Blood purification device and method for priming blood circulation passage

Abstract

To reduce a burden on a medical worker and to suppress the use of a dialysate as a priming liquid.SOLUTION: The dialysate feed channel 34 is provided with a feed port P1, and the dialysate discharge channel 35 is provided with a discharge port P3. A supply passage 23 is branched on the upstream side of the blood pump 8 in the artery passage 21, and a vein passage connection part (a branch passage 24) capable of connecting the vein passage 22 is arranged in the supply passage 23. When priming is to be performed, the dialysate supplying means and the pump 8 are operated in a state in which the supplying path 23 is connected to the supplying port P1, the arterial path 21 is connected to the discharging port P3, and the venous path 22 is connected to the branch path 24 of the supplying path 23.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to a blood purification apparatus and a method for priming a blood circulation passage, and more particularly to a blood purification apparatus and a method for priming a blood circulation passage by supplying dialysate from a dialysate circuit to a blood circuit. [Background technology]

[0002] A blood purification device used in blood purification treatments such as hemodialysis includes a blood circuit having an arterial passage and a venous passage connected to a blood purifier, and a dialysate circuit having a dialysate supply passage and a dialysate discharge passage connected to the blood purifier, and purifies the blood with the blood purifier while circulating it outside the body (Patent Document 1). In such blood purification devices, the blood purifier and blood circuit must be replaced with new ones every time blood purification treatment is performed, and when using a new device, priming must be performed by circulating a priming solution through the blood circulation passage consisting of the blood purifier and blood circuit to remove internal air. In conventional blood purification devices, dialysate is supplied as a priming fluid from a dialysate circuit to a blood circuit during the priming process. In the blood purification device of Patent Document 1, the dialysate is supplied using a fluid replacement passage provided between the dialysate supply passage of the dialysate circuit and the blood circuit. Furthermore, the blood purification device of Patent Document 1 is designed to select either pre-fluid replacement (pre-dilution method), in which replacement fluid is supplied to the arterial passage of the blood circuit, or post-fluid replacement (post-dilution method), in which replacement fluid is supplied to the venous passage, depending on the patient's condition and the doctor's judgment, and priming is performed in the blood circuit where the replacement fluid passage branches off from either the arterial passage or the venous passage. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2024-35694 Summary of the Invention [Problem to be solved by the invention]

[0004] When performing blood purification treatment using the blood purification device of Patent Document 1, the blood purifier is held so that the arterial header (red), to which the arterial passage of the blood circuit is connected, is at the top and the venous header (blue), to which the venous passage is connected, is at the bottom, and blood is circulated from top to bottom inside the hollow fiber membrane, which is made up of a large number of hollow fibers installed inside the blood purifier. In contrast, when priming a blood purifier, it is necessary to circulate the priming fluid inside the hollow fiber membrane from bottom to top. In other words, if the priming fluid is circulated inside the hollow fiber membrane from top to bottom, some air may rise against the flow of the priming fluid and remain in the header above. Therefore, to ensure good air removal, it is necessary to circulate the priming fluid inside the hollow fiber membrane from bottom to top, so that the air flows out of the blood purifier together with the priming fluid. In Patent Document 1, the arterial header is placed on top and blood is circulated from top to bottom during treatment. As a result, when post-fluid replacement is selected, a blood circuit in which a fluid replacement passageway branches off from the venous passageway is used, and during priming, dialysate is supplied to the venous passageway, so the blood purifier can perform priming by circulating priming fluid from bottom to top with the venous header facing downward, and since the arterial header is located on top, treatment can be started directly. However, when pre-fluid replacement is selected, a blood circuit is used in which a fluid replacement passage is branched off from an arterial passage, and dialysate is supplied to the arterial passage during priming. Therefore, the blood purifier must be held with the arterial header facing downward, and the priming fluid must be circulated from bottom to top. Therefore, in order to perform treatment after priming, medical personnel had to turn the blood purifier over so that the arterial header was facing up. As described above, in Patent Document 1, operations may be required when transitioning from priming to treatment, and since the operations are different for host fluid replacement and pre-fluid replacement, there is a risk of human error. In addition, in the blood purification device of Patent Document 1, when priming the hollow fiber membrane of the blood purifier, the dialysate that has passed through the hollow fiber membrane is completely discharged without being recycled, and a large amount of dialysate is used to sufficiently remove air. In view of these problems, the present invention provides a blood purification apparatus and a method for priming a blood circulation passage that can reduce the workload of medical personnel, prevent the occurrence of human error, and reduce the amount of dialysate used during priming. [Means for solving the problem]

[0005] That is, the blood purification apparatus according to the invention of claim 1 comprises a blood circuit having an arterial passage and a venous passage connected to a blood purifier, a dialysate circuit having a dialysate supply passage and a dialysate discharge passage connected to the blood purifier, dialysate supply means for supplying dialysate to the blood purifier through the dialysate supply passage, a blood pump provided in the arterial passage for sending blood to the blood purifier, and control means for controlling the operation of the dialysate supply means and the blood pump, a supply port for discharging dialysate from the dialysate supply passage and a discharge port for introducing dialysate into the dialysate discharge passage; a supply passage branching from the arterial passage at an upstream side of the blood pump, and a venous passage connection part capable of connecting the venous passage to the supply passage, When priming the blood circulation passage consisting of the blood purifier and the blood circuit, With the supply passage connected to the supply port, the arterial passage connected to the discharge port, and the venous passage connected to the venous passage connection portion of the supply passage, The control means operates the dialysate supply means and the blood pump to supply the dialysate from the dialysate supply passage through the supply passage to the arterial passage, and further circulates the dialysate from the arterial passage through the blood purifier and the venous passage, and causes the dialysate to flow from the arterial passage to the dialysate discharge passage. A method for priming a blood circulation passage according to the invention of claim 3 is a method for priming a blood circulation passage consisting of the blood purifier and blood circuit in a blood purification apparatus comprising: a blood circuit having an arterial passage and a venous passage connected to the blood purifier; a dialysate circuit having a dialysate supply passage and a dialysate discharge passage connected to the blood purifier; dialysate supply means for supplying dialysate to the blood purifier through the dialysate supply passage; a blood pump provided in the arterial passage for sending blood to the blood purifier; and control means for controlling operation of the dialysate supply means and the blood pump, the dialysate supply passage and the arterial passage upstream of the blood pump are connected by a supply passage, the venous passage is connected to the supply passage, and the arterial passage is connected to the dialysate discharge passage; The dialysate supply means supplies the dialysate from the dialysate supply passage through the supply passage to the arterial passage, and the blood pump circulates the dialysate from the arterial passage through the blood purifier and the venous passage, while discharging the dialysate from the arterial passage to the dialysate discharge passage. [Effects of the Invention]

[0006] According to the inventions of claims 1 and 3, during priming, the dialysate is supplied as a priming fluid from the dialysate supply passage through the supply passage to the arterial passage upstream of the blood pump, so that the dialysate is supplied to the blood purifier from below. Furthermore, during blood purification treatment, blood is supplied to the blood purifier from below, eliminating the need to invert the blood purifier before blood purification treatment, thereby reducing the burden on medical staff and preventing human error. Furthermore, by connecting the venous passage to the middle of the supply passage, a circulation path passing through the blood purifier can be formed and priming can be performed, thereby reducing the amount of dialysis fluid used. [Brief explanation of the drawings]

[0007] [Figure 1] FIG. 1 is a front view of a blood purification device according to the present embodiment. [Figure 2] A diagram explaining the operation of the blood purification device during priming. [Figure 3] A diagram explaining the operation of the blood purification device during priming. [Figure 4] A diagram explaining the operation of the blood purification device during priming. [Figure 5] A diagram explaining the operation of the blood purification device during priming. [Figure 6] FIG. 1 is a diagram illustrating the operation during priming when the blood purification device is used with pre-fluid replacement. DETAILED DESCRIPTION OF THE INVENTION

[0008] The illustrated embodiment will now be described. Figure 1 shows a front view of the blood purification device 1, and Figures 2 to 6 show fluid delivery circuit diagrams of the blood purification device 1, which explain the fluid delivery operation during priming in the blood purification device 1. Here, the above-mentioned priming refers to the process of, before performing blood purification treatment such as hemodialysis, connecting the blood purifier 2 to the blood circuit 3 and the dialysate circuit 4, circulating a priming solution through the blood purifier 2 via the blood circuit 3 to remove air from the hollow fiber membrane 2B and the blood circuit 3 provided in the blood purifier 2, and circulating dialysate through the blood purifier 2 via the dialysate circuit 4 to remove air around the hollow fiber membrane 2B in the main body case 2A. Furthermore, in the blood purification device 1 of this embodiment, it is possible to perform fluid replacement by supplying dialysate from the dialysate circuit 4 to the blood circuit 3 during blood purification treatment, and this can be performed by selecting either post-fluid replacement (post-dilution method, see Figure 2), in which dialysate is supplied downstream of the blood purifier 2, or pre-fluid replacement (pre-dilution method, see Figure 6), in which dialysate is supplied upstream of the blood purifier 2.

[0009] The blood purification apparatus 1 includes a blood purifier 2 that purifies blood, a blood circuit 3 having an arterial passage 21 and a venous passage 22 connected to the blood purifier 2, and a dialysate circuit 4 having a dialysate supply passage 34 and a dialysate discharge passage 35 connected to the blood purifier 2. The operation of various on-off valves and pumps provided in the blood purification apparatus 1 is controlled by control means 5, which is a computer such as a microcomputer or a personal computer. In FIG. 1, the blood circuit 3 is attached to a front panel 6 a of the main body 6 that constitutes the blood purification device 1 , whereas most of the dialysate circuit 4 is housed inside the main body 6 . The control means 5 is placed on top of the main body 6, and the control means 5 is equipped with a touch panel 5a for displaying various settings and the progress of blood purification treatment, as well as for performing necessary operations.A purifier holder 7 is provided on the side of the main body 6, and holds the blood purifier 2 so that blood and dialysis fluid can flow up and down. In addition, a blood pump 8 for pumping blood in the blood circuit 3 is provided on the front panel 6a of the main body 6, and the blood pump 8 is provided in the middle of the arterial passage 21 by attaching a piping tube that constitutes the arterial passage 21 of the blood circuit 3. Further, below the blood pump 8 on the front panel 6a, an arterial clamp V1 capable of clamping the piping tube of the arterial passage 21 is provided. In addition, a chamber holder 27 is provided in parallel to the blood pump 8, and is configured to hold the air trap chamber 9 provided in the venous passage 22 of the blood circuit 3, and a liquid level sensor 28 is provided below the chamber holder 27 to detect the height of the liquid level in the held air trap chamber 9. Further, below the chamber holder 27 and the liquid level sensor 28, a venous clamp V2 capable of clamping the piping tube of the venous passage 21 is provided.

[0010] Furthermore, a supply port P1 communicating with the dialysate supply passage 34 of the dialysate circuit 4 is provided below the blood pump 8 on the front panel 6a of the main body 6 in order to connect the blood circuit 3 to the dialysate circuit 4 inside the main body 6, and a replacement fluid port P2 communicating with the dialysate supply passage 34 is provided below the chamber holder 27, and a discharge port P3 communicating with the dialysate discharge passage 35 of the dialysate circuit 4 is provided below the supply port P1. Furthermore, an atmosphere release port P4 connecting to the air trap chamber 9 is provided above the chamber holder 27 on the front panel 6a. For each of the ports P1 to P3, the configuration described in Japanese Patent No. 5920575 can be used, and the front panel 6a is provided with rotatable cover members L corresponding to each of the ports P1 to P3. With this configuration, when the blood circuit 3 is attached, the cover member L is rotated to expose each of the ports P1 to P3 to the outside, and the corresponding passages of the blood circuit 3 are connected, and when blood purification treatment is performed, the connector 21a of the arterial passage 21 can be removed from the discharge port P3 and covered with the cover member L to prevent it from being exposed to the outside.

[0011] The blood purifier 2 is made entirely of resin and includes a hollow fiber membrane 2B, which is a bundle of many hollow fibers, inside a transparent, cylindrical main body case 2A. The interior of each hollow fiber of the hollow fiber membrane 2B forms a blood passage 2a through which blood flows, and the area around the hollow fiber membrane 2B inside the main body case 2A forms a dialysate passage 2b through which dialysate flows. Both ends of the main body case 2A are closed with headers 2C, and the arterial side header 2Ca, which has a blood inlet to which the arterial passage 21 is connected, is colored red, while the venous side header 2Cb, which has a blood outlet to which the venous passage 22 is connected, is colored blue, and these headers connect the ends of the hollow fiber membranes 2B to the arterial passage 21 and the venous passage 22, respectively. Furthermore, a dialysate inlet / outlet port 2D is provided adjacent to the header 2C on the outer peripheral surface of the main body case 2A, and the dialysate supply passage 34 is connected to the dialysate inlet 2Da formed adjacent to the venous header 2Cb, while the dialysate outlet 2Db formed adjacent to the arterial header 2Ca is connected to the dialysate discharge passage 35, which communicate with the dialysate passage 2b around the hollow fiber membrane 2B inside the main body case 2A. In the blood purification device 1 of the present invention, the blood purifier 2 is held in the purifier holder 7 of the main body 6 so that the arterial header 2Ca is positioned downward. Accordingly, during blood purification treatment, blood withdrawn from the patient in the arterial passage 21 flows from bottom to top through the blood passage 2a in the hollow fiber membrane 2B (from left to right in Figures 2 to 6) and is discharged into the venous passage 22. The dialysate supplied from the dialysate supply passage 34 flows through the dialysate passage 2b around the hollow fiber membrane 2B from top to bottom in the opposite direction to the flow of blood (from right to left in Figures 2 to 6), and is discharged into the blood discharge passage 35. The arterial passage 21, the hollow fiber membrane 2B of the blood purifier 2, and the venous passage 22 form a blood circulation passage. During priming, as during blood purification treatment, the blood purifier 2 is held in the purifier holder 7 with the arterial header 2Ca facing downward, and the dialysis fluid as a priming fluid flows from bottom to top through the blood passage 2a in the hollow fiber membrane 2B.

[0012] The distal end of the arterial passage 21 is an open end provided with a connector 21a to which a puncture needle is attached during treatment, and a supply passage 23 for supplying dialysate from the dialysate circuit 4 branches off from the connector 21a to the attachment point to the blood pump 8 during the priming or blood return operation after blood purification treatment. The blood pump 8 is configured as a so-called tube pump in which multiple rotors r are arranged at equal intervals around the outer periphery of a rotating rotor R. As the rotor R rotates, the rollers r sequentially compress the piping tube that forms the arterial passage 21 around the rotor R, thereby drawing in and pushing out liquid into the piping tube. In this embodiment, the direction of fluid supply from the connector 21a in the arterial passage 21 toward the blood purifier 2 is defined as the forward direction, and the rotation of the rotor R of the blood pump 8 in the forward direction is defined as normal rotation. Conversely, the direction of fluid supply from the blood purifier 2 toward the connector 21a is defined as reverse direction, and the rotation of the rotor R of the blood pump 8 in the reverse direction is defined as reverse rotation. The standard operation of the blood pump 8 is to supply fluid in the forward direction, and the forward direction side of the blood pump 8 is defined as the downstream side, and the reverse direction side is defined as the upstream side. During priming, the connector 21a of the arterial passage 21 is connected to a discharge port P3 provided on the front panel 6a of the main body 6, and the dialysate that has circulated through the blood circuit 3 is discharged to the dialysate discharge passage 35. The arterial side clamp V1 clamps the piping tube of the arterial passage 21 between the connection point 21P of the supply passage 23 and the connector 21a, and the arterial passage 21 is automatically opened and closed by a driving means (not shown) controlled by the control means 5.

[0013] The supply passage 23 is used during the priming and blood returning operations, and supplies the dialysate flowing through the dialysate supply passage 34 to the blood circuit 3. The supply passage 23 is provided integrally with the blood circuit 3 and is connected to the dialysate supply passage 34 via the supply port P1. A connector 23a is provided at the tip of the supply passage 23 to connect to the supply port P1, and a check valve B1 is provided at the base to branch off from the arterial passage 21 while blocking inflow. Furthermore, a branch pipe 24 is provided midway along the supply passage 23 as a venous passage connection part according to the present invention, and a connection part 24a is provided at the tip of the branch pipe 24 to which the connector 22a provided at the tip of the venous passage 22 can be connected. When the connector 22a is not connected, the branch pipe 24 is closed with a clamp 24b.

[0014] A puncture needle is attached to the connector 22a at the tip of the venous passage 22, which is an open end. The venous clamp V2 clamps the piping tube of the venous passage 22 between the air trap chamber 9 and the connector 22a, and the venous passage 22 is automatically opened and closed by a driving means (not shown) controlled by the control means 5. In addition, the fluid replacement passage 25 for post fluid replacement is branched off between the blood purifier 2 and the air trap chamber 9 in the venous passage 22, and is connected to the dialysate supply passage 34 via the fluid replacement port P2. The tip of the fluid replacement passage 25 is an open end provided with a connector 25a to connect to the fluid replacement port P2, and is branched off at its base with a check valve B2 to block inflow from the venous passage 22.

[0015] As shown in FIG. 1, the air trap chamber 9 comprises a cylindrical transparent container 9a, a cap 9b that seals the top of the container 9a, and a filter 9c that is provided at the bottom of the container 9a, and the cap 9b is provided with an air piping tube 9d for connection to the atmosphere release port P4. The air trap chamber 9 is provided midway through the venous passage 22, and the downstream piping tube of the venous passage 22 is connected to the bottom of the container 9a, and the upstream piping tube of the venous passage 22 is connected to the upper side, so that the air trap chamber 9 is in communication with these. With this configuration, liquid flows in from the top of container 9a and out from the bottom, and air that flows in with the liquid is released and trapped inside container 9a, and filter 9c captures thrombi that flow in with the blood. The atmosphere release port P4 is connected to a gas passage 26 and is open to the outside, and an atmosphere release valve V3 is provided in the gas passage 26 so that the gas passage 26 can be opened and closed. A pressure gauge 26a is provided between the atmosphere release port P4 and the atmosphere release valve V3 so as to measure the venous pressure of the blood circuit 3. Below the chamber holder 27, a liquid level sensor 28 is provided for detecting when the liquid level in the air trap chamber 9 held by the chamber holder 27 drops to the level of the filter 9c. The liquid level sensor 28 monitors the liquid level in the air trap chamber 9, and when it detects that air has accumulated in the air trap chamber 9 during priming and the liquid level has dropped, the control means 5 opens the atmosphere release valve V3 to open the air trap chamber 9 to the atmosphere, thereby raising the liquid level. The atmosphere release valve V3 closes when the liquid level has risen to a predetermined height.

[0016] In FIG. 2, the dialysate circuit 4 includes first and second dialysate chambers 31, 32, each having supply chambers 31a, 32a and collection chambers 31b, 32b formed therein by a diaphragm, a supply passage 33 for supplying purified dialysis water to the supply chambers 31a, 32a, a dialysate supply passage 34 for supplying fresh dialysate from the supply chambers 31a, 32a to the blood purifier 2, a dialysate discharge passage 35 for discharging used dialysate from the blood purifier 2 to the collection chambers 31b, 32b, and a drain passage 36 for draining used dialysate from the collection chambers 31b, 32b. The fluid supply passage 33 is connected to a water supply source (not shown) that supplies purified dialysis water at its upstream fluid supply port, and an on-off valve V4 is provided at the fluid supply port, with a fluid supply pump 38 provided downstream thereof. The downstream portion of fluid supply passage 33 branches into two directions and connects to supply chambers 31a, 32a of first and second dialysate chambers 31, 32, and fluid supply valves V5, V6 are provided in the branched passages, respectively. In addition, a first bypass passage 37 is provided which branches off between the on-off valve V4 and the liquid supply pump 38 and is connected to the liquid discharge passage 36, and a seventh on-off valve V7 is provided in the first bypass passage 37.

[0017] A stock solution B pump 39 for supplying stock solution B and a stock solution A pump 40 for supplying stock solution A are connected to the stock solution passage 33 between the stock solution pump 38 and the branched downstream portion as stock solution supply means for supplying dialysis stock solutions. The stock solution A and stock solution B supplied in predetermined amounts by the stock solution pumps 39 and 40 flow through the supply passage 33 together with the dialysis water delivered by the supply pump 38, and flow into the supply chambers 31a and 32a of the first and second dialysis solution chambers 31 and 32. These stock solutions A and B and the dialysis water are mixed inside the supply chambers 31a and 32a, thereby preparing a dialysis solution of a predetermined concentration.

[0018] The upstream portion of the dialysate supply passage 34 branches into two directions and is connected to the supply chambers 31a and 32a of the first and second dialysate chambers 31 and 32, respectively, and the downstream end is connected to the dialysate inlet 2Da adjacent to the venous header 2Cb of the blood purifier 2, and communicates with the dialysate passage 2b within the blood purifier 2. Furthermore, supply valves V9 and V10 are provided at the branched upstream portions of the dialysate supply passage 34, and two filters CF1 and CF2 that capture endotoxin in the dialysate and purify the dialysate are provided adjacent to each other downstream of the upstream portions. The supply port P1 and the replacement fluid port P2 are located downstream of these filters CF1 and CF2 so that the purified dialysate is supplied to the blood circuit 3.

[0019] A replacement fluid branch passage 34a is branched off at a position downstream of the filters CF1 and CF2, and a first flow rate restricting means MV1 is provided in the dialysate supply passage 34 downstream of the branching position, and a second flow rate restricting means MV2 and a twelfth on-off valve V12 are provided in the replacement fluid branch passage 34a. A replacement fluid port P2 is provided at the tip of the replacement fluid branch passage 34a, allowing the dialysate to flow out of the dialysate supply passage 34. When fluid replacement is performed during blood purification treatment, the control means 5 adjusts the aperture of the first flow rate restricting means MV1 and the second flow rate restricting means MV2 and opens the twelfth on-off valve, thereby causing a portion of the dialysate flowing through the dialysate supply passage 34 to flow through the fluid replacement branch passage 34a and be supplied from the fluid replacement passage 25 to the venous passage 22 or the arterial passage 21 via the fluid replacement port P2. In addition, flow path control for supplying replacement fluid from such a dialysis fluid circuit to a blood circuit is described, for example, in JP 2021-062067 A and is publicly known.

[0020] A supply branch passage 34b branches off from the dialysate supply passage 34 downstream of the first flow rate restricting means MV1, and a thirteenth on-off valve V13 is provided in the supply branch passage 34b, and a supply port P1 is provided at the tip of the supply branch passage 34b, allowing the dialysate to flow out of the dialysate supply passage 34. Furthermore, an eleventh on-off valve V11 is provided in the dialysate supply passage 34 downstream of the branch position of the supply branch passage 34b, and its downstream end is connected to the blood purifier 2.

[0021] A second bypass passage 41 branches off between the branching position of the supply branch passage 34b and the eleventh on-off valve V11 and is connected to the dialysate discharge passage 35, and the second bypass passage 41 is provided with a fourteenth on-off valve V14 and a fifteenth on-off valve V15. A discharge passage 42 is provided branching off from between the fourteenth on-off valve V14 and the fifteenth on-off valve, and a sixteenth on-off valve V16 is provided in the discharge passage 42. A discharge port P3 is provided at the tip of the discharge passage 42, and the dialysate is allowed to flow into the dialysate discharge passage 35 via the second bypass passage 41.

[0022] The dialysate discharge passage 35 has an upstream end connected to the blood purifier 2. A seventeenth on-off valve V17 is provided in the dialysate discharge passage 35 upstream of the connection position of the second bypass passage 41, and a degassing tank 43 for removing air bubbles from the dialysate and a dialysate pump 44 for delivering the dialysate are provided in this order downstream. The downstream portion of the dialysate discharge passage 35 branches into two directions and is connected to the recovery chambers 31b, 32b of the first and second dialysate chambers 31, 32, and recovery valves V18, V19 are provided at the branched portions. Furthermore, a drainage passage 36, whose upstream portion branches into two directions, is connected to the collection chambers 31b and 32b of the first and second dialysate chambers 31 and 32, and drainage valves V22 and V23 are provided in the branched upstream portion, while an opening / closing valve V24 is provided at the downstream outlet.

[0023] The gas removal tank 43 is provided with an exhaust passage 46 whose tip is connected to the drainage passage 36, and the exhaust passage 46 is provided with a twentieth on-off valve V20. The air removal tank 43 is conventionally known, and when used dialysate flows in during blood purification treatment, it separates the air that flows in together with the used dialysate and discharges it from the drainage passage 36 via the exhaust passage 46. Furthermore, it is designed so that excess dialysate can overflow from the dialysate discharge passage 35 to the drainage passage 36. The first bypass passage 37 is connected between the air removal tank 43 and the dialysate pump 44, and is used to replenish the dialysate discharge passage 35 with dialysis water from the fluid supply passage 33 during priming. That is, by opening the seventh on-off valve V7, the dialysis water can be drawn from the dialysis fluid supply passage 33 to the dialysis fluid discharge passage 35 by the action of the dialysis fluid pump 44, and stored in the collection chambers 31b and 32b.

[0024] A water removal passage 45 is connected to the downstream side of the dialysate pump 44 in the dialysate discharge passage 35, and discharges used dialysate from the dialysate discharge passage 35 to the drainage passage 36 without passing through the collection chambers 31b and 32b. A water removal pump 47 is provided in the water removal passage 45. During blood purification treatment, the water removal pump 47 is operated to generate a pressure difference between the dialysate chamber 2b and the blood chamber 2a in the blood purifier 2, which causes the water in the blood to move through the hollow fiber membrane 2B to the dialysate circuit 4 side and be removed.

[0025] 2 to 5, a method for priming the blood circulation passage in the blood purification device 1 having the above-described configuration will be described. Here, a blood circuit 3 in which the above-described fluid replacement passage 25 branches off from the venous passage 22 is used to perform post-fluid replacement in blood purification therapy. In each figure, the parts through which the dialysate and dialysis water flow are indicated by bold lines. However, regarding the flow of dialysate in the dialysate circuit 4, the bold lines are omitted for the flow of dialysate during normal operation, such as during blood purification treatment, and the bold lines are used to explain the flow of liquid that occurs during priming. Furthermore, unless otherwise specified, among the valves and clamps in the drawings, black indicates a closed state, and white indicates an open state.

[0026] Before priming, the blood purifier 2 and the blood circuit 3 are attached to the blood purification device 1. 1, the medical professional holds the piping tubes that make up the blood circuit 3 in a holder (not shown) provided on the front panel 6a of the main body 6, connects the connector 21a provided at the tip of the arterial passage 21 to the discharge port P3, and attaches the piping tubes that make up the arterial passage 21 to the blood pump 8 and the arterial clamp V1. Also, connects the connector 23a provided at the tip of the supply passage 23 branching off from the arterial passage 21 to the supply port P1. Furthermore, the medical staff connects connector 22a provided at the tip of venous passage 22 to connection portion 24a of branch pipe 24 branched from supply passage 23, and releases clamp 24b of branch pipe 24. The medical staff also attaches the piping tube constituting venous passage 22 to venous clamp V2. The medical staff also attaches the air trap chamber 9 to the chamber holder 27, connects the air piping tube 9d to the atmosphere release port P4, and connects the connector 25a provided at the tip of the replacement fluid passage 25 to the replacement fluid port P2. The medical staff then holds the blood purifier 2 in the purifier holder 7 with the red arterial header 2Ca facing downward and the blue venous header 2Cb facing upward, and connects the arterial passage 21 to the blood inlet of the arterial header 2Ca and the venous passage 22 to the blood outlet of the venous header 2Cb. Furthermore, a dialysate discharge passage 35 of the dialysate circuit 4 is connected to a dialysate outlet 2Db adjacent to the arterial header 2Ca, and a dialysate supply passage 34 is connected to a dialysate inlet 2Da adjacent to the venous header 2Cb.

[0027] After the blood purifier 2 and blood circuit 3 are attached to the main body 6 in this way, the medical staff operates the touch panel 5a to instruct the start of priming. In the following explanation, a detailed description of the operation of delivering dialysis fluid and dialysis water in the dialysis fluid circuit 4 will be omitted, but the state shown in FIG. 2 shows a state in which the supply valve V9 of the supply chamber 31a and the recovery valve V18 of the recovery chamber 31b in the first dialysis fluid chamber 31 are open, and the dialysis fluid prepared in the supply chamber 31a is delivered to the dialysis fluid supply passage 34, and in which the supply valve V6 of the supply chamber 32a and the drain valve V23 of the recovery chamber 32b in the second dialysis fluid chamber 32 are open, and the dialysis fluid is prepared in the supply chamber 32a. In addition, in the fluid supply passage 33, the water supply valve V4 is opened to operate the fluid supply pump 38, and the seventh on-off valve V7 of the first bypass passage 37 provided between the fluid supply passage 33 and the dialysis fluid discharge passage 35 is in an open state. That is, in this state, when the dialysis fluid pump 44 of the dialysis fluid discharge passage 35 performs fluid transfer, dialysis water flows from the fluid supply passage 33 through the first bypass passage 37, into the dialysis fluid discharge passage 35, and into the collection chamber 31b of the first dialysis fluid chamber 31. Then, the volume of the collection chamber 31b increases due to the inflow of dialysis water, and accordingly, the dialysis fluid is sent from the supply chamber 31a to the dialysis fluid supply passage 34, causing the volume of the supply chamber 31a to decrease. Meanwhile, in the second dialysis fluid chamber 32, the supply pump 38, the B concentrate pump 39, and the A concentrate pump 40 are operated to mix predetermined amounts of dialysis water, dialysis B concentrate, and dialysis A concentrate in the supply chamber 32a to prepare the dialysis fluid, and the dialysis water stored in the recovery chamber 32b is discharged into the drainage passage 36. During blood purification treatment, the pathways from the supply chambers 31a, 32a via the blood purifier 2 to the collection chambers 31a, 32a are filled with dialysate, so by operating the dialysate pump 44, the dialysate flows from the supply chambers 31a, 32a through the dialysate supply passage 34, the dialysate passage 2b of the blood purifier 2, and the dialysate discharge passage 35 to the collection chambers 31a, 32a. On the other hand, when priming begins, the blood circulation passage consisting of the blood purifier 2 and the blood circuit 3 is not filled with dialysate, so even if the dialysate pump 44 is operated in the same way as during treatment, no dialysate is stored in the collection chambers 31a, 32a, and the dialysate cannot be delivered from the supply chambers 31a, 32a. Therefore, in this embodiment, the seventh on-off valve V7 of the first bypass passage 37 is opened to supply dialysis water from the first bypass passage 37 to the collection chambers 31a, 32a via the dialysate collection passage 35, thereby enabling the dialysate to be delivered from the supply chambers 31a, 32a. This allows the dialysis fluid to flow through the blood purifier 2 and the blood circuit 3, but if the dialysis fluid spreads throughout the entire flow path formed by the blood purifier 2 and the blood circuit 3, excess dialysis fluid will be generated. Therefore, the 20th on-off valve V20 of the exhaust passage 46 is opened to allow the excess dialysis fluid to flow from the exhaust passage 46 of the degassing tank 43 to the drain passage 36. The supply operation of the dialysis fluid by such a dialysis fluid supply means alternates between preparation and drainage, and supply and recovery of the dialysis fluid in the first dialysis fluid chamber 31 and the second dialysis fluid chamber 32, thereby enabling a continuous supply of dialysis fluid. The supply pump 38, the concentrate supply means, the first dialysate chamber 31, the second dialysate chamber 32, and the dialysate pump 44 constitute the dialysate supply means of the present invention, and the operation of these components is controlled by the control means 5.

[0028] When priming is started, the fluid replacement passage 25 shown in FIG. 2 is first primed. The control means 5 adjusts the flow rate of the dialysate by the first flow throttling means MV1 in the dialysate supply passage 34 and the second flow throttling means MV2 in the replacement fluid branch passage 34a so that the dialysate flows into the replacement fluid branch passage 34a, and also closes the eleventh on-off valve V11, the thirteenth on-off valve V13 in the supply branch passage 34b, and the fourteenth on-off valve V14 in the second bypass passage 41. The control means 5 also opens the arterial clamp V1 of the arterial passage 21 and the venous clamp V2 of the venous passage 22, closes the air release valve V3 of the gas passage 26, and stops the blood pump 8. As a result, the dialysate that has flowed through the dialysate supply passage 34 flows from the replacement fluid branch passage 34a through the replacement fluid passage 25 and into the venous passage 22, thereby priming the replacement fluid passage 25. Furthermore, the dialysis fluid that has flowed into the venous passage 22 between the blood purifier 2 and the air trap chamber 9 does not flow toward the blood purifier 2, but instead flows toward the air trap chamber 9, because the blood pump 8 has stopped and the roller r is compressing the piping tube of the arterial passage 21, blocking the passage. The dialysate that has flowed into the air trap chamber 9 then flows further through the venous passage 22 and then flows into the supply passage 23 via the branch pipe 24. Since the thirteenth on-off valve V13 of the supply passage 23 is closed, the dialysate passes through the supply passage 23 and the check valve B1 and flows into the arterial passage 21. Furthermore, since the blood pump 8 is stopped and the passage is closed, the dialysate flows through the arterial passage 21 toward the discharge port P3.

[0029] The control means also closes the 17th on-off valve V17 of the dialysis fluid discharge passage 35, opens the 16th on-off valve V16 of the discharge passage 42 and the 15th on-off valve V15 of the second bypass passage 41, and opens the 20th on-off valve V20 of the exhaust passage 46 connected to the degassing tank 43. As a result, the dialysate that has flowed through the arterial passage 21 flows into the discharge passage 42 via the discharge port P3, and then flows out into the dialysate discharge passage 35 via the second bypass passage 41. The dialysate is then collected in the recovery chamber 31b by the action of the dialysate pump 44, or is discharged from the air removal tank 64 to the drain passage 36 via the exhaust passage 67. The control means 5 continues the above operation for a predetermined time, whereby the replacement fluid passage 25 is filled with the dialysis fluid, and the priming of the replacement fluid passage 25 is completed.

[0030] FIG. 3 shows the operation of removing air from the filter 9c provided in the air trap chamber 9 of the venous passage 22, which is performed before the operation of simultaneously priming the arterial passage 21 and the venous passage 22 of the blood circuit 3 shown in FIG. 4. During priming of the replacement fluid passage 25 shown in Figure 2, the dialysis fluid flows into the air trap chamber 9 and passes through the filter 9c located at the bottom, but the air bubbles adhering to the filter 9c cannot be easily removed. The control means 5 adjusts the first flow rate restricting means MV1 of the dialysate supply passage 34 and the second flow rate restricting means MV2 of the replacement fluid branch passage 34a so that no fluid flows into the replacement fluid branch passage 34a, closes the twelfth on-off valve V12 of the replacement fluid branch passage 34a, and opens the thirteenth on-off valve V13 of the supply branch passage 34b. Furthermore, the control means 5 reverses the rotation of the blood pump 8 in the arterial passage 21, keeps the arterial clamp V1 open, and opens and closes the venous clamp V2 of the venous passage 22 at predetermined intervals. Then, the dialysate flowing through the dialysate supply passage 34 flows from the supply branch passage 34b to the supply passage 23, and due to a pressure loss caused by the check valve B1, the dialysate does not flow into the arterial passage 21 but flows from the branch pipe 24 into the venous passage 22. In this way, the check valve B1 functions as a flow blocking means for blocking the flow of dialysate from the supply passage 23 to the arterial passage 21, but the flow blocking means is not limited to a check valve and may be any means, such as an on-off valve or an orifice, that can block the flow of dialysate when the blood pump 8 is rotated in the reverse direction. In this way, the dialysis fluid flowing through the venous passage 22 in the opposite direction to that during treatment flows into the air trap chamber 9 from the lower side, and when passing through the filter 9c, the fluid flows in the opposite direction, causing a backwashing effect to remove air bubbles adhering to the filter 9c. In addition, by opening and closing the venous clamp V2, pressure fluctuations occur in the circulating dialysate, and the pulsation makes it possible to efficiently remove air bubbles from the filter 9c. Thereafter, the dialysate discharged from the upper side of the air trap chamber 9 passes through the blood purifier 2, is sent to the blood pump 8 which is rotating in the reverse direction, and flows further in the reverse direction through the arterial passage 21, and then flows out from the discharge passage 42 to the dialysate discharge passage 35 via the discharge port P3. Here, the supply passage 23B is provided with a check valve B1, so that the dialysis fluid flowing through the arterial passage 21 does not flow into the supply passage 23.

[0031] FIG. 4 shows the operation of simultaneously priming the arterial passage 21 and the venous passage 22 of the blood circuit 3. In the operation shown in FIG. 4, the dialysate is supplied from the dialysate supply passage 34 to the arterial passage 21 via the supply passage 23, and the supplied dialysate is divided at the branch point 21P of the arterial passage 21 with the supply passage 23 so as to flow in the direction toward the blood purifier 2 (forward direction) and in the direction toward the tip connected to the discharge port P3 (reverse direction). The dialysate that has flowed toward the blood purifier 2 flows through the venous passage 22 and returns to the supply passage 23 from the tip of the venous passage 22 via the branch passage 24a. Specifically, the control means 5 switches the blood pump 8 from the state shown in FIG. 3 to the forward direction, where the blood pump 8 has been rotated in the reverse direction, so that the blood pump 8 sends fluid in the forward direction at a predetermined flow rate.

[0032] As a result, the dialysate flowing into the branch point 21P of the arterial passage 21 with the supply passage 23 flows in the forward direction, i.e., toward the blood purifier 2, by the blood pump 8 rotating in the forward direction, and forms a circulation path consisting of part of the arterial passage 21, the hollow fiber membrane 2B of the blood purifier 2, the venous passage 22, the branch passage 24, and part of the supply passage 23. The dialysate flowing from the branch passage 24 into the supply passage 23 is merged with the dialysate supplied from the dialysate supply passage 34 and circulating through the supply passage 23, and then flows into the arterial passage 21. The flow rate of the dialysate flowing from the branch passage 24 into the supply passage 23 depends on the flow rate set by the blood pump 8, and the flow rate of the dialysate supplied from the dialysate supply passage 34 depends on the flow rate set by the dialysate pump 44 constituting the dialysate supply means. Therefore, the flow rate of the dialysate flowing from the supply passage 23 into the arterial passage 21 is the total flow rate thereof. Therefore, at branch point 21P, the dialysate corresponding to the set flow rate of blood pump 8 flows in the forward direction, and the remaining flow rate of dialysate flows in the reverse direction and is discharged to dialysate discharge passage 35. For example, at the position where the branch pipe 24 joins the supply passage 23, when 600 ml / min of dialysate supplied from the dialysate supply passage 34 joins with 500 ml / min of dialysate circulated through the circulation path by the blood pump 8, a total of 1100 ml / min of dialysate is supplied to the arterial passage 21. Since the blood pump 8 pumps the dialysate in the forward direction at a flow rate of 500 ml / min, at the branch point P21 of the supply passage 23 in the arterial passage 21, 500 ml / min of the dialysate flows in the forward direction and merges with the supply passage 23 again through the circulation path, and the remaining 600 ml / min of the dialysate flows in the reverse direction through the arterial passage 21 and is then discharged to the dialysate discharge passage 35 via the discharge passage 42. In this way, the dialysate can be circulated throughout the entire pathways of the arterial passage 21 and the venous passage 22, and these can be primed simultaneously. The set flow rates of the blood pump 8 and the dialysate pump 44 (dialysate supply means) are not limited to the dialysate pump 44 (dialysate supply means) being higher than the arterial passage 21 as in the above example, but may be the same flow rate, or the blood pump 8 may be higher. Furthermore, at this time, if the amount of air released in the air trap chamber 9 increases and the liquid level drops to the detection level of the liquid level sensor 28, the control means 5 opens the air release valve V3 for a predetermined time to release the air in the air trap chamber 9. Once the air has been released, the air release valve V3 is closed again, and the liquid level in the air trap chamber 9 returns to the predetermined height.

[0033] FIG. 5 shows the priming of the hollow fiber membrane 2B of the blood purifier 2, which is carried out after the simultaneous priming of the arterial passage 21 and the venous passage 22 of the blood circuit 3 shown in FIG. 4, the control means 5 closes the thirteenth on-off valve V13 of the supply branch passage 34b and the sixteenth on-off valve V16 of the discharge passage 42, and opens the fourteenth on-off valve V14 of the second bypass passage, and also closes the seventh on-off valve V7 of the first bypass passage 37 and the twentieth on-off valve V20 of the exhaust passage 46 of the degassing tank 43. As a result, the dialysate supply means only recovers the dialysate prepared in the supply chambers 31a and 32a into the recovery chambers 31b and 32b and drains it, and the supply of dialysate from the dialysate supply passage 34 to the blood circuit 3 is stopped. Furthermore, the control means 5 controls the blood circuit 3 by rotating the blood pump 8 in the normal direction to send fluid in the forward direction, and by opening and closing the venous clamp V2 of the venous passage 22 at predetermined intervals. As a result, the dialysis fluid pumped by the blood pump 8 flows from the arterial passage 21 into the arterial header 2Ca facing downward in the blood purifier 2, circulates through the hollow fiber membrane 2B, flows from the venous header 2Cb facing upward through the venous passage 22, and then circulates back to the arterial passage 21 via the branch pipe 24 and the supply passage 23. During this time, the venous clamp V2 is opened and closed to generate pulsation in the dialysate, causing the air adhering to the hollow fiber membrane 2B to flow out into the venous passage 22 and be collected by the air trap chamber 9. The control means 5 continues to circulate the dialysis fluid for a predetermined time while detecting an increase in the amount of air in the air trap chamber 9 with the liquid level sensor 28 and opening the air release valve V3 to release the air to the outside. Since priming is performed by circulating the dialysate in this manner, the amount of dialysate used can be reduced compared to when priming is performed while the supplied dialysate is being discharged.

[0034] As described above, according to the blood purification device 1 and the method for priming the blood circulation passage of the above embodiment, it is possible to simultaneously prime the hollow fiber membrane 2B of the blood purifier 2 and the arterial passage 21 and venous passage 22 of the blood circuit 3. Specifically, the distal end of the arterial passage 21 is connected to the discharge port P3 to communicate with the dialysate discharge passage 35, and the distal end of the venous passage 22 is connected to the supply passage 23 to form a circulation path, and the blood pump 8 is operated to pump the fluid in the forward direction. As a result, part of the dialysate supplied from the dialysate supply passage 34 circulates through the circulation path, and the remaining dialysate flows in the opposite direction through the arterial passage 21 and is discharged from the discharge port P3, thereby simultaneously priming the hollow fiber membrane 2B of the blood purifier 2 and the entire arterial passage 21 and venous passage 22. Subsequently, by circulating the dialysate through the formed circulation path passing through the blood purifier and priming the blood purifier while stopping the supply of dialysate from the dialysate supply passage 34, the hollow fiber membrane 2B of the blood purifier can be sufficiently primed without using new dialysate, thereby reducing the use of dialysate.

[0035] Furthermore, in the present invention, blood purification treatment is performed by orienting the blood purifier 2 with the arterial header 2Ca downward and the venous header 2Cb upward, and pumping blood from bottom to top. Priming of the hollow fiber membrane 2B of the blood purifier 2 is performed by supplying dialysate to the arterial passage 21 and circulating the dialysate from bottom to top. Therefore, when performing blood purification treatment after priming, there is no need to turn the blood purifier 2 over, which reduces the workload of medical personnel.

[0036] Furthermore, according to this embodiment, whether post-fluid replacement using a blood circuit branched from the venous passage 22 is selected in which the fluid replacement passage 25 uses a blood circuit branched from the venous passage 22 or pre-fluid replacement using a blood circuit branched from the arterial passage 21 is selected in which the fluid replacement passage 25 uses a blood circuit branched from the arterial passage 21, the blood purifier 2 and the blood circuit 3 can be primed by the same operation by supplying dialysis fluid from the fluid supply passage 23 branched from the arterial passage 21. However, since the priming of the fluid replacement passage 25 is different, the priming method of the fluid replacement passage 25 when pre-fluid replacement is selected will be described below. Figure 6 shows the priming operation when using a blood circuit 3 in which the fluid replacement passage 25 is branched off from the arterial passage 21 to perform pre-fluid replacement, and corresponds to the priming operation of the fluid replacement passage 25 in the blood circuit 3 when performing post-fluid replacement as shown in Figure 2. When the fluid replacement passage 25 branches off from the arterial passage 21, the dialysate supplied from the dialysate supply passage 34 flows through the fluid replacement passage 25 and then flows into the arterial passage 21 between the blood pump 8 and the blood purifier 2. Even in this case, since the arterial passage 21 is blocked due to the blood pump 8 being stopped, the dialysate that has flowed into the arterial passage 21 passes through the hollow fiber membrane 2B of the blood purifier 2, flows through the venous passage 22, flows into the supply passage 23 from the branch pipe 24, flows into the discharge passage 42 from the arterial passage 21 via the discharge port P3, and is discharged into the dialysate discharge passage 35. As for the subsequent priming operation, since the fluid replacement passage 25 is not used to supply dialysis fluid, it can be performed in the same manner as the operation shown in Figures 3 to 5, as in the case of post-fluid replacement using a blood circuit 3 in which the fluid replacement passage 25 branches off from the venous passage 22. Thus, according to this embodiment, whether post-fluid replacement or pre-fluid replacement is performed, priming of the blood circulation passage consisting of the blood purifier 2 and the blood circuit 3 can be performed using the same operation.

[0037] It should be noted that, by using the priming method of this embodiment, priming can be performed in the same manner even in a blood circuit 3 that does not have a fluid replacement passage 25. In the above embodiment, the blood purification apparatus 1 is a so-called personal blood purification apparatus, which is equipped with a dialysis concentrate supply means and prepares dialysis fluid by mixing supplied dialysis water and dialysis concentrate solution. However, the blood purification apparatus 1 may not be equipped with a dialysis concentrate supply means, and may be a so-called console-type dialysis monitoring device that receives a supply of dialysis fluid prepared by a multiperson dialysis fluid supply apparatus. [Explanation of symbols]

[0038] 1 Blood Purification Device 2 Blood Purification Device 3 Blood circuit 4 Dialysate circuit 8 Blood pump 9 Air trap chamber 21 Arterial passage 22 Venous passage 23 Supply passage 24 Branch pipe (venous passage connection part) 25 Replacement fluid passage 34 Dialysate supply passage 35 Dialysate discharge passage 42 Discharge passage P1 Supply port P2 Fluid replacement port P3 exhaust port

Claims

1. A blood purification apparatus comprising: a blood circuit having an arterial passage and a venous passage connected to a blood purifier; a dialysate circuit having a dialysate supply passage and a dialysate discharge passage connected to the blood purifier; dialysate supply means for supplying dialysate to the blood purifier through the dialysate supply passage; a blood pump provided in the arterial passage for sending blood to the blood purifier; and control means for controlling operation of the dialysate supply means and the blood pump, a supply port for discharging dialysate from the dialysate supply passage and a discharge port for introducing dialysate into the dialysate discharge passage; a supply passage branching from the arterial passage at an upstream side of the blood pump, and a venous passage connection part capable of connecting the venous passage to the supply passage, When priming the blood circulation passage consisting of the blood purifier and the blood circuit, With the supply passage connected to the supply port, the arterial passage connected to the discharge port, and the venous passage connected to the venous passage connection portion of the supply passage, a blood purification apparatus characterized in that the control means operates the dialysate supply means and the blood pump to supply the dialysate from the dialysate supply passage through the supply passage to the arterial passage, and further circulate the dialysate from the arterial passage through the blood purifier and the venous passage, and cause the dialysate to flow from the arterial passage to the dialysate discharge passage.

2. a replacement fluid port for discharging the dialysis fluid from the dialysis fluid supply passage, separate from the supply port; 2. The blood purification apparatus according to claim 1, further comprising a fluid replacement passage branching off from either the arterial passage or the venous passage, in addition to the supply passage.

3. A blood purification apparatus comprising: a blood circuit having an arterial passage and a venous passage connected to a blood purifier; a dialysate circuit having a dialysate supply passage and a dialysate discharge passage connected to the blood purifier; dialysate supply means for supplying dialysate to the blood purifier through the dialysate supply passage; a blood pump provided in the arterial passage for sending blood to the blood purifier; and control means for controlling operation of the dialysate supply means and the blood pump, said method comprising: the dialysate supply passage and the arterial passage upstream of the blood pump are connected by a supply passage, the venous passage is connected to the supply passage, and the arterial passage is connected to the dialysate discharge passage; a dialysate supply means for supplying dialysate from the dialysate supply passage through the supply passage to the arterial passage, a blood pump for circulating the dialysate from the arterial passage through the blood purifier and the venous passage, and a blood pump for discharging the dialysate from the arterial passage to the dialysate discharge passage.

4. The dialysate supply means supplies the dialysate from the dialysate supply passage through the supply passage to the arterial passage, and the blood pump circulates the dialysate from the arterial passage through the blood purifier and the venous passage, and then discharges the dialysate from the arterial passage to the dialysate discharge passage.

4. The method for priming a blood circulation passage according to claim 3, wherein the inflow of dialysate from the dialysate supply passage to the supply passage and the outflow of dialysate from the arterial passage to the dialysate discharge passage are prevented, and the dialysate is circulated by the blood pump through the arterial passage, the blood purifier, and the venous passage.

5. The dialysate supply means supplies the dialysate from the dialysate supply passage through the supply passage to the arterial passage, and the blood pump circulates the dialysate from the arterial passage through the blood purifier and the venous passage, and before the dialysate is discharged from the arterial passage to the dialysate discharge passage, 5. The method for priming a blood circulation passage according to claim 4, wherein the inflow of dialysate from the supply passage to the arterial passage is blocked, the dialysate is allowed to flow from the supply passage to the venous passage, and the blood pump is reversed to pump the dialysate in the opposite direction through the arterial passage, so that the dialysate is circulated from the venous passage to the blood purifier and discharged from the arterial passage to the dialysate discharge passage.

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