JP6513923B2 - Blood purification apparatus and priming method - Google Patents

Description

  The present invention relates to a blood purification apparatus and a priming method.

  For example, a blood purification apparatus for performing blood purification treatment such as hemodialysis includes a blood purifier having a blood purification membrane such as a hollow fiber membrane. The blood purification apparatus includes a blood circuit that sends the patient's blood to the blood purifier by the blood pump and returns it to the patient from the blood purifier, and a dialysate supply circuit that supplies dialysate to the secondary side of the blood purification membrane of the blood purifier. And a dialysate discharge circuit for discharging the dialysate from the secondary side of the blood purification membrane of the blood purifier. In this blood purification apparatus, blood is circulated extracorporeally in the blood circuit, and unnecessary components in the blood are discharged from the blood flowing on the primary side of the blood purification membrane in the blood purification apparatus into the dialysate flowing on the secondary side of the blood purification membrane. To purify the blood (see Patent Documents 1 and 2).

Patent No. 5431199 gazette Patent No. 5399218 gazette

  By the way, in the above-described blood purification apparatus, the dialysate of the dialysate supply circuit is supplied to the blood circuit through the blood purification membrane as a priming solution for washing the circuit before treatment or as a replacement fluid for the patient to be performed during treatment. It is considered to supply (reverse filtration). In such a case, since dialysate may enter the patient's body from the blood circuit, a filter for purifying dialysate in the dialysate supply circuit leading to the blood purifier assumes a single failure, I'm thinking of putting more than one in order.

  However, when a plurality of filters are disposed in the dialysate supply circuit, the pressure loss of the circuit becomes large, and there is a possibility that high flow rate dialysate can not be supplied to the blood purifier at the time of normal dialysis treatment.

  The present application has been made in view of such a point, and a blood purification apparatus and a priming method capable of flowing a high flow rate of dialysate while arranging a plurality of filters assuming a single failure in a dialysate supply circuit. Its purpose is to provide.

According to the present invention for achieving the above object, a blood purifier provided with a blood purification membrane, and blood of a blood collection unit is sent to the primary side of the blood purification membrane of the blood purifier. A blood circuit returning from the primary side to the blood return unit, a dialysate supply circuit for supplying dialysate to the secondary side of the blood purification membrane of the blood purifier, and a secondary of the blood purification membrane of the blood purifier A dialysate discharge circuit for discharging from the side, the dialysate supply circuit comprising a plurality of filters, and a first flow path through which the dialysate passes to the blood purifier through the plurality of filters ; And a second flow path through which the dialysate communicates with the blood purifier through a smaller number of filters than the first flow path, and the first flow path and the first flow path. A blood purification apparatus is included that is configured to be able to switch the second flow path.

  The above-mentioned blood purification apparatus performs the reverse filtration processing in which a part or all of the dialysate supplied to the secondary side of the blood purification membrane of the blood purifier is supplied to the primary side through the blood purification membrane. When the dialysate is supplied to the blood purifier through the first flow path and the reverse filtration process is not performed, the dialysate is supplied to the blood purifier through the second flow path. You may have a switching means which switches 1 flow path and a said 2nd flow path.

  The blood purification apparatus further includes a replacement fluid circuit that connects the downstream side of the plurality of filters in the first flow path and the blood circuit, and the dialysate supply circuit performs dialysis through the first flow path. The liquid may be configured to be able to be supplied to the replacement fluid circuit.

  The blood purification apparatus further includes a connection circuit connecting the replacement fluid circuit and the dialysate discharge circuit, and the connection between the replacement fluid circuit and the first flow path and the connection between the dialysate discharge circuit are It may be configured to be switchable.

  The filters of the first flow path and a part of the second flow path may be common.

  The common filter may be provided upstream of the other filters.

  When the flow rate of the dialysate supplied to the most upstream filter is less than 700 mL / min, the dialysate is allowed to flow through the first flow path, and when the flow rate is 700 mL / min or more, the dialysate is The second flow path may be circulated.

  According to another aspect of the present invention, there is provided a method of priming a blood purification apparatus, comprising: connecting a blood collecting portion and a blood returning portion of a blood circuit; and making the blood circuit annular; The dialysate is supplied to the secondary side of the blood purification membrane of the blood purifier through the filter, and the dialysate is made to flow out to the primary side through the blood purification membrane, and the dialysate of the blood circuit including the primary side is discharged to the dialysate discharge circuit. The priming method, comprising a step, wherein the number of filters through which the dialysate passes in the dialysate supply circuit of the step is greater than the number of filters through which the dialysate passes in the dialysate supply circuit during blood purification treatment Is included.

  According to the present invention, high flow rate dialysate can be allowed to flow while arranging a plurality of filters assuming a single failure in the dialysate supply circuit.

It is an explanatory view showing an outline of composition of a blood purification device. It is explanatory drawing which shows the state of the blood purification apparatus at the time of a priming. It is explanatory drawing which shows the state of the blood purification apparatus at the time of blood purification processing. It is explanatory drawing which shows the state of the blood purification apparatus at the time of other blood purification processes. It is an explanatory view showing other composition of the 2nd dialysate supply circuit.

  Hereinafter, an example of a preferred embodiment of the present invention will be described with reference to the drawings. In addition, positional relationships such as upper, lower, left, and the like in the drawings are based on the positional relationships shown in the drawings unless otherwise specified. The dimensional ratio of the drawings is not limited to the illustrated ratio. Furthermore, the following embodiments are exemplifications for explaining the present invention, and the present invention is not limited to the embodiments. Moreover, the present invention can be variously modified without departing from the scope of the invention.

  FIG. 1 is an explanatory view showing an outline of a configuration of a blood purification apparatus 1 according to the present embodiment. The blood purification apparatus 1 includes, for example, a blood circuit 10, a dialysate circuit 11, a replacement fluid / priming circuit 12, and a control device 13.

  The blood circuit 10 includes, for example, a blood collection circuit 22 connecting the blood collection unit 21 and the blood purifier 20, and a blood return circuit 24 connecting the blood purifier 20 and the blood return unit 23.

  The blood purifier 20 has a blood purification membrane 30 made of a hollow fiber membrane or the like in a cylindrical module. The blood purifier 20 has an inlet 20a and an outlet 20b communicating with the primary side (blood side) of the blood purification membrane 30, and an inlet 20c and an outlet 20d communicating with the secondary side (dialysate side) of the blood purification membrane 30. have.

  The blood collection circuit 22 is composed of a soft tube and is connected to the inlet 20 a of the blood purifier 20. The blood collection circuit 22 is provided with a blood pump 40 and a drip chamber 41. As the blood pump 40, for example, a pump capable of rotating in the forward and reverse directions is used. For the blood pump 40, for example, a tubing pump having a flow rate range of about 0 to 600 mL / min and about 10 mL per revolution is used.

  The blood return circuit 24 is composed of, for example, a soft tube, and is connected to the outlet 20 b of the blood purifier 20. The blood return circuit 24 is provided with, for example, a drip chamber or a pressure sensor (not shown).

  The blood collecting unit 21 and the blood returning unit 23 can be connected to each other, for example, and can make the blood circuit 10 a closed circuit.

  The dialysate circuit 11 includes, for example, a metering pump 70. The metering pump 70 has a diaphragm 80 which is displaceable within a fixed volume body. The inside of the metering pump 70 is divided by a partition 80 into a dialysate supply chamber 81 and a dialysate discharge chamber 82.

  The dialysate circuit 11 includes, for example, a first dialysate supply circuit 90 leading from a dialysate supply source (not shown) to the dialysate supply chamber 81 of the metering pump 70 and a dialysate supply chamber 81 of the metering pump 70 from the blood purifier 20. It has a second dialysate supply circuit 91 communicating with the inlet 20c on the secondary side. Further, the dialysate circuit 11 includes a first dialysate discharge circuit 92 communicating from the outlet 20 d on the secondary side of the blood purifier 20 to the dialysate discharge chamber 82 of the metering pump 70, and a dialysate drain chamber 82 of the metering pump 70. And a second dialysate discharge circuit 93 leading to the outside of the apparatus. The first dialysate supply circuit 90, the second dialysate supply circuit 91, the first dialysate discharge circuit 92, and the second dialysate discharge circuit 93 are constituted by, for example, soft tubes.

  In the first dialysate supply circuit 90, for example, the dialysate supply pump 100 and the on-off valve 101 are provided in order from the upstream side. For the dialysate supply pump 100, for example, a gear pump having a flow rate range of about 0 to 1500 mL / min and fluctuating with discharge pressure is used.

  The second dialysate supply circuit 91 has a first flow path 112 having a plurality of, for example, two filters 110 and 111, and a second flow path having a smaller number of, for example, one filter 110 than the first flow path 112. A channel 113 is provided. The uppermost stream filters 110 of the first flow path 112 and the second flow path 113 are in common. That is, the first channel 112 passes from the metering pump 70 through the first filter 110 and further through the second filter 111 to the blood purifier 20, and the second channel 113 is the metering pump From 70 to the first filter 110 directly into the blood purifier 20.

  The filters 110 and 111 are, for example, hollow fiber modules, and can remove unnecessary substances such as endotoxin contained in the dialysate to purify the dialysate.

  An on-off valve 114 is provided between the first filter 110 and the metering pump 70. An on-off valve 115 is provided between the first filter 110 and the blood purifier 20 in the first flow path 112, and between the second filter 111 and the blood purifier 20 in the second flow path 113. , An on-off valve 116 is provided. The on-off valves 115 and 116 constitute a switching device, and the first flow path 112 and the second flow path 113 can be switched. The downstream side of the on-off valve 115 of the first flow path 112 and the downstream side of the on-off valve 116 of the second flow path 113 are connected to the blood purifier 20 through a common flow path.

  The first dialysate discharge circuit 92 is provided with, for example, an on-off valve 120, a drainage pump 122, and an on-off valve 123 sequentially from the upstream side.

  The second dialysate discharge circuit 93 is provided with, for example, an on-off valve 130.

  The dialysate circuit 11 has a water removal circuit 140 which directly connects the first dialysate discharge circuit 92 and the second dialysate discharge circuit 93 without using the metering pump 70. The water removal circuit 140 has, for example, a first circuit 142 including a water removal pump 141 and a second circuit 144 including an open / close valve 143. The first circuit 142 and the second circuit 144 are connected in parallel. For the water removal pump 141, for example, a piston pump having a flow rate range of about 0 to 90 mL / min, and about 0.5 to 1.0 mL per stroke is used.

  The fluid replacement / priming circuit 12 includes a fluid replacement circuit 150 that communicates with the drip chamber 41 of the blood collection circuit 22 from between the second filter 111 and the on-off valve 115 in the first fluid channel 112, a fluid replacement circuit 150, and the first dialysate. A connection circuit 151 is provided to connect the discharge circuit 92. The fluid replacement circuit 150 and the connection circuit 151 are formed of, for example, a soft tube.

  The replacement fluid circuit 150 is provided with a replacement fluid pump 160 capable of rotating in the forward and reverse directions. As the replacement fluid pump 160, for example, a tubing pump having a flow rate range of about 0 to 600 mL / min and about 10 mL per rotation is used. Further, the liquid replacement circuit 150 is provided with an on-off valve 161.

  The connection circuit 151 is in communication with the first dialysate discharge circuit 92 from between the fluid replacement pump 160 and the on-off valve 161 of the fluid replacement circuit 150. The connection circuit 151 is provided with an on-off valve 170. In the present embodiment, the on-off valve 161 and the on-off valve 170 can switch between the connection with the first flow path 112 of the fluid replacement circuit 150 and the connection with the first dialysate discharge circuit 92, and constitute a switching device. doing.

  The control device 13 is, for example, a computer that controls the overall operation of the hemodialysis device 1 and, for example, the pumps 40, 100, 122, 141, 160, the valves 101, 114, 115, 116, 120, 123, 130, 143, The blood purification apparatus 1 can be operated so as to execute the priming and blood purification processing described later by controlling the operations of 161, 170, and the like. For example, the controller 13 executes a program to perform reverse filtration to supply a part or all of the dialysate supplied to the secondary side of the blood purification membrane 30 of the blood purifier 20 to the primary side through the blood purification membrane 30. In the case where a reverse filtration process is not performed, the dialysate is supplied to the blood purifier 20 through the first channel 112 by controlling the on-off valves 115 and 116. The first flow path 112 and the second flow path 113 are switched to control to supply the dialysate to the blood purifier 20 through the second flow path 113. In the present embodiment, for example, the on-off valves 115 and 116 and the control device 13 constitute switching means.

  Next, priming, which is reverse filtration, performed in the blood purification apparatus 1 configured as described above will be described.

  In priming, as shown in FIG. 2, the blood collecting unit 21 and the blood returning unit 23 are connected in the blood circuit 10, the on / off valves 114, 115, 120, 123, 170 are opened in the dialysate circuit 11, and the on / off valves 101 and 116 , 130, 143, 161 are closed. The fluid delivery pump 122 is actuated, the fluid replacement pump 160 is actuated in the reverse rotational direction (direction of the first dialysate discharge circuit 92), and the blood pump 40 is actuated in the positive rotational direction (direction of the blood purifier 20). Thus, the dialysate in the dialysate supply chamber 81 of the metering pump 70 is supplied to the secondary side of the blood purification membrane 30 of the blood purifier 20 through the first flow path 112 of the second dialysate supply circuit 91. Be done. That is, the dialysate is supplied to the secondary side of the blood purification membrane 30 through the two filters of the first filter 110 and the second filter 111. A part of the dialysate supplied to the secondary side of the blood purification membrane 30 flows directly into the first dialysate discharge circuit 92 by the liquid feed pump 122 and is discharged into the dialysate discharge chamber 82 of the metering pump 70. Further, the remaining dialysate on the secondary side of the blood purification membrane 30 flows into the primary side of the blood purification membrane 30 (reverse filtration processing) by the negative pressure on the blood circuit 10 side generated by the replacement fluid pump 160. It is diverted and flows in the blood circuit 10. The dialysate of the blood circuit 10 flows into the fluid replacement circuit 150 by the fluid replacement pump 160, flows into the first dialysate fluid discharge circuit 92 through the connection circuit 151, and is discharged into the dialysate fluid discharge chamber 82 of the metering pump 70. Thus, the blood circuit 10, the dialysate circuit 11, and the replacement fluid priming circuit 12 are replaced and cleaned with fresh dialysate, and air bubbles in these circuits are removed.

  Next, the blood purification process which is performed by the blood purification apparatus 1 and which does not perform the reverse filtration process will be described.

  First, as shown in FIG. 3, a puncture needle (not shown) is connected to the blood collection unit 21 and the blood return unit 23, and the patient is punctured. Next, the on-off valves 114, 116, 120, 123, 161 of the dialysate circuit 11 are opened, and the on-off valves 101, 115, 130, 143, 151 are closed. The fluid delivery pump 122 is actuated, the fluid replacement pump 160 is actuated in the forward rotation direction (direction of the blood circuit 10), and the blood pump 40 is actuated in the forward rotation direction (direction of the blood purifier 20). Thereby, in the blood circuit 10, the patient's blood is sent to the primary side of the blood purification membrane 30 of the blood purifier 20 through the blood collection circuit 22, and the blood having passed through the primary side of the blood purification membrane 30 is Will be returned to

  In the dialysate circuit 11, the dialysate of the dialysate supply chamber 81 of the metering pump 70 is supplied to the secondary side of the blood purification membrane 30 of the blood purifier 20 through the second flow path 113 of the second dialysate supply circuit 91. Be done. That is, the dialysate of the second dialysate supply circuit 91 is supplied to the secondary side of the blood purification membrane 30 only through the first filter 110. The dialysate which has passed through the secondary side of the blood purification membrane 30 is discharged to the dialysate discharge chamber 82 of the metering pump 70 through the first dialysate discharge circuit 92. In the metering pump 70, when the diaphragm 80 moves and the dialysate in the dialysate supply chamber 81 runs out, the on-off valves 101 and 130 are opened, the on-off valves 114 and 123 are closed, and the dialysate supply pump 100 Fresh dialysate is replenished into the dialysate supply chamber 81 through the first dialysate supply circuit 90. At this time, the dialysate in the dialysate discharge chamber 82 is discharged through the second dialysate discharge circuit 93.

  Thus, in the blood purifier 20, blood flows to the primary side of the blood purification membrane 30, and dialysate flows to the secondary side, whereby waste products in the blood are discharged to the dialysate side through the blood purification membrane 30. , Blood is purified.

  Further, a part of the dialysate of the metering pump 70 flows into the first flow path 112 side, passes through the first filter 110 and the second filter 111, and passes through the replacement fluid circuit 150 by the replacement fluid pump 160 and the blood circuit 10. Supplied to Thus, the patient is refilled.

  Furthermore, in the water removal circuit 140, the water removal pump 141 is operated, the on-off valve 143 is closed, and a part of the dialysate in the first dialysate discharge circuit 92 passes through the water removal circuit 140 without using the metering pump 70. The fluid is discharged to the second dialysate discharge circuit 93. The amount of dialysate passing through the water removal circuit 140 at this time is adjusted according to the amount of water removal from the patient being removed from the blood.

  According to the present embodiment, the second dialysate supply circuit 91 includes the first flow path 112 having the two filters 110 and 111 and the number of one filters 110 smaller than the first flow path 112. Since the first flow path 112 and the second flow path 113 can be switched, the blood circuit 10 in which the dialysate may enter the patient's body. When the dialysate is supplied to the side through the blood purification membrane 30 of the blood purifier 20, the dialysate is flowed using the first flow path 112 having a plurality of filters serving as a backup, and the dialysate is treated as a blood purification membrane When the blood is not supplied to the blood circuit 10 via the H.30, the dialysate can be made to flow using the second flow path 113 having a small number of filters and a small pressure loss. Therefore, a high flow rate of dialysate can be allowed to flow while arranging the plurality of filters 110, 111 assuming a single failure in the second dialysate supply circuit 91.

  In the present embodiment, the blood purification apparatus 1 performs reverse filtration to supply a part or all of the dialysate supplied to the secondary side of the blood purification membrane 30 of the blood purifier 20 to the primary side through the blood purification membrane 30. At the time of priming, the dialysate is supplied to the blood purifier 20 through the first flow path 112, and during the dialysis process without reverse filtration, the dialysate is supplied to the blood purifier 20 through the second flow path 113. Thus, it has switching means for switching between the first channel 112 and the second channel 113. For this reason, the switching of the first flow path 112 and the second flow path 113 is appropriately performed between the reverse filtration process that requires filter backup and the case where the reverse filtration process that does not require filter backup is not performed. Can.

  The blood purification apparatus 1 has a replacement fluid circuit 150 that connects the blood circuit 10 with the downstream side of the plurality of filters 110 and 111 in the first flow path 112, and the second dialysate supply circuit 91 Since it is configured to be able to be supplied to the fluid replacement circuit 150 through the first flow path 112, passing the dialysate supplied as fluid replacement to the blood circuit 10 without passing through the blood purification membrane 30 through the plurality of filters 110 and 111 it can. Therefore, also for replacement fluid supplied to the blood circuit 10 without passing through the blood purification membrane 30, a circuit assuming a single failure can be used.

  The blood purification apparatus 1 has a connection circuit 151 that connects the replacement fluid circuit 150 and the first dialysate discharge circuit 92, and the connection between the replacement fluid circuit 150 and the first flow path 112 and the first dialysate discharge circuit Since the connection with the connection 92 is configured to be switchable, the dialysate of the blood circuit 10 can be discharged to the first dialysate discharge circuit 92 via the replacement fluid circuit 150. Therefore, priming using reverse filtration can be appropriately performed.

  Further, since the first filter 110 of the first flow path 112 and the second flow path 113 are common, even if the two flow paths 112 and 113 are provided in the second dialysate supply circuit 91, the filter The increase in the number of

  Further, since the common filter 110 is provided on the upstream side of the other filters 111, for example, the dialysate flows simultaneously in the first flow path 112 and the second flow path 113, and the dialysate flowing in each of them is Depending on the application, it can be diverted to another circuit. That is, as in the present embodiment, at the time of dialysis treatment, the dialysate that has passed one filter is supplied to the blood purifier 20 while the dialysate that has passed two filters is supplied to the blood circuit 10 as a replacement fluid. Can.

  In the priming in the present embodiment, the number (two) of filters through which the dialysate passes in the second dialysate supply circuit 91 causes the dialysate to pass in the second dialysate supply circuit 91 during blood purification processing. Since the number of filters is larger than one (one), the number of filters in the blood purification process is ensured while ensuring a single failure of the filter for the dialysate supplied to the blood circuit 10 in the priming which is the reverse filtration process. A small amount of high flow rate dialysate can be secured.

  In the blood purification apparatus 1 described in the above embodiment, when the flow rate of the dialysate supplied to the most upstream filter is less than 700 mL / min, the dialysate is caused to flow through the first flow path 112, and the flow rate If the flow rate is 700 mL / min or more, the dialysate may be caused to flow through the second flow path 113.

  For example, in the blood purification process, when the flow rate of the dialysate supplied to the first filter 110 is 700 mL / min or more, the on-off valves 114, 116, 120 of the dialysate circuit 11 are as shown in FIG. 123 and 161 are opened, and the on-off valves 115 and 170 are closed, the liquid feed pump 122 and the replacement fluid pump 160 operate. Thus, the dialysate in the dialysate supply chamber 81 of the metering pump 70 is supplied to the blood purifier 20 through the second flow path 113 of the second dialysate supply circuit 91. In addition, a part of the dialysate is refilled into the blood circuit 10 through the refill circuit 150. In this example, since the dialysate supplied to the blood purifier 20 flows through the second flow path 113, a desired high flow rate of dialysate can be secured without causing a decrease in the flow rate.

  On the other hand, as shown in FIG. 4, when the flow rate of the dialysate supplied to the first filter 110 is less than 700 mL / min, the open / close valves 114, 115, 120, 123, 161 of the dialysate circuit 11 are opened. With the open / close valves 116 and 170 closed, the liquid delivery pump 122 and the replacement fluid pump 160 operate. As a result, the dialysate in the dialysate supply chamber 81 of the metering pump 70 is supplied to the blood purifier 20 through the first flow path 112 of the second dialysate supply circuit 91. In addition, a part of the dialysate is refilled into the blood circuit 10 through the refill circuit 150. In such an example, since the dialysate which does not require a high flow rate flows through the first flow path 112, the dialysate can flow through the backup flow path of the filter.

  In the above embodiment, the number of filters in the first channel 112 is two and the number of filters in the second channel 113 is one. However, the number of filters in the first channel 112 is one. If the number is greater than the number of filters in two channels, the number can be selected arbitrarily. In addition, although the first filter was shared by the first flow path and the second flow path, as shown in FIG. 5, the second dialysate supply circuit 91 does not share the filter in parallel. A single flow passage 112 and a second flow passage 113 may be provided.

  In the above embodiment, the reverse filtration is performed in the priming, but the reverse filtration is performed in another process, and in such a case, the dialysate may be supplied to the blood purifier 20 through the first channel 112 in such a case. Good. The other process of performing the reverse filtration process may be, for example, a process of replenishing the blood circuit 10 from the second dialysate supply circuit 91 through the blood purification membrane 30. In the present invention, even when reverse filtration is not performed, the dialysate may be supplied to the blood purifier 20 using the first channel 112.

  The circuit configuration and the device configuration of the blood purification apparatus 1 described in the above embodiment are not limited to this, and may have other configurations. The blood purification device 1 may be applied not only to a device that performs hemodialysis but also to a device that performs continuous slowing blood filtration and the like.

  Although the preferred embodiments of the present invention have been described above with reference to the accompanying drawings, the present invention is not limited to such examples. It is obvious that those skilled in the art can conceive of various modifications or alterations within the scope of the idea described in the claims, and they are naturally within the technical scope of the present invention. It is understood that.

  The present invention is useful in flowing a high flow rate of dialysate while arranging a plurality of filters assuming a single failure in the dialysate supply circuit.

DESCRIPTION OF SYMBOLS 1 blood purification apparatus 10 blood circuit 11 dialysate circuit 12 replacement fluid / priming circuit 13 control device 20 blood purifier 30 blood purification membrane 40 blood pump 70 metering pump 91 second dialysate supply circuit 92 first dialysate discharge circuit 110 First filter 111 Second filter 112 First flow path 113 Second flow path 115, 116 Opening / closing valve 150 Liquid replacement circuit 151 Connection circuit 160 Liquid replacement pump

Claims (8)

A blood purifier provided with a blood purification membrane,
A blood circuit that sends the blood of the blood collection unit to the primary side of the blood purification membrane of the blood purifier, and returns it from the primary side of the blood purification membrane of the blood purifier to the blood return unit;
A dialysate supply circuit for supplying dialysate to the secondary side of the blood purification membrane of the blood purifier;
And a dialysate discharge circuit for discharging dialysate from the secondary side of the blood purification membrane of the blood purifier,
The dialysate supply circuit comprises a plurality of filters, a first flow path through which the dialysate passes to the blood purifier through the plurality of filters, and a smaller number of filters than the first flow path. And a second flow path through which the dialysate communicates with the blood purifier through the filter, and the first flow path and the second flow path can be switched. Blood purification device.   When a reverse filtration process is performed to supply a part or all of the dialysate supplied to the secondary side of the blood purification membrane of the blood purifier to the primary side through the blood purification membrane, the first flow path is used. When the dialysate is supplied to the blood purifier and the reverse filtration process is not performed, the first flow path and the first flow path may be supplied to supply the dialysate to the blood purifier through the second flow path. The blood purification apparatus according to claim 1, further comprising switching means for switching the second flow path. The blood flow circuit further includes a fluid replacement circuit that connects the blood circuit to the downstream side of the plurality of filters in the first flow path,
The blood purification apparatus according to claim 1, wherein the dialysate supply circuit is configured to be able to supply dialysate to the replacement fluid circuit through the first flow path. It further has a connection circuit that connects the fluid replacement circuit and the dialysate discharge circuit,
The blood purification apparatus according to claim 3, wherein the connection between the replacement fluid circuit and the first flow path and the connection between the dialysate discharge circuit are switchable.   The blood purification apparatus according to any one of claims 1 to 4, wherein the filters of the first flow path and a part of the second flow path are common.   The blood purification apparatus according to claim 5, wherein the common filter is provided upstream of the other filters.   When the flow rate of the dialysate supplied to the most upstream filter is less than 700 mL / min, the dialysate is allowed to flow through the first flow path, and when the flow rate is 700 mL / min or more, the dialysate is The blood purification apparatus according to any one of claims 1 to 6, wherein the second flow path is caused to flow. A method of priming a blood purification apparatus,
In a state in which the blood collecting portion and the blood returning portion of the blood circuit are connected and the blood circuit is made annular, the dialysate is supplied through the filter in the dialysate supply circuit to the secondary side of the blood purification membrane of the blood purifier, and the dialysate is The method further comprises the steps of flowing out through the blood purification membrane to the primary side and discharging the dialysate of the blood circuit including the primary side to the dialysate discharge circuit.
The priming method, wherein the number of filters through which the dialysate passes in the dialysate supply circuit in the step is larger than the number of filters through which the dialysate passes in the dialysate supply circuit at the time of blood purification treatment.

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