determine that the clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and send a command to a balancing system to change the switching rate, reducing the dialysate flow rate to the reduced flow rate. The reduced flow rate reduces the rate at which bicarbonate is pumped out of the bicarbonate source while maintaining the clearance value of treatment at or above the clearance threshold.

[0032] Some implementations include one or more computer-readable media storing instructions executable by a processing device. When executed, the instructions cause the processing device to perform the following operations: determine a treatment time for dialysis treatment of a patient based on a patient prescription received from an external source; receive, from at least one sensor of the dialysis machine, the dialysate containing bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial bicarbonate amount before the start of dialysis treatment; predict, based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, that the amount of remaining bicarbonate in the bicarbonate source at the end of dialysis treatment will not exceed a specific threshold; and, in response, determine that a clearance value during treatment is currently higher than or will be higher than the specific clearance threshold; and send instructions to a balancing system receiving the dialysate to change the switching rate, reducing the dialysate flow rate to a reduced flow rate, the balancing system being part of the dialysis machine. The reduced flow rate can decrease the rate at which bicarbonate is pumped out of the bicarbonate source, while maintaining the clearance value of the treatment at no less than the clearance threshold. Attached Figure Description

[0033] Figure 1 This is a schematic diagram of a dialysis system.

[0034] Figure 2This is a user interface diagram showing the dialysate concentration and the calculated exhaustion time.

[0035] Figure 3 This is a user interface diagram showing the predicted clearing value and clearing threshold.

[0036] Figure 4 This is a diagram showing the dialysis system during the dialysis process.

[0037] Figure 5 This is a diagram of the containers attached to the dialysis machine in a dialysis system.

[0038] Figure 6 This is a flowchart of an exemplary method for performing dialysis.

[0039] The same reference numerals in each of the figures denote the same elements. Detailed Implementation

[0040] To avoid treatment interruptions due to replenishing or changing supply sources (such as bicarbonate bags), it is best to ensure the dialysis machine has sufficient supply sources before starting treatment. However, each treatment has its specific parameters, and the required supply source usage may differ from other treatments. Calculating the required usage of each supply source for each treatment is tedious, time-consuming (delaying current and subsequent treatment processes), and error-prone for operators. Furthermore, if the supply source is not completely depleted before treatment begins but is determined to run out before the treatment ends, it results in wasted supply sources.

[0041] The technology disclosed herein can make the most of the supply source before it is necessary to replace or supplement the supply source, while reducing the possibility of treatment being interrupted due to the supplementation or replacement of the supply source.

[0042] Figure 1 A dialysis system 100 is schematically shown, comprising a dialyzer 102, a balancing system 104, a bicarbonate concentrate source 106, an acid source 108, and a water source 110. The balancing system 104 is fluidly connected to the bicarbonate concentrate source 106, the acid source 108, and the water source 110. Bicarbonate concentrate from the bicarbonate concentrate source 106, acid from the acid source 108, and water from the water source 110 can be mixed to prepare a dialysate. As described herein, this dialysate can be used for dialysis.

[0043] The balancing system 104 receives dialysate and controls the dialysate flow rate. For example, the switching switch 112 can change the switching rate of the balancing system 104 to reduce the dialysate flow rate to a reduced rate or increase it to a increased rate. The switching switch 112 can be located in a position suitable for controlling the switching rate of the balancing system 104; for example, the switching switch can be located at the input terminal 114, the output terminal 116, or inside the balancing system 104.

[0044] The state of the switch 112 can change the switching rate of the balancing system 104. For example, the state of the switch 112 may include binary states, such as on and off, open and closed, rate increase and rate decrease, etc. In other embodiments, the switch 112 may include other states, such as a linear state, to control the switching rate in a linear manner.

[0045] Dialyzer 102 receives dialysate from balancing system 104, the dialysate flow rate being determined, for example, by the switching rate of balancing system 104. A semipermeable membrane within the dialyzer separates the blood from the dialysate, allowing diffusion and osmotic exchange between the dialysate and blood. These transmembrane exchanges remove waste products from the blood (including solutes such as urea and creatinine) and regulate the levels of other substances in the blood, such as sodium and water. Balancing system 104 receives used dialysate from dialyzer 102 and directs it to waste container 118.

[0046] Sensors 120a and 120b are arranged between the balancing system 104 and the dialyzer 102. Sensor 120c is arranged on the fluid line 126 connecting the balancing system 104 to the bicarbonate source 106, the acid source 108, and the water source 110. Sensors 120a, 120b, and 120c may include flow rate sensors for measuring the dialysate flow rate, or may include other sensors (e.g., pressure sensors) for measuring other properties of the dialysate that can be used to determine the dialysate flow rate. The dialysate flow rate may be increased or decreased as described above.

[0047] In some embodiments, the dialysis machine is configured to determine or receive the volume of a supply source, such as the volume of a bicarbonate concentrate container attached to the dialysis machine for preparing dialysate. The dialysis machine is also configured to detect the time (referred to as the "depletion time") at which the bicarbonate concentrate will be exhausted or fall below a specific threshold volume using the volume determination result, a measured flow rate, and a prescription entered into the dialysis machine. In some embodiments, the prescription includes detailed information about the treatment process, such as flow rate, minimum clearance value, etc.

[0048] The dialysis machine is configured to compare the calculated exhaustion time with details contained in the prescription, such as the prescribed treatment time. To avoid interrupting dialysis, the exhaustion time should be longer than the prescribed treatment time to prevent the need to change the bicarbonate container mid-treatment. The dialysis machine compares the exhaustion time length with the treatment time length. When the exhaustion time is longer than the treatment time, treatment can proceed normally. When the exhaustion time is shorter than the treatment time, the dialysis machine will notify or remind the user.

[0049] The dialysis machine is configured to alter one or more characteristics of the treatment process to prolong the exhaustion time. For example, the dialysis machine may reduce the dialysate flow rate to reduce the rate at which resources are obtained from any one or all of the bicarbonate source 106, acid source 108, or water source 110.

[0050] In some implementations, the dialysis machine maintains a clearance value above a specific value while or after reducing the flow rate. The current or predicted clearance value can be measured or predicted based on the conductivity of the dialysate entering the dialyzer 102 and the conductivity of the used dialysate leaving the dialyzer 102.

[0051] The dialysis machine 100 may include multiple conductivity sensors. In some embodiments, sensors 120a, 120b, and 120c may also include conductivity sensors for measuring the conductivity of the dialysate. In some embodiments, the conductivity sensors are separate from and / or different from the flow rate sensors.

[0052] The conductivity of the dialysate can be used to determine the clearance value of a treatment (e.g., efficacy). For example, the clearance value (Kt / V) can be calculated by dividing the product of the urea clearance rate (K) and time (t) by the volume of fluid (v) flowing through the fluid conduit during that time period.

[0053] The clearance value is an indicator of treatment progress. A higher clearance value means faster treatment (i.e., dialysis) progress, but also indicates a faster rate of resource consumption by the dialysis machine. There is a trade-off between treatment time and resource consumption rate. A minimum threshold can be set for the clearance value to ensure that treatment is not unreasonably prolonged by falling below this threshold. In some implementations, this threshold is included as part of the treatment prescription. In some implementations, a default threshold is set if the healthcare provider treating the patient does not recommend or prescribe a minimum clearance value.

[0054] In some embodiments, clearance values ​​can be measured by introducing a sodium bolus into the dialysate entering dialyzer 102. The conductivity of the dialysate (including the sodium bolus) can be measured, for example, by a first sensor 120a, before the dialysate enters dialyzer 102. While in dialyzer 102, the dialysate diffuses and osmotically exchanges with the blood through a membrane. When the dialysate leaves dialyzer 102, the used dialysate may contain all, some, or no sodium bolus, depending on the amount of sodium absorbed by the patient's blood. The higher the amount of sodium absorbed by the patient, the higher the clearance value (e.g., due to higher urea clearance). The lower the amount of sodium absorbed by the patient, the lower the clearance value (e.g., due to lower urea clearance). The conductivity of the used dialysate can be measured, for example, by a second sensor 120b, as the used dialysate exits dialyzer 102 to determine the amount of sodium absorbed by the patient's blood. For example, the difference between the conductivity of the dialysate (e.g., measured by the first sensor 120a) and the conductivity of the used dialysate (e.g., measured by the second sensor 120b) can correspond to the amount of sodium absorbed by the patient's blood.

[0055] return Figure 1The processor 122 is operatively connected to the toggle switch 112 and sensors 120a, 120b, 120c to receive signals from sensors 120a, 120b, 120c and control the toggle switch 112. In some embodiments, a memory (124) is operatively connected to the processor 122 and stores instructions for the processor to perform operations. In some embodiments, the memory is part of the processor, such as part of a processor chip.

[0056] In some implementations, processor 122 can conserve dialysis resources by reducing, for example, the flow rate of bicarbonate concentrate into balancing system 104. For instance, the processor can directly reduce the flow rate of bicarbonate concentrate from bicarbonate concentrate source 106 to balancing system 104. Similarly, the processor can directly reduce the flow rate of acid from acid source 108 to balancing system 104.

[0057] The processor 122 can send instructions to control the state of the switching switch 112, such as controlling the switching rate of the balancing system 104, thereby managing the dialysate flow rate to reduce the rate of consumption of dialysis resources (e.g., bicarbonate). The processor can also monitor or predict conductivity, and in turn monitor or predict the clearance value of treatment, thereby reducing the flow rate to a level that will not cause the clearance value to fall below a certain threshold.

[0058] For example, processor 122 may receive signals from sensors 120a and 120b representing the conductivity of the dialysate and the used dialysate. Processor 122 may use the formula Kt / V to determine the current clearance value of the treatment based on the measured conductivity.

[0059] Processor 122 can also determine a predicted clearance value based on the determined clearance value and treatment time, as will be discussed further below. In some embodiments, processor 122 may receive multiple clearance value measurements. Processor 122 may determine whether the predicted clearance value has reached or exceeded a clearance threshold. For example, the clearance threshold may be provided by the patient's prescription. If the predicted clearance value exceeds the clearance threshold, processor 122 may change the state of switch 112 to reduce the dialysate flow rate (e.g., by changing the switching rate of balancing system 104).

[0060] Processor 122 can send instructions to switching switch 112 to reduce the dialysate flow rate while ensuring that the predicted clearance value does not fall below the clearance threshold. Maintaining proximity to (e.g., within a predetermined specific range) or reaching the clearance threshold, rather than exceeding it indefinitely, conserves resources (e.g., water, acid, bicarbonate concentrate, and other chemicals) for dialysis treatment while meeting patient prescription requirements. As described above, reducing the dialysate flow rate reduces the amount of dialysate used during treatment. Reducing the amount of dialysate used during treatment reduces the amount of resources needed to prepare the dialysate, thereby conserving these resources. Conserving resources for dialysis treatment increases the likelihood that resources can sustain the entire treatment (or multiple treatments).

[0061] In some implementations, the processor may send a command to the controllable valve 128 to reduce the bicarbonate flow rate from the bicarbonate source. For example, the dialysate flow rate may remain constant, while the bicarbonate flow rate may be directly reduced to decrease bicarbonate consumption.

[0062] In some implementations, the dialysis machine is configured to determine a predicted clearance value based on multiple clearance measurements performed over a period of time. For example, the effectiveness of dialysis treatment can be measured by clearance values ​​determined periodically during treatment. In some implementations, clearance measurements are recalculated at regular intervals. The clearance measurements can be recalculated using a conductivity sensor or other additional sensors. The clearance measurements can be used to determine the predicted clearance value at the end of treatment. If the predicted clearance value is higher than a clearance threshold, the dialysate flow rate can be reduced to decrease the predicted clearance value.

[0063] In some implementations, the dialysis machine can reduce the dialysate flow rate at specific stages of dialysis treatment (i.e., stages requiring relatively small amounts of dialysate and / or low clearance values). For example, the dialysis machine can reduce the dialysate flow rate during the pre-treatment preparation phase and / or during the post-treatment procedure.

[0064] In some implementations, the dialysis machine can determine that treatment has ended and the machine has been disconnected from the patient. For example, the dialysis machine can determine that treatment has ended based on sensor measurements indicating changes in tubing pressure connected to the patient during treatment, or indicating a significant reduction (e.g., cessation) in the blood flow rate through the dialyzer. In some implementations, the dialysis machine can reduce the dialysate flow rate to less than half of the current dialysate flow rate before or during the pre-treatment or post-treatment process.

[0065] In some implementations, the processor may retrieve the current switching rate, for example, from sensors in the balancing system. The processor may send a second switching rate to the balancing system based on a predicted clear value. The difference between the current switching rate and the second switching rate may be the amount by which the switching rate in the balancing system is reduced.

[0066] The predicted clearance value and / or current clearance threshold may be displayed on the user interface. The user interface may be located on the dialysis machine. In some embodiments, the elapsed time and remaining treatment time may be displayed on the user interface. In some embodiments, graphical or visual indicators of the predicted clearance value and clearance threshold are displayed on the user interface.

[0067] Figure 2 An exemplary user interface 200 for a dialysis machine is shown. The user interface 200 is configured to display information related to dialysis treatment. For example, the user interface 200 may be a main interface for user interaction and notifications. This interface may display notifications (e.g., 202) to indicate alarms, such as dialysis treatment pause.

[0068] exist Figure 2 In the user interface, prescription details are entered into the prescription interface 212. For example, the prescription interface 212 may indicate the volume of the bicarbonate concentrate container, the volume of the acid container, the dialysate composition, treatment time, and / or the clearance threshold specified in the prescription for a particular patient. The user interface 200 also displays blood pressure 214 and other treatment and patient information.

[0069] User interface 200 displays the remaining exhaustion time 208 during dialysis treatment (e.g., treatment time calculated based on a determined or provided container volume). As described below, exhaustion time 208 can be used to determine the predicted clearance value. Elapsed treatment time 210 and remaining treatment time 216 are displayed next to the total exhaustion time 208. These times can be adjusted throughout the treatment based on prescription details, dialysate flow rate, current and / or predicted clearance values, etc. Additionally, a visual image of the exhaustion time or treatment time is displayed. Figure 2 The exemplary visual image shown includes a bar 204 defining the total treatment time, and a highlighted portion 206 of the bar 204 for marking the amount of time elapsed.

[0070] One or more displayed indicators can be removed or hidden from the user interface. For example, graphical representations of treatment time (e.g., 204 / 206) or textual representations (e.g., 201 / 216) can be hidden, for example, to simplify the display. The representations and indicators on the user interface can be updated as dialysis treatment progresses to ensure information accuracy.

[0071] Figure 3 An exemplary user interface 300 for a dialysis machine is shown. User interface 300 can be configured to display information related to dialysis treatment, for example, as a supplement to or alternative to user interface 200. For example, user input can switch user interface 200 to user interface 300.

[0072] User interface 300 displays the volume 302 of the resources connected to the machine (e.g., the volume of a bicarbonate concentrate container, an acid container, a water container, etc.). As described above, volume 302 can be used to determine depletion time. In some embodiments, the machine receives this volume, for example, through user input or by a sensor that reads the size of a full container. For example, a full container may be labeled by the manufacturer with the amount of substance it contains. If a full container is connected to the machine before treatment begins (i.e., at the beginning of treatment), the machine uses that volume as the initial amount of resources for treatment (e.g., 302). If a non-full container (e.g., a container used in a previous treatment) is connected to the machine before treatment begins, the machine can retrieve or determine the initial amount of resources for the current treatment based on the amount of substance extracted from that container in a previous treatment. The amount of substance extracted during each treatment may be determined according to the techniques described in this disclosure (e.g., based on the full container volume and the flow rate of the extracted substance) and recorded in the machine's storage medium or a storage medium in communication with the machine.

[0073] The user interface 300 also displays a clearance threshold 304. In some embodiments, the clearance threshold may be provided by a prescription. The user interface 300 also displays the actual clearance value 306 provided. Throughout the dialysis treatment, the actual clearance value 306 provided should not be lower than the clearance threshold 304. The actual clearance value 306 provided can be determined by conductivity measurement as described above.

[0074] User interface 300 displays the predicted clearance value 308 and a visual representation 310 of the predicted clearance value. In some embodiments, the predicted clearance value can be determined by linear regression. For example, the dialysis machine can calculate a linear relationship between the actual clearance value 306 provided and the treatment time.

[0075] The user interface 300 also displays multiple clearance value measurements 312a, 312b, 312c, 312d, 312e, and 312f, each measured or calculated at a corresponding time point during treatment. For example, in the user interface 300 shown, six clearance value measurements 312a, 312b, 312c, 312d, 312e, and 312f have been performed. At each clearance value measurement, the dialysis machine plots the treatment time point at which the actual clearance value 306 was provided was measured or calculated.

[0076] Multiple clearance value measurements can be used to determine the relationship between elapsed time and clearance value, for example, through regression analysis (e.g., linear regression, quadratic regression, etc.). Dialysis machines can use a defined relationship to determine the predicted clearance value at any future specific time point (e.g., at the end of treatment (i.e., the end of the prescribed treatment period)).

[0077] The predicted clearance value 308 can be compared with the clearance threshold 306 to determine whether the predicted clearance value 308 has reached or exceeded the clearance threshold. If the predicted clearance value 308 exceeds the clearance threshold 306, the dialysis machine can reduce the dialysate flow rate, as described above. Reducing the dialysate flow rate based on the predicted clearance value 308 can reduce the amount of resources consumed during treatment, such as saving resources, while maintaining the clearance threshold 306 in the patient's prescription.

[0078] Figure 4 An exemplary dialysis system 400 is shown, in which a patient 408 is connected to a dialysis machine 406 via venous tubing 410 and arterial tubing 410. The system 400 shown herein is a hemodialysis system, but other types of systems may also be used. System 400 may include... Figure 1 Any of the components discussed herein, and can be configured to monitor and manage supply source usage as described above, while maintaining the desired clearance value.

[0079] System 400 includes a dialysis machine 406. Dialysis machine 406 may include multiple components, such as... Figure 1 The system 400 describes supply sources 106, 108, 110, a balancing system 104, and a processor 122. The system 400 also includes a dialyzer 412 (e.g., dialyzer 102), a container 404, a user interface 402, a processor 414, and a fluid source 416. The dialyzer 412, the dialyzer 406, and the arterial and venous tubing 410 are in fluid communication with each other, thereby forming an extracorporeal blood circulation loop. The extracorporeal blood circulation loop is supported and controlled by the processor 414 and the user interface 402, and also includes the fluid source 416 and the container 404.

[0080] The patient's blood flows from a venous tubing into an extracorporeal blood circulation loop, where toxins are removed, and then flows back into the body through an arterial tubing. In the extracorporeal blood circulation loop, blood flows through a dialyzer 412, which is configured to remove toxins and excess fluid from the blood. The dialyzer 412 is divided into two chambers: one for the patient's blood and the other for the dialysate produced by the dialysis machine. The two chambers are separated by a semipermeable membrane. Toxins and excess fluid typically move from the blood to the dialysate chamber due to a concentration gradient. The dialysate is produced by mixing the contents of the container with additional fluids and substances. The concentration and flow rate of the dialysate are prescribed by a medical professional. Different concentrations and flow rates can alter treatment time and affect the patient. For example, a higher flow rate may result in a shorter treatment time but may place a greater burden on the patient.

[0081] The container can be connected to and disconnected from the dialysis machine. The container is connected to the machine via tubing and conduits. Some of the conduits connected to the container are responsible for adding or removing fluid from the container. The dialysis machine is configured to connect its tubing and conduits to connectors on the container. The connectors for each volume of container provided are similar, allowing for a similar connection and installation procedure regardless of the container volume. Operators can use containers of various volumes. For example, the dialysis machine can be connected to containers with volumes of 650 mg and 900 mg.

[0082] Figure 5 A container 500 (e.g., bicarbonate source 106) is shown configured for insertion into a dialysis machine 406 and for containing a substance. The container may contain a substance for dialysis treatment, such as a liquid or powdered bicarbonate solution. For example, the substance may be a powder concentrate that can be mixed with a fluid to form a solution.

[0083] Dialysis machine 406 is configured to allow fluid to flow into container 500 through inlet 508 integrated in connector 504, thereby forming a solution. Inlet 504 is also connected to a fluid source. The dialysis machine is further configured to remove the dissolved fluid from container 500 through outlet 506 integrated in connector 504 and deliver it to a location for mixing with other substances. After being removed from the container, the solution is mixed with other solutions to prepare dialysate or other dialysate fluids. The dialysate then flows through a dialyzer to remove toxins from the blood and is discharged into a waste container.

[0084] To prepare the dialysis machine, the operator inserts container 500 into dialysis machine 406 and connects connector 504 of cap 502 to the fluid lines of dialysis machine 406. Connector 504 facilitates connection of inlet port 508 to fluid source 416 and outlet port 506 to dialyzer 412. Fluid source 416 provides a mixed fluid at a suitable temperature. Warm fluid helps improve dissolution and form a more saturated solution.

[0085] Fluid flows into container 500 through inlet 508. Inlet 508 is connected to a pressure sensor (not shown) configured to measure the pressure inside container 500. Once the pressure sensor measures a predetermined pressure, the processor recognizes that container 500 is full. The processor sends a signal to a fluid source pump (not shown) located upstream of inlet 508 and / or a fluid valve (not shown) located upstream of inlet 508 to stop fluid flow into container 500. The fluid valve can prevent fluid flow by blocking the fluid line upstream of inlet 508, thus preventing fluid from entering container 500. Fluid stops entering from inlet 508.

[0086] After fluid inflow stops, fluid is drawn from container 504 through opening 510 of conduit 512 connected to outlet 506. Opening 510 is covered by filter 514 to ensure that only fluid is drawn from container 500. The dissolved fluid continues to flow along the fluid conduit, mixing with other substances to produce dialysate. In some embodiments, the substance in container 500 is bicarbonate. In some embodiments, the substance is an acidic compound used in dialysis. In some embodiments, the substance in container 500 is a liquid concentrate.

[0087] Figure 6 This is a flowchart of an exemplary process 600 for performing dialysis. Process 600 can be executed by the processor of a dialysis machine, for example... Figure 1 The processor 122 shown.

[0088] Process 600 includes determining the patient's dialysis treatment time (602). For example, the treatment time may be based on a prescription received from an external source (e.g., the patient). In some implementations, the prescription can be provided by user input.

[0089] Process 600 may also include receiving or determining the amount of remaining bicarbonate in a bicarbonate source attached to the dialysis machine (604), such as the initial amount of bicarbonate before treatment begins. The processor may receive the amount of bicarbonate from a first sensor or via operator input. The first sensor may include, for example, a pressure sensor and / or an ultrasonic sensor. In the case of using a full container, the sensor may be a read sensor that reads a label on the source to determine the volume of the container filled by the manufacturer. In the case of using a container used in a previous treatment, the processor may subtract the volume withdrawn from the container in a previous treatment from the full volume of the container to determine the amount of remaining bicarbonate in the source. In some embodiments, the processor determines the amount of remaining bicarbonate in the bicarbonate source based on a signal received from the first sensor.

[0090] Process 600 also includes receiving the dialysate flow rate (606) of the dialysate flowing through the machine. For example, the processor may receive the dialysate flow rate from a second sensor. The second sensor may include, for example, a flow rate sensor. In some embodiments, the processor determines the dialysate flow rate based on a signal received from the second sensor. The dialysate may contain bicarbonate pumped from a bicarbonate source.

[0091] Process 600 continues to determine that at the end of dialysis treatment, the amount of bicarbonate remaining in the bicarbonate source does not exceed a specific threshold (608). For example, the processor may predict that the amount of bicarbonate remaining in the bicarbonate source will not exceed the specific threshold based on the treatment time, the amount of bicarbonate remaining in the bicarbonate source, and the dialysate flow rate. The processor may use the dialysate flow rate to determine the rate at which bicarbonate flows out of the bicarbonate source. The processor may then use the treatment time and the rate at which bicarbonate flows out of the bicarbonate source to determine how much bicarbonate will flow out of the bicarbonate source at the end of the treatment time. The processor may subtract the amount of bicarbonate that will flow out of the bicarbonate source from the amount of bicarbonate remaining in the bicarbonate source to determine the amount of bicarbonate remaining at the end of the treatment.

[0092] In some implementations, the processor determines whether the amount of bicarbonate remaining in the bicarbonate source does not exceed a specific threshold. In some implementations, the threshold may be preset by the operation of the dialysis machine (e.g., a default threshold). In some implementations, the threshold may be set by the user. For example, the threshold may be set to zero. In some implementations, the threshold may be set to the minimum amount of bicarbonate used in the post-treatment procedure. The post-treatment procedure may include passing a fluid (e.g., water, bicarbonate solution, etc.) through the dialysis machine before starting treatment for the next patient to remove any residue remaining after the current patient's treatment.

[0093] Process 600 continues to determine whether the clearance value is currently higher than or will be higher than a specific threshold (610). For example, determining that the clearance value is currently higher than a specific threshold means determining that the current clearance value is higher than the specific threshold. For example, the processor may receive the corresponding conductivity measurement of the dialysate and calculate the current clearance value based on the received conductivity value. Determining that the clearance value will be higher than the specific threshold means determining that the predicted future value will be higher than the specific threshold. The processor may predict the future clearance value at or before the end of treatment. For example, the processor may predict the future clearance value based on the trend of multiple clearance values ​​and the current clearance value. The trend of multiple clearance values ​​and the current clearance value may be determined, for example, by regression analysis (e.g., linear regression, quadratic regression, etc.) as described above. The trend of multiple measured clearance values ​​can be used to predict future clearance values.

[0094] A specific clearance threshold can be determined based on the patient's prescription. If the predicted future clearance value is greater than the specific clearance threshold, the processor can determine that the predicted future clearance value is higher than the specific clearance threshold.

[0095] In response to determining that the clearance value is currently higher than or will be higher than a specific threshold, process 600 continues to send an instruction (612) to the balancing system to change the switching rate. For example, this instruction may change the switching rate to reduce the dialysate flow rate to a reduced rate. In some embodiments, the processor may send an instruction to a switching switch on the balancing system to reduce the dialysate flow rate such that the predicted clearance value reaches the clearance threshold. Reaching or substantially approaching (e.g., within a predetermined range, such as within 5% of the clearance threshold) the clearance threshold, rather than exceeding it, can save resources (e.g., water, acid, bicarbonate concentrate, and other chemicals) for dialysis treatment while meeting patient prescription requirements. Reducing the dialysate flow rate reduces the amount of dialysate used during treatment. Reducing the amount of dialysate used during treatment reduces the amount of resources used to prepare the dialysate. For example, reducing the dialysate volume can reduce the rate at which bicarbonate is pumped from the bicarbonate source while maintaining the clearance value above the clearance threshold.

[0096] If the predicted clearance value is less than a specific clearance threshold, the processor can determine that the predicted future clearance value is less than the specific clearance threshold. The processor can then send an instruction to change the switching rate to increase the dialysate flow rate to the increased rate. For example, the processor can send an instruction to the balancing system receiving the dialysate as described above. In some embodiments, the processor can send an instruction to a switching switch to increase the dialysate flow rate such that the predicted clearance value reaches (or, as described above, approaches) the clearance threshold. Increasing the predicted clearance value can ensure that dialysis treatment meets the requirements specified in the patient's prescription.

[0097] In some implementations, the processor may determine that treatment has ended and the machine has been disconnected from the patient. For example, the processor may determine that treatment has ended based on sensor measurements indicating changes in tubing pressure connected to the patient during treatment, or indicating a significant reduction (e.g., cessation) in the blood flow rate through the dialyzer. In some implementations, the processor may send a post-treatment command to reduce the dialysate flow rate. For example, the processor may send a post-treatment command to the balancing system to reduce the dialysate flow rate to less than half of the current flow rate.

[0098] The embodiments of the subject matter and functional operation described in this specification can be implemented in various types of digital electronic circuits, or in computer software, firmware, or hardware (including the structures disclosed in this specification and their equivalents), or in one or more combinations thereof. Embodiments of the subject matter described in this specification can be implemented as one or more computer program products, i.e., one or more computer program instruction modules encoded on a tangible program carrier (e.g., a computer-readable medium) for execution by a processing system or for controlling the operation of a processing system. The computer-readable medium can be a machine-readable storage device, a machine-readable storage substrate, a memory device, a combination of substances affecting machine-readable propagation signals, or one or more combinations thereof.

[0099] The term "computer system" can include all means, devices, and machines used for processing data, such as programmable processors, computers, or multiple processors or computers. A processing system can include code, in addition to hardware, that creates the execution environment for computer programs, such as code that constitutes processor firmware, protocol stacks, database management systems, operating systems, or one or more combinations thereof.

[0100] Computer programs (also known as programs, software, software applications, scripts, or executable logic) can be written in any programming language, including compiled or interpreted languages, declarative or procedural languages, and can be deployed in any form, including as standalone programs or as modules, components, subroutines, or other units suitable for use in a computing environment. A computer program does not necessarily correspond to a file in a file system. A program may be stored as a part of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to the program in question, or in multiple coordinating files (e.g., a file storing one or more modules, subroutines, or code sections). Computer programs can be deployed to execute on a single computer, or on multiple computers located at one site or distributed across multiple sites and interconnected by a communication network.

[0101] Computer-readable media suitable for storing computer program instructions and data include all forms of non-volatile or non-volatile memory, media, and memory devices, such as semiconductor memory devices (e.g., EPROM, EEPROM, and flash memory devices); magnetic disks (e.g., internal hard disks or removable disks or magnetic tapes); magneto-optical disks; and CD-ROM and DVD-ROM disks. Processors and memory may be supplemented by or incorporated into dedicated logic circuitry. System components may be interconnected via any form or type of digital data communication (e.g., communication networks). Examples of communication networks include local area networks (“LANs”) and wide area networks (“WANs”), such as the Internet.

[0102] Although this specification contains numerous details, these should not be construed as limiting the scope of this disclosure or the claimable content, but rather as descriptions of specific features of particular embodiments. Some features described in this specification within the context of individual embodiments may also be implemented in combination in a single embodiment. Conversely, various features described in the context of a single embodiment may also be implemented individually in multiple embodiments or in any suitable sub-combination. Furthermore, although features may be described above as functioning in certain combinations, or even initially claimed in this way, in some cases one or more features may be removed from the claimed combination, and the claimed combination may involve sub-combinations or variations thereof.

[0103] Similarly, although operations are shown in a specific order in the accompanying drawings, this should not be construed as requiring these operations to be performed in the specific order shown or sequentially, or to perform all shown operations to achieve the desired result. In some cases, multitasking and parallel processing may be advantageous. Furthermore, the separation of various system components in the above embodiments should not be construed as requiring such separation in all embodiments. It should also be understood that the described program components and systems can generally be integrated into a single software product or packaged into multiple software products.

[0104] Several embodiments of the present invention have been described. However, it should be understood that various modifications can be made without departing from the spirit and scope of the invention. For example, various forms of the process shown above can be used, and steps can be reordered, added, or deleted. Therefore, other embodiments are also within the scope of the following claims.

Claims

1. A computer-implemented method executable by the processor of a dialysis machine, the method comprising: Based on prescriptions received from external sources, the treatment duration for dialysis treatment of patients is determined; The dialysate flow rate of the dialysate flowing through the dialysis machine is received from at least one sensor of the dialysis machine, the dialysate comprising bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein the bicarbonate source has an initial amount of bicarbonate before the dialysis treatment begins; and Based on (i) the treatment time, (ii) the initial amount of bicarbonate, and (iii) the dialysate flow rate, it is predicted that at the end of the dialysis treatment, the amount of remaining bicarbonate in the bicarbonate source will not exceed a specific threshold, and in response, Determine whether the clearance value during the treatment period is currently higher than or will be higher than a specific clearance threshold; and A command is sent to the balancing system receiving the dialysate to change the switching rate, reducing the dialysate flow rate to a reduced rate. The balancing system is part of the dialysis machine. The reduced flow rate can decrease the rate at which bicarbonate is pumped out of the bicarbonate source, while maintaining the clearance value of the treatment at no less than the clearance threshold.

2. The method according to claim 1, wherein, The determined clearance value is or is based on the current clearance value of the treatment, and the method further includes determining the current clearance value by: Receives measurements of the conductivity of the dialysate flowing into or out of the dialyzer from multiple sensors; and The current clearance value is calculated based on the received conductivity value.

3. The method according to claim 1 or 2, wherein, The determined clearing value is a future clearing value, and the method further includes predicting the future clearing value by: Multiple clearance values ​​are calculated for a specific time period during treatment, each clearance value being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within the time period. Based on the trends of the multiple clearance values ​​and the current clearance value of the treatment, the future clearance value at a certain point in time before the end of the treatment is predicted.

4. The method of claim 3, further comprising generating instructions for the balancing system based on predicted future clearing values, wherein, The instruction includes a reduction in the switching rate, which depends on the difference between the predicted future clearance value and a specific clearance threshold; the larger the difference, the larger the reduction.

5. The method according to claim 3 or 4, wherein, The instruction is a first instruction, and the method further includes: Determine if the predicted future clearance value is less than a specific clearance threshold, and respond accordingly. A second instruction is sent to the balancing system to increase the dialysate flow rate, thereby increasing the clearance value of the treatment. The second instruction is sent after the first instruction.

6. The method according to any one of claims 3-5, further comprising sending the predicted future clear value to a display for presentation.

7. The method according to any one of claims 1-6, wherein, The instruction to change the switching rate includes a rate reduction amount for the switching rate.

8. The method according to any one of claims 1-7, further comprising: Once it is confirmed that treatment has ended and the dialysis machine has been disconnected from the patient, and in response, The system sends a post-treatment instruction to the balancing system to reduce the dialysate flow rate.

9. The method according to claim 8, wherein, The post-treatment instructions include instructions to reduce the dialysate flow rate to less than half of its original value.

10. A dialysis system, comprising: Dialyzer; Fluid lines used to transport dialysate from the bicarbonate source to the balance system; A sensor configured to measure the flow rate of dialysate flowing through the fluid conduit, the dialysate comprising bicarbonate pumped from the bicarbonate source; The balancing system is configured to deliver purified dialysate from the fluid line to the dialyzer and discharge used dialysate from the dialyzer to a discharge device. The balancing system includes a switching switch whose state changes with a switching rate, the change in the switching rate causing a change in the flow rate of the dialysate through the fluid line. A processor configured to perform the following operations: Based on prescriptions received from external sources, the treatment duration for the patient's dialysis therapy is determined. The dialysate flow rate is received from the sensor, wherein the bicarbonate source has an initial bicarbonate level before the start of the dialysis treatment. Based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, it is predicted that at the end of the dialysis treatment, the amount of remaining bicarbonate in the bicarbonate source will not exceed a specific threshold, and in response, Determine whether the clearance value during the treatment period is currently higher than or will be higher than a specific clearance threshold, and A command is sent to the balancing system to change the switching rate, reducing the dialysate flow rate to the reduced flow rate. The reduced flow rate can decrease the rate at which bicarbonate is pumped out of the bicarbonate source, while maintaining the clearance value of the treatment at no less than the clearance threshold.

11. The dialysis system of claim 10 further includes a plurality of sensors operatively connected to the fluid lines of the dialysis machine, the plurality of sensors being configured to measure the corresponding conductivity values ​​of the dialysate flowing into or out of the dialyzer.

12. The dialysis system according to claim 11, wherein, The determined clearance value is or is based on the current clearance value of the treatment, and the operation further includes determining the current clearance value by: Receive corresponding conductivity values ​​from the plurality of sensors; as well as The current clearance value is calculated based on the received conductivity value.

13. The dialysis system according to any one of claims 10-12, wherein, The determined clearing value is a future clearing value, and the operation further includes predicting the future clearing value in the following manner: Calculate multiple clearance values ​​for a treatment period during the treatment, each of the multiple clearance values ​​being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within the treatment period; as well as Based on the trends of the multiple clearance values ​​and the current clearance value of the treatment, the future clearance value at a certain point in time before the end of the treatment is predicted.

14. The dialysis system according to claim 13, wherein, The operation further includes generating instructions based on the predicted value, wherein the instructions include a reduction in the switching rate, the reduction depending on the difference between the predicted future clearing value and a specific clearing threshold, the larger the difference, the larger the reduction.

15. The dialysis system according to claim 13 or 14, wherein, The instruction is a first instruction, and the operation further includes: Determine if the predicted future clearance value is less than a specific clearance threshold, and respond accordingly. A second instruction is sent to the balancing system to increase the dialysate flow rate, thereby increasing the clearance value of the treatment. The second instruction is sent after the first instruction.

16. The dialysis system according to any one of claims 13-15, wherein, The operation also includes sending the predicted future clear value to a display for presentation.

17. The dialysis system according to any one of claims 10-16, wherein, The instruction to change the switching rate includes a rate reduction amount for the switching rate.

18. One or more computer-readable media storing instructions executable by a processing device, which, when executed, cause the processing device to perform the following operations: Based on the patient's prescription received from an external source, the treatment time for dialysis treatment of the patient is determined; The dialysate flow rate is received from at least one sensor of the dialysis machine, the dialysate comprising bicarbonate pumped from a bicarbonate source attached to the dialysis machine, wherein... The bicarbonate source has an initial amount of bicarbonate before the start of the dialysis treatment; Based on (i) the treatment time, (ii) the initial bicarbonate amount, and (iii) the dialysate flow rate, it is predicted that at the end of the dialysis treatment, the amount of remaining bicarbonate in the bicarbonate source will not exceed a specific threshold, and in response, Determine whether the clearance value during the treatment period is currently higher than or will be higher than a specific clearance threshold, and A command is sent to the balancing system receiving the dialysate to change the switching rate, reducing the dialysate flow rate to a reduced rate. The balancing system is part of the dialysis machine. The reduced flow rate can decrease the rate at which bicarbonate is pumped out of the bicarbonate source, while maintaining the clearance value of the treatment at no less than the clearance threshold.

19. The computer-readable medium for storing instructions according to claim 18, wherein, The determined clearing value is a future clearing value, and the operation further includes predicting the future clearing value in the following manner: Calculate multiple clearance values ​​for a treatment period during the treatment, each of the multiple clearance values ​​being calculated based on the corresponding conductivity value of the dialysate at the corresponding time point within the treatment period; as well as Based on the trends of the multiple clearance values ​​and the current clearance value of the treatment, the future clearance value at a certain point in time before the end of the treatment is predicted.

20. The computer-readable medium for storing instructions according to claim 18 or 19, wherein, The operation also includes: Instructions are generated based on the predicted values, wherein the instructions include a reduction in the switching rate, the reduction depending on the difference between the predicted future clearing value and a specific clearing threshold, the larger the difference, the larger the reduction.

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