JPH07313589A - Dialyzing liquid control device for blood dialyzing device - Google Patents

Abstract

PURPOSE:To reduce dialytic cost, maintain the concentration of an adsorbing component almost constant, and supply a supplementary liquid to supply water content by arranging a circulating pump, an adsorbing-separating device for an unnecessary component, a water removing device from dialyzate and a supplementary liquid supply device to supply water content in a dialyzing liquid circuit. CONSTITUTION:A blood dialyzing device is constituted so that an unnecessary component adsorbed to plasma protein in blood is adsorbed to and separated from an adsorbing component in dialyzing liquid by making the liquid flow in contact with a blood flow through a semipermeable membrane of a dialyzer 1. In the blood dialyzing device, a dialyzing liquid circuit 3 is provided to pass the dialyzing liquid through the dialyzer 1 while circulating, and a dialyzing liquid control device circulates the dialyzing liquid with a circulating pump 36, and adsorbs and separates an unnecessary component adsorbed to an adsorbing component in the liquid by a dialyzate purifying adsorbent internally installed in an adsorbing-separating device 39. Water content of the dialyzing liquid is sucked and removed as drainage by a removing device 4, and a supplementary liquid to supply water content is supplied to a vein side chamber 20 by a supplementary liquid supply device 5, thus water content is supplied to the blood.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dialysate management device for a hemodialysis machine, and more specifically, it transfers unnecessary components in blood to circulating dialysate and removes the transferred unnecessary components. The present invention relates to a device capable of favorably circulating and utilizing a dialysate.

[0002]

2. Description of the Related Art Among toxic substances dissolved in blood, many organic compounds exist in a state of being adsorbed by plasma proteins. For example,
Albumin, which is a plasma protein, adsorbs metabolites such as bilirubin. These adsorbed states are considered to be a phenomenon in which molecules that do not easily form a bond with water molecules in an aqueous solution, or atomic groups in the molecules aggregate with an affinity. This phenomenon is called, for example, hydrophobic binding.

In such a bound state, unnecessary components such as metabolites adsorbed on plasma proteins are difficult to separate and remove with a general hemodialysis apparatus. Therefore, a hemodialysis apparatus for solving this problem is proposed in Japanese Patent Application Laid-Open No. 49-42189. In this hemodialysis device, for example, albumin is contained in the dialysate, and a metabolite adsorbed to albumin in blood is adsorbed and separated to albumin in the dialysate through the semipermeable membrane of the dialyzer. ing.

By the way, the hemodialysis apparatus includes a so-called single-pass system and a batch system. The one-pass method is to prepare a dialysate while continuously diluting a concentrated stock solution for dialysate with water, and discard the dialysate that has passed through the dialyzer. Therefore, in the one-pass method,
It is necessary to prepare a large amount of dialysate of nearly 300 liters. On the other hand, in the batch system, the dialysate prepared in advance is circulated and passed through the dialyzer, and in the batch system, it is sufficient to prepare about 70 liters of dialysate. However, in the batch method, the required amount of dialysate is smaller and the dialysis cost is lower than the one-pass method, but the one-pass method is more popular because of its excellent treatment efficiency.

However, in the conventional hemodialysis apparatus disclosed in JP-A-49-42189, no reference is made to the dialysate that has passed through the dialyzer, and it is considered that the dialysate is discarded as it is. That is, the above-mentioned conventional hemodialysis apparatus is considered to be a single-pass type, but this is not preferable because the dialysis cost is high. Therefore, there has been a demand for a new device in which the conventional hemodialysis device described above is improved to a batch system.

It is an object of the present invention to provide a dialysate management device for a hemodialysis machine which can solve the above problems.

[0007]

In order to achieve the above object, a feature of the present invention is that a blood flow is brought into contact with a dialysate flow through a semipermeable membrane of a dialyzer, and A method for adsorbing and separating unnecessary components adsorbed to plasma proteins into adsorbed components in a dialysate is provided with a dialysate circuit that passes through a dialyzer while the dialysate circulates.
A circulation pump that circulates the dialysate, and (2) an unnecessary component adsorbed by the adsorbed component in the dialysate is absorbed by the adsorbent.
It has an adsorption / separation device for adsorption and separation, (3) a water removal device for removing water from the dialysate, and (4) a replacement liquid supply device for supplying the replacement liquid for supplying water to blood after passing through the dialyzer.

In some cases, the circulation pump has a pair of pump parts that perform a pumping action of substantially the same flow rate, and each pump part is arranged on the upstream side and the downstream side of the dialyzer.

Further, the water removing apparatus comprises (1) a separator having a semipermeable membrane, and a dialysate flowing through one side of the semipermeable membrane;
(2) On the other surface side of the semipermeable membrane in the separator, there may be provided a suction removing means for sucking and removing water from the dialysate.

Further, the replacement fluid supply device comprises (1) a replacement fluid tank for storing the replacement fluid for water supply, and (2) a supply means for supplying the replacement fluid for water supply in the replacement fluid tank to the blood after passing through the dialyzer. May have.

Further, an adjusting pump is provided, and the adjusting pump has a pair of pump portions that perform a pumping action of substantially the same flow rate, one pump portion serving as suction removing means, and the other pump portion supplying. It is sometimes used as a means.

Further, the dialysate circuit has a dialysate tank for storing the dialysate, and (1) detection means for detecting that the dialysate volume in the dialysate tank exceeds a set amount, and (2) )
A control unit that drives the adjustment pump according to the detection of the detection unit may be provided.

[0013]

[Function] During hemodialysis, the blood from the patient is passed through the dialyzer and returned to the patient. On the other hand, in the dialysate circuit,
The dialysate is circulated by each pump section of the circulation pump. That is, the dialysate in the dialysate tank is passed through the dialyzer and the adsorption / separation device and then refluxed in the dialysate tank.

As described above, when the dialysate is circulated in the dialysate circuit, the dialysate flow contacts the patient's blood flow through the semipermeable membrane. At this time, since the dialysate contains adsorbed components, unnecessary components adsorbed on plasma proteins in blood are
After passing through the semipermeable membrane, it rapidly binds to adsorbed components in the dialysate and is adsorbed and separated. Further, the unnecessary components adsorbed by the adsorbed components of the dialysate are adsorbed and separated by the adsorbent of the adsorption separation device.

During hemodialysis, transmembrane pressure (hereinafter referred to as TMP) causes water to move from the blood to the dialysate, and the amount of dialysate in the dialysate circuit gradually increases. When the dialysate volume gradually increases and the dialysate volume in the dialysate tank exceeds the set volume,
Detected by the detection unit, the control unit drives each pump unit of the adjustment pump.

As a result, in the separator of the water removing apparatus, water is removed from the dialysate, that is, water is sucked and removed from the dialysate as drainage through the semipermeable membrane, and the water is discharged to the drainage tank for dialysis. The dialysate volume in the fluid circuit is returned to the original volume at the start of dialysis. Further, in the replacement fluid supply device, the replacement fluid for water supply in the replacement fluid tank is supplied to the blood after dialysis. At this time, since each pump portion of the adjusting pump performs a pumping action with substantially the same flow rate, the amount of water removed from the dialysate and the amount of replacement fluid supplied to the blood become substantially the same.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. 1 and 2 show a continuous hemodialysis apparatus, which has a blood circuit 2 and a dialysate circuit 3 each passing through the inside of a dialyzer 1, a dewatering apparatus 4, a replacement fluid supply apparatus 5, and the like. .

It should be noted that the continuous hemodialysis device is used as a continuous albumin purification system.
System: CAPS), a device for removing toxic substances in blood, and a blood purification device. What is continuous dialysis?
It refers to dialysis that is performed slowly over a period of about 24 hours at a blood flow rate of about 30 ml / min, and is applied to critically ill patients and the like.

As shown in FIG. 3, the dialyzer 1 is a large area type hollow fiber type, and comprises a cylindrical case 6 having both ends open and a large number of hollow fibers 7A exemplified as a semipermeable membrane. It is composed of a hollow fiber bundle 7 and a pair of upper and lower headers 8 and 9 which are externally fitted and fixed to each end of the case 6.

The case 6 has a pair of upper and lower dialysate ports 10 and 11 for passing dialysate to the outside of the hollow fiber 7A.
Is provided.

The material of the hollow fiber 7A is preferably polyamide, polyacrylonitrile, cellulose triacetate, polysulfone or the like, but polymethylmethacrylate, which is somewhat inefficient, can also be used. The hollow fiber 7A used for ordinary hemodialysis has an average pore diameter of 20 to 30Å, but in the present invention, the hollow fiber 7A has an average pore diameter of 20 to 100Å,
In particular, a hyper-performance type of 50 to 100Å is preferable. The thickness of the hollow fiber 7A is 15 to 60 μm, preferably 15 to 50 μm. Each end of the hollow fiber bundle 7 is fixed to the inner surface of each end of the case 6 with an adhesive 12.

Each of the headers 8 and 9 is provided with blood ports 13 and 14 for introducing blood into the hollow fiber 7A. 15 is an O-ring.

The blood circuit 2 uses the blood from the patient for the dialyzer 1.
For passing back to the patient and connecting the artery of the patient with the upper blood port 13 of the dialyzer 1
6 and a venous line 17 connecting the lower blood port 14 of the dialyzer 1 and the vein of the patient. In the arterial line 16, a blood pump 18 such as a series of roller pumps for pumping arterial blood of a patient, and an arterial chamber 19 for temporarily storing the pumped arterial blood are arranged in the blood flow direction (arrow direction). And the arterial chamber 19 is
The stored arterial blood is supplied to the dialyzer 1. Vein line 1
7 has a vein side chamber 20 that temporarily stores the blood dialyzed (purified) in the dialyzer 1.
Causes the pooled blood to return to the patient's vein. In addition, each device of the arterial line 16 and the venous line 17,
They are connected by elastic tubes 16A and 17A.

An additional circuit 22 is often connected downstream of the vein side chamber 20 in the vein line 17 through a pair of bypass flow paths 23 and 24 indicated by imaginary lines, but not connected. Sometimes. The attached circuit 22 includes continuous hemodialysis (CH).
D) Circuit, continuous hemofiltration (Continuous Hemofiltratio)
n: CHF) circuit or continuous simultaneous hemofiltration (Continuou
s Hemodiafiltraion (CHDF) circuit is used.
When the attached circuit 22 is connected, the vein line 17
The flow path 25 between the two bypass flow paths 23 and 24 is blocked.

The dialysate circuit 3, the dewatering device 4 and the replacement liquid supply device 5 constitute a single unit system, which is a closed system.

The dialysate circuit 3 allows the dialyser 1 to pass through while circulating the dialysate.
And the dialysate tank 27 and the lower dialysate port 1 of the dialyzer 1.
1 has a dialysate supply line 28, and a dialysate reflux line 29 that connects the upper dialysate port 10 of the dialyzer 1 and the dialysate tank 27.

The dialysate is also called a perfusate,
It contains a suitable adsorbent component. The adsorbed component adsorbs and separates unnecessary components adsorbed to plasma proteins in blood (sometimes referred to as organic compounds, toxic substances, and toxic substances). For example, plasma proteins such as albumin and various globulins, or Although a polymer, a polymer compound or the like having the same function as this is used, albumin is used in the examples. When plasma protein is used as the adsorbing component, the concentration of plasma protein in the dialysate may be higher than that in blood. When albumin is used as the plasma protein, the albumin concentration (content) in the dialysate is 25
~ 50 g / l is preferred. Albumin concentration is 25
When the amount is less than g / liter, the amount of unnecessary components adsorbed and separated decreases, and when the amount is 50 g / liter or more, expensive albumin is used in a large amount, so that the dialysis cost becomes too high, which causes an economic problem.

The organic compounds which are unnecessary components adsorbed on plasma proteins in blood include the following. That is, as organic compounds that are adsorbed to albumin in blood, there are metabolites such as bilirubin and bazoflavin, physiologically active substances such as chloromycetin and barbicylic acid, and dyes such as indocyanine green and bromsulfophthalene. From the viewpoint of the presence in blood, bilirubin includes free, conjugated and unconjugated bilirubin that weakly binds to albumin and δ (delta) bilirubin that strongly binds to albumin. In addition, as organic compounds that are adsorbed on various globulin in blood, vitamins A, D, E,
There are K etc. Other organic compounds adsorbed to plasma proteins include toxic substances that induce hepatic coma at the end of liver failure.
There are toxic substances that appear at the end of renal failure.

The dialysate tank 27 (also referred to as a stock tank or a storage tank) stores the dialysate, and is transparent or translucent so that the stored amount can be visually checked. In the dialysate in the dialysate tank 27,
Although the end of the dialysate supply line 28 is inserted, the end of the dialysate reflux line 29 may or may not be inserted into the dialysate.

In the dialysate supply line 28, a separator (which will be described later) 33 and an upstream side heating device 34.
And the circulation pump 36 are arranged in the above order in the dialysate circulation direction (arrow direction). In the dialysate reflux line 29, the circulation pump 36, the downstream heating device 38, and the adsorption / separation device 39 are arranged in the dialysate circulation direction in the above order. The respective devices of the dialysate supply line 28 and the dialysate reflux line 29 are connected by elastic tubes 28A and 29A, respectively.

The upstream heating device 34 heats the dialysate supplied to the dialyzer 1 to about 37 ° C. which is a physiological temperature (body temperature), and the downstream heating device 38 adsorbs and separates the dialysate. Device 3
The temperature (eg, about 3
The temperature is 7 to 38 ° C., but may be higher or lower than this. ) To warm. Each heating device 34, 38
As shown in FIG. 4, a main body 41, a lid 42 that is openably and closably attached to the main body 41, a heating bag 4 that is detachably attached to the main body 41 and is sandwiched between the main body 41 and the lid 42.
3 and 3. A panel heater is installed in each of the main body 41 and the lid 42, and the lid 42 is fixed in a closed state by fixing members 44A and 44B. The heating bag 43 is provided with a flow passage 45 through which the dialysate is meandered from side to side and flows vertically. The upstream side / downstream side heating devices 34, 38 may be integrated.

The circulation pump 36 has a pump function of circulating the dialysate at a desired flow rate on the upstream side and the downstream side of the dialyzer 1. In the embodiment, the circulation pump 36 is a two-roll roller pump, and has a pair of upper and lower guide surfaces 46 and 47 each having a curved concave shape, and a rotating body 48 that is rotationally driven.
And three rollers 49 arranged on the rotating body 48 at equal intervals in the circumferential direction, and by these, a pair of upper and lower pump portions 50 and 51 that perform a pumping action of substantially the same flow rate are configured. Then, elastic tubes 28A and 29A forming respective parts of the dialysate supply line 28 and the dialysate reflux line 29.
Is guided along each of the guide surfaces 46 and 47 and is squeezed by the roller 49, so that a pumping action is performed.

The adsorption / separation device 39 (also referred to as an adsorption column) is internally provided with an adsorbent for purifying the dialysate, and by this adsorbent, an unnecessary component adsorbed to albumin (adsorbable component) in the dialysate. Are separated by adsorption. As the adsorbent, for example, as shown in Japanese Examined Patent Publication No. 56-7437, a single monomer composed of 2% by weight or more and less than 100% by weight of a crosslinkable monomer and less than 98% by weight of a monovinyl monomer. The monomer mixture is copolymerized, and a porous copolymer having an average pore size of 300 to 9000Å (preferably 600 to 8000Å) is used. Examples of the cross-linkable polymerizable monomer include divinylbenzene and divinyltoluene, and examples of the monovinyl monomer include styrene and alkyl-substituted styrene.

In the dialysate reflux line 29, another adsorption device is provided in series or in parallel with the adsorption / separation device 39 for the purpose other than the adsorption / separation device 39.
Another adsorbent may be mixed with the adsorbent in the adsorption separation device 39. An adsorbent that is installed in another adsorption device,
As the other adsorbent to be mixed, various activated carbons commonly used as an adsorbent (for example, fibrous activated carbon) are used, but in addition, a mixture of activated carbon and alumina may be used. It should be noted that these adsorbents well adsorb metabolites having a molecular weight of 2000 or less, such as creatine, vitamin B12, and uric acid, which are not strongly adsorbed to plasma proteins, and in particular, a mixture of activated carbon and alumina adsorbs an inorganic phosphorus compound. However, the adsorbent hardly adsorbs large molecules such as proteins, and therefore does not adsorb metabolites bound to albumin, such as bilirubin. Therefore, the adsorbent is not suitable as an adsorbent for the adsorption separation device 39.

A water removing device (sometimes referred to as a water removing device) 4 removes water from the dialysate, that is, sucks and removes water from the dialysate as drainage, and includes the separator 33 and an adjusting pump. 62 and a drainage tank 63, each of these devices includes the elastic tube 4 in the draining direction (arrow direction) in the above order.
Connected by A.

As shown in FIG. 5, the separator 33 is a hollow fiber type having the same structure as the dialyzer 1, but unlike the dialyzer 1, it is a small area type. Separator 33
Is composed of a cylindrical case 66, a hollow fiber bundle 67 composed of a large number of hollow fibers 67A exemplified as a semipermeable membrane, and a pair of upper and lower headers 68, 69.

The case 66 is provided with a closing port 71 located at the upper part and a suction port 72 located at the lower part, and each communicates with the external space of the hollow fiber 67A inside the case 66. Closure port 71 is cap 7
3, the suction port 72 is connected to the elastic tube 4A.

The hollow fiber 67A has an average pore diameter of 20 to 100Å, and usually 50 to 50, as in the case of the dialyzer 1.
A 100 Å hyper-performance type is used. Each end of the hollow fiber bundle 67 has an adhesive 75 on the inner surface of each end of the case 66.
It is stuck in.

Each header 68, 69 has a dialysate port 7 for guiding the dialysate into the hollow fiber 67A.
7, 78, the upper dialysate port 77 is connected to the dialysate tank 27, and the lower dialysate port 78 is connected to the upstream heating device 34. 79 is an O-ring.

The adjusting pump 62 is used both for the water removing device 4 and for the replacement liquid supplying device 5. In the embodiment, the adjusting pump 62 is a double roller pump, and a pair of upper and lower curved pumps are provided. Guide surfaces 81 and 82, a rotating body 83 that is driven to rotate, and three rollers 84 that are arranged on the rotating body 83 at equal intervals in the circumferential direction. A pair of upper and lower pump portions 85 and 86 for performing the operation are configured. Then, the elastic tube 4A of the water removing device 4 is
By being laid along the upper guide surface 81 and being squeezed by the rollers 84, the upper pump portion 85 (the water removing device 4
The pumping action is performed by the suction removal means).

The drainage tank 63 stores the drainage from the dialysate and is transparent or translucent.

The replacement fluid supply device 5 includes a vein side chamber 20.
By supplying a supplemental fluid for water supply such as saline to
It supplies water to blood, and is composed of a replacement fluid tank 88 for storing a replacement fluid for water supply, the adjustment pump 62, etc., and each device is arranged in the above order in the supply direction (arrow direction) of the replacement fluid. It is connected by an elastic tube 5A. An elastic tube 5A is provided on the lower guide surface 82 of the adjusting pump 62.
The lower pump portion 86 (supplying means of the replacement fluid supply device 5) by being squeezed by the rollers 84 as the
Pumping is performed by.

On / off detection sensors (detection means) 90, 9 for driving the adjusting pump 62.
1 and a control device (control means) 92.

The ON / OFF detection sensors 90, 91 are provided outside or inside the dialysate tank 27 using, for example, proximity sensors utilizing ultrasonic waves or optical detection. The detection sensor 90 for ON detects that the amount of dialysate in the dialysate tank 27 has exceeded the upper limit set amount, and the detection sensor 91 for OFF has the amount of dialysate in the dialysate tank 27 lower than the lower limit set amount. Detect that.

The control device drives the adjustment pump 62 when the ON detection sensor 90 is detected, and stops the driving adjustment pump 62 when the OFF detection sensor 91 is detected.

A weight sensor is used as the detection sensor, or a single detection sensor is used, and the adjustment pump 62 is operated only when the amount of dialysate in the dialysate tank 27 exceeds a preset amount. It may be driven.

According to the embodiment configured as described above, at the time of hemodialysis (blood purification, removal of toxic substances in blood), in the blood circuit 2, the arterial blood from the patient's artery is pumped to the blood pump 18, the artery side chamber. After passing through the inside of the hollow fiber 7A of the dialyzer 1 via 19, the vein side chamber 2
Perfusion into the patient's vein via 0. Before this reflux, the blood is further purified by passing through the attached circuit 22, and water is removed from the blood, or the blood is supplied with water by a fluid replacement solution such as physiological saline. Sometimes I do it.

On the other hand, in the dialysate circuit 3, the circulation pump 3
The dialysate is circulated by the respective pump units 50 and 51 of No. 6. That is, the dialysate in the dialysate tank 27 is separated from the separator 33.
After being sent to the upstream side heating device 34 through the inside of the hollow fiber 67A and heated to about 37 ° C. which is the physiological temperature, the dialyzer 1
The hollow fiber 7A is passed through the outside. Then, the dialysate that has passed through the dialyzer 1 is sent to the downstream warming device 38 to be reheated to a temperature at which the adsorptive separation action by the adsorptive separator 39 can be accelerated, and then passed through the inside of the adsorptive separator 39. , To be refluxed in the dialysate tank 27.

At the beginning of the circulation of the dialysate, the amount of dialysate in the dialysate tank 27 is detected by the ON detection sensor 90 as shown in FIG. 2 (this detection level is predetermined in the vertical direction). , And the detection level of the off detection sensor 91 is an intermediate position between the on and
The off detection sensors 90 and 91 are set in the non-detection state, and the adjustment pump 62 is stopped.

As described above, by the pump parts 50 and 51 of the circulation pump 36 on the upstream side and the downstream side of the dialyzer 1,
Since the dialysate is circulated, the dialysate can be circulated well in the entire dialysate circuit 3.

When the dialysate is circulated in the dialysate circuit 3 as described above, the dialysate flow is a hollow fiber 7 which is a semipermeable membrane.
Contact the blood stream of the patient via A. At this time, since the dialysate contains albumin as an adsorbing component,
Bilirubin, which is an unnecessary component adsorbed to albumin in blood, metabolites such as bazoflavin, physiologically active substances such as chloromycetin and barbicylic acid, pigments such as indocyanine green and bromsulfophthalene, and especially bilirubin is a hollow fiber. After passing through 7A, it rapidly binds to albumin in the dialysate and is adsorbed and separated.

Although the reason for the adsorption and separation has not been clarified, it is considered that the reason is due to the agglutination reaction. For example,
Albumin serves as an agglutinating source, and bilirubin serves as an agglutinin, and bilirubin serves as a bridge between albumin in blood and albumin in the dialysate to form an aggregate, and the affinity between bilirubin and albumin in the dialysate is It is speculated that it will overcome the affinity between bilirubin and albumin in blood. Based on this estimation, the average pore diameter of the hollow fibers 7A was set to 50 to 100 as in the example.
Å, thickness is 15-60μm (preferably 15-50μ
With m), favorable results were obtained.

Further, as described above, although the dialysate passing through the dialyzer 1 comes into contact with the blood flow of the patient, the upstream side warming device 34
As a result, since the dialysate is heated to a physiological temperature of about 37 ° C., the patient's body temperature will not drop, and there is no fear of adversely affecting the patient.

As described above, the albumin of the dialysate that has passed through the dialyzer 1 adsorbs unnecessary components such as bilirubin, but when passing through the adsorption / separation device 39, the adsorbent inside the Only unnecessary components are adsorbed and separated, and are returned to the dialysate tank 27. Therefore, reuse the dialysate,
Can be reperfused.

Before the adsorption separation with the adsorbent,
Since the downstream dialyzer 38 reheats the dialysate to a temperature at which the adsorption separation action can be promoted, the adsorption separation action by the adsorbent can be promoted, and the adsorption separation efficiency can be improved.

By the way, during the dialysis, TMP, which is the difference between the blood pressure in the dialyzer 1 and the dialysate pressure, removes water from the blood (removes water) and transfers water from the blood to the dialysate. As a result, the amount of dialysate in the dialysate circuit 3 gradually increases, and the albumin concentration of the dialysate decreases. The above TM
P is the number of revolutions of the blood pump 18 and the circulation pump 36,
It is determined by the difference in osmotic pressure between blood and dialysate.

Each pump section 50 of the circulation pump 36,
51 is a dialysate supply line 28 or a dialysate reflux line 29, respectively, and performs pumping action at substantially the same flow rate, but as described above, since water is transferred from blood to the dialysate,
The flow rate of the pump section 50 is larger than that of the pump section 51, and the difference in flow rate between the pump sections 50 and 51 is absorbed exclusively by the elastic deformation of the elastic tube 29A of the dialysate reflux line 29.

As described above, when the dialysate volume in the dialysate circuit 3 gradually increases, the dialysate volume in the dialysate tank 27 also gradually increases, but the dialysate volume in the dialysate tank 27 is set to the upper limit. When it exceeds the amount, it is detected by the ON detection sensor 90. By this detection, the control device 92 drives the pump portions 85 and 86 of the adjustment pump 62.

As a result, in the water removing device 4, the separator 33
The outer side of the hollow fiber is sucked, and water is removed from the dialysate, that is, water is sucked and removed as drainage (water accounts for most of the water) and discharged to the drainage tank 63. When the amount of dialysate in the dialysate tank 27 decreases due to the water removal and falls below the lower limit set amount and reaches the detection level of the off detection sensor 91, the controller 92 stops driving the adjustment pump 62. To be done. As a result, the amount of dialysate in the dialysate circuit 3 is substantially returned to the original amount at the start of dialysis, and the albumin concentration of the dialysate is maintained substantially constant. The fact that the amount of dialysate almost returns to the original amount at the start of dialysate means that the amount of water removed from the blood and the amount of water removed from the dialysate are almost the same.

Further, by the above driving of the adjusting pump 62,
In the replacement fluid supply device 5, the replacement fluid for water supply in the replacement fluid tank 88 is supplied to the vein side chamber. In this case, since the pump parts 85 and 86 of the adjustment pump 62 perform the pumping action of substantially the same flow rate, the water removal amount from the dialysate and the supply amount of the replacement fluid to the venous chamber 20 become substantially the same. Then, as described above, since the amount of water removed from the blood and the amount of water removed from the dialysate are almost the same, the amount of water removed from the blood,
The supply amount of the replacement fluid becomes almost the same, and the water content of blood after dialysis can be made almost the same as that before dialysis.

Although the present invention is applied to the artificial kidney in the embodiment, the present invention can also be applied to an artificial liver, a toxic poisoning treatment device and the like.

Next, in order to confirm the effectiveness of the device shown in the above-mentioned embodiment, the following test was conducted.

In the apparatus shown in the above embodiment, cellulose triacetate fiber (outer diameter about 250μ, inner diameter about 200μ, molecular weight cutoff about 10,000) was used as the hollow fiber of the dialyzer.
0, length 20 cm), and 15,000 fibers were bundled to form a hollow fiber bundle. The total dialysis effective area of the hollow fiber bundle was 1.5 m ² .

Further, 350 g of BR-350 manufactured by Asahi Medical Co., Ltd., which is a styrene-di-vinylbenzene copolymer resin, was used as an adsorbent for purifying the dialysate of the adsorption separator. The amount of adsorbent used for blood purification is generally 350 g or less.

Then, the following processing was performed. That is, plasma having a bilirubin concentration of 37 mg / deciliter (however, collected from the plasma exchange waste liquid) was maintained at a temperature of 37 ° C. and continuously maintained at 60 ml / min in the hollow fiber of the dialyzer.
It was supplied at a flow rate of minutes and circulated.

On the other hand, the dialysate used was Kinderley AF-2 solution manufactured by Fuso Chemical Industry Co., Ltd., in which sodium chloride, potassium chloride, sodium bicarbonate, glucose and the like were dissolved, and albumin was contained at 42 g / liter,
Osmolarity was adjusted to 298 milliosmoles. The dialysate was continuously circulated in the dialysate circuit at a flow rate of 30 ml / min while maintaining the temperature at 37 ° C.

As a result of measuring the bilirubin concentration in the dialysate by the diazo method, the bilirubin concentration was 0.
6 mg / deciliter, 0.7 mg / deciliter after 40 minutes, 0.8 mg / deciliter after 60 minutes, 0.9 mg / deciliter after 90 minutes, 0.9 m after 120 minutes
It was g / deciliter. In addition, the concentration of bilirubin in plasma was 22 mg / deciliter after 120 minutes.

From the above test results, it can be considered that about 5 g of bilirubin per liter of plasma was transferred from the plasma to the dialysate and most of the bilirubin was adsorbed by the adsorbent.

[0069]

As described in detail above, according to the present invention,
Unnecessary components adhering to plasma proteins in the blood can be removed, and the dialysis solution can be circulated and used well in a batch system, so that the dialysis cost can be reduced. In addition, the concentration of the adsorbed component of the dialysate can be maintained almost constant,
A replacement fluid for supplying water can be supplied to the blood removed by dialysis.

According to the second aspect, the dialysate can be satisfactorily circulated throughout the dialysate circuit.

According to the fifth aspect, the amount of water removed from the dialysate and the amount of the replacement fluid for supplying water to the blood after passing through the dialyzer can be made substantially the same, and the amount of water in the blood after dialysis can be changed to that before dialysis. Can be almost the same as. Further, since a single adjusting pump is used for both the water removing device and the replacement liquid supplying device, the cost can be reduced.

According to the sixth aspect, the water removing device and the replacement fluid supply device can be automatically operated according to the amount of dialysate in the dialysate tank.

[Brief description of drawings]

FIG. 1 is a blood circuit diagram showing an embodiment of the present invention.

FIG. 2 is a circuit diagram of a unit system showing an embodiment of the present invention.

FIG. 3 is a vertical cross-sectional view of a dialyzer showing an embodiment of the present invention.

FIG. 4 is a perspective view of a heating device according to an embodiment of the present invention.

FIG. 5 is a vertical cross-sectional view of a separator showing an embodiment of the present invention.

[Explanation of symbols]

 1 dialyzer 2 blood circuit 3 dialysate circuit 4 water removal device 5 replacement fluid supply device 6A, 67A hollow fiber (semipermeable membrane) 27 dialysate tank 28 dialysate supply line 29 dialysate reflux line 33 separator 36 circulation pump 39 Adsorption / separation device 50, 51, 85, 86 Pump unit 62 Adjustment pump 63 Drainage tank 88 Replacement liquid tank 90, 91 ON / OFF detection sensor (detection means) 92 Control device (control means)

Claims (6)

[Claims] 1. A method in which a dialysate flow is brought into contact with a blood flow through a semipermeable membrane of a dialyzer to adsorb and separate unnecessary components adsorbed by plasma proteins in blood into adsorbed components in the dialysate. In the above, a dialysate circuit is provided that allows the dialysate to circulate and pass through the dialyzer. The dialysate circuit is (1) a circulation pump for circulating the dialysate, and (2) adsorbed by adsorbed components in the dialysate. And an adsorption separation device that adsorbs and separates unnecessary components with an adsorbent,
(3) A dialysate management device for a hemodialysis device, comprising: a water removal device for removing water from a dialysate; and (4) a replacement liquid supply device for supplying a water supply replacement liquid to blood after passing through a dialyzer. . 2. The circulation pump has a pair of pump portions that perform a pumping action of substantially the same flow rate, and each pump portion is arranged on the upstream side and the downstream side of the dialyzer, respectively. Dialysate management device for hemodialysis equipment. 3. A water removing apparatus comprising: (1) a separator having a semipermeable membrane, and a dialysate flowing through one surface side of the semipermeable membrane;
(2) The dialysate management device for a hemodialysis apparatus according to claim 1 or 2, further comprising: a suction removal unit that suctions and removes water from the dialysate on the other surface side of the semipermeable membrane in the separator. 4. A replacement fluid supply device comprises (1) a replacement fluid tank for storing a replacement fluid for water supply, and (2) a supply means for supplying the replacement fluid for water supply in the replacement fluid tank to blood after passing through a dialyzer. The dialysate management device of the hemodialysis device according to any one of claims 1 to 3. 5. An adjusting pump is provided, and the adjusting pump has a pair of pump parts that perform pumping operations of substantially the same flow rate, one pump part serving as a suction removing means, and the other pump part supplying. The dialysate management device of the hemodialysis device according to claim 4, which is used as a means. 6. A dialysate circuit has a dialysate tank for storing dialysate, and (1) a detection means for detecting that the dialysate volume in the dialysate tank exceeds a set amount, and (2) 7. The dialysate management device for a hemodialysis machine according to claim 5, further comprising: a control unit that drives the adjustment pump according to the detection of the detection unit.