KR20070018780A - An apparatus, a system and a method relating to hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis - Google Patents

Abstract

The present invention relates to a device for hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis. The device has at least one conduit 10, 14 for flowing dialysis fluid and / or injection fluid. The apparatus includes a measuring unit 48 for measuring at least one optically active substance in the fluid. The measuring unit 48 is arranged to measure the concentration of the substance in the fluid by measuring the effect of the substance in the fluid on the polarized light transmitted through the fluid. The invention also relates to a system comprising the aforementioned device as well as a method for performing the concentration measurement of the optically active substance in the dialysis fluid and / or the injection fluid.

Description

AN APPARATUS, A SYSTEM AND A METHOD RELATING TO HEMODIALYSIS, HEMODIAFILTRATION, HEMOFILTRATION OR PERITONEAL DIALYSIS}

The present invention relates to a device for hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis. The device has at least one conduit for flowing dialysis fluid and / or injection fluid. The apparatus includes a measuring unit for measuring at least one substance in the fluid.

The invention also relates to a system comprising the aforementioned device, as well as to a method relating to hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis.

Blood permeation is a treatment intended to correct the chemical composition of blood by removing accumulated metabolic products and adding buffers in the diffusion process through natural or artificial semipermeable membranes.

Common forms of blood permeation devices are well known to those skilled in the art. An example of such a device is the device described with reference to FIG. 1 of EP-A2-904 789. Hemoperfusion devices are used to treat patients suffering from kidney failure. The dialysis fluid (dialysis solution) is prepared in advance in the dialysis apparatus. This dialysis fluid is used to perform dialysis in a dialysis machine that is part of a hemodialysis apparatus. The dialysis fluid may be prepared in advance in the device by supplying water and one or more concentrates to the device. The device may also be arranged to provide an infusion solution to the patient. Such injection solution may be the same as or different from the dialysis fluid. Since the hemoperfusion device is well known to those skilled in the art, the detailed description will be omitted here.

Blood permeation is a treatment intended to remove accumulated metabolic products from blood by a convective transfer process as a result of ultrafiltration through a high-flux type semipermeable membrane; The desired volume of fluid filtered beyond the desired weight loss is replaced with a pyrogen-free sterile infusion solution. Permeate is not typically used in pure hemofiltration processes.

Hemofiltration is a treatment intended to remove accumulated metabolic products from blood by a combination of diffusion and convective transfer through a high flux type semipermeable membrane; The fluid is removed by ultrafiltration and the desired volume of fluid filtered beyond the desired weight loss is replaced by a sterile infusion solution that is free of pyrogen.

There are devices that can be used for both hemodialysis and hemofiltration as well as hemofiltration.

There is also a device for peritoneal dialysis. Peritoneal dialysis does not require a dialysis machine that is part of the device. Instead, the peritoneum of the patient is used as the permeable membrane. Also, in the device for peritoneal dialysis, permeate and / or infusion fluid are added.

It is also known that a device of the above kind can be equipped with a measuring unit for measuring some material in the dialysis fluid or infusion fluid. The apparatus may, for example, be equipped with a measuring unit for measuring the conductivity of the dialysis fluid to estimate the concentration of the dialysis concentrate mixed with water in the apparatus.

Concentrates containing glucose or similar substances are often added to devices of the kind described above. Glucose is often provided as a concentrate to be fed to the device. Glucose concentrates may be provided in a variety of containers, from which the concentrates are fed to the apparatus. Since these concentrates can be provided at different concentrations of glucose, it is important to ensure that the concentrates of the correct glucose concentration are fed into the device. Occasionally, a concentrate containing glucose is provided in the flexible fluid bag. Such a bag may comprise a plurality of compartments. Since the compartments are configured to be connected to each other, fluids in different compartments mix with each other before the fluid is supplied to the device. Glucose concentrate may be included in one compartment within such a fluid bag. In fluid bags of this kind, it is important to ensure that the contents of the different compartments are mixed with each other before the fluid is supplied to the device. Because human factors can make mistakes, the container containing the wrong concentration of glucose is not connected to the device in question, or the contents of the different compartments do not mix properly with each other before the fluid is supplied to the device. In a state, a flexible fluid bag having different compartments is connected to the device.

It is an object of the present invention to provide a device of the type as defined in the first paragraph above which makes it possible to measure the concentration of substances in the fluid to be supplied to or to be delivered to the device. It is a further object to provide a device having means which allow to avoid the above-mentioned probable mistakes with regard to the concentration of substances added to the device. Such materials may be glucose or similar materials. It is a further object to provide such means which are relatively simple and inexpensive to implement in an apparatus of the kind mentioned above. Another object is to provide the aforementioned apparatus for detecting in a reliable manner whether the concentration of the aforementioned substance in the fluid is correct.

The above object is that the material to be measured is an optically active substance, and the measuring unit measures the concentration of the material in the fluid by measuring the effect of the material in the fluid on the polarized light transmitted through the fluid. By means of a device of the type defined in the first paragraph, which is arranged to measure.

Accordingly, the inventors of the present invention have recognized that since a substance such as glucose is an optically active substance, a device of the above-described kind may be provided with a measuring unit for measuring the effect of the substance in the fluid on the polarized light. By using such a measuring unit, it is possible to ensure that the correct concentration of material is supplied to or through the device. Such a measuring unit can also be manufactured very simply and does not have to be expensive.

In this regard, for example, glucose is known as an optically active substance. It is known that the concentration of an optically active material can also be measured by transmitting polarized light through the material. For example, US Pat. No. US-A-5,357,960 discloses methods and apparatus for the quantitative determination of optically active substances in vivo. International Patent WO 01/84121 A1 discloses a method and apparatus for polarimetric mesurement of glucose concentrations in vivo, for example, in blood. The devices and methods disclosed in the above-mentioned documents are very complicated because the concentration of the substance to be measured in vivo is very low. However, the inventors of the present invention have found that the concentration of the substance to be measured in the device according to the present invention is always very high. Thus, the inventors have found that the measuring unit installed in the apparatus according to the invention can be very simple and can measure the concentration of the substance in question very accurately.

It should be noted that the concept of dialysis fluid or infusion fluid in this document not only refers to the final dialysis fluid or infusion fluid, but also to other concentrates and / or dilute concentrates to obtain the final dialysis fluid or infusion fluid.

When using the expression “light” in this document, it should also be noted that the concept of this includes not only electromagnetic waves in the visible wavelength range but also electromagnetic waves of other wavelengths.

According to a preferred embodiment, the device comprises a plurality of inlets for different materials, the device being arranged such that the various materials injected via the inlet are mixed with each other in the device, and the measuring unit is configured to By mixing with all other materials injected through the inlet, the concentration of material in the fluid is positioned in or on the device before its final form is obtained in the device. Before the fluid is mixed with all other materials, the fluid usually contains a high concentration of material to be measured. Thus, the present invention is particularly advantageous for measuring the concentration of a substance before the final form of the substance is obtained in the device.

Preferably, the plurality of inlets comprises a first inlet through which the fluid to be measured passes and is injected into the device, wherein the measuring unit is configured to allow the fluid to be injected via the first inlet to Prior to mixing with any other material injected via another inlet, the concentration of material in the fluid is positioned in or on the device such that the concentration of the material in the fluid is measured. Thus, according to this embodiment, the concentration of the substance is measured before the fluid is mixed with any other substance in the device. Thus, the concentration of substance in the fluid is very high. Moreover, if it is determined that the concentration of the substance is wrong, the fluid supply to the device can be stopped at an early stage.

According to another embodiment, the measuring unit is designed to measure the concentration of the substance that is at least 100 g / l. This measuring unit is especially designed for measuring sugars in the fluid, preferably glucose in the form of glucose. When the concentration of the substance is above 100 g / l, it is particularly advantageous to use the present invention, since the measuring unit can be designed in a very simple way. For example, the device according to the invention is particularly useful because the concentration of glucose supplied from the concentrate to the device is usually substantially higher than 100 g / l.

According to another embodiment, the device comprises means arranged to generate a warning signal if the measured concentration of the substance in the fluid does not meet a preset requirement. The warning signal can be, for example, an electrical signal that indicates that certain measurements are being made. For example, the signal may cause the dialysis process to stop and / or allow a sound or light signal to be sent as a warning to the person who operated the device.

According to a preferred embodiment, the device comprises at least partially transparent conduit provided in the device or at the inlet to the device, through which the fluid to be measured passes and the measuring unit is at least partially transparent. Positioned and positioned to produce polarized light rays that pass through the fluid to be measured in the conduit. By passing the fluid through the transparent conduit, it is possible to pass light rays through the transparent conduit and thereby through the fluid.

The measuring unit is preferably arranged to provide planar polarized light rays. Thus, the measuring unit is arranged together with measuring means for measuring the entity displayed by using the angle of rotation of the polarization plane of the polarized light when the polarized light passes through the fluid. The measuring means may comprise a light intensity detector. By measuring the angle at which the polarized light is rotated in the fluid, the concentration of the optically active substance in the fluid is obtained.

The invention also relates to a system comprising a device containing a device and a fluid according to any of the embodiments described above, the container being connected to the device such that fluid in the container is supplied to the device, the measuring unit Is arranged to measure the concentration of the substance in the fluid from the container. Thus, such a device can be used to determine whether the correct concentration of the substance in the fluid from the container has been fed to the device.

The container preferably comprises at least two compartments, the contents of which are mixed before the fluid leaves the container. The container may be a flexible fluid bag and the concentration of the material to be measured is at least 100 g / l. As noted above, it is important to be able to determine whether the contents of the different compartments in these containers have been correctly mixed before the fluid is supplied to the device. This can be done effectively and accurately at low cost using the apparatus or system according to the invention.

The present invention also provides a method for measuring the concentration of an optically active substance in a dialysis fluid and / or infusion fluid arranged to be supplied to and / or through a device for hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis. It is about. The method includes providing polarized light rays; Transmitting the polarized light beam through the fluid; Detecting the effect of the substance in the fluid on the polarized light rays passing through the fluid to obtain an indication of the concentration of the substance in the fluid. With this method, the same advantages as the above with regard to the apparatus and system are obtained.

The substance is preferably a sugar such as glucose. The fluid may be a concentrate to be mixed and / or diluted with other materials in the device. The fluid is preferably supplied to the device, eg, from a flexible fluid white container, which may include at least two compartments, the contents of the compartment being mixed before the fluid leaves the container.

Further preferred ways to carry out the method are described in the appended claims and the following detailed description of the invention.

1 schematically illustrates a dialysis apparatus and system according to the present invention.

2 is a schematic illustration of a measuring unit that may be used in a dialysis apparatus and system according to the present invention.

3 is a view schematically showing a modification of the measuring unit.

4 is a flowchart schematically showing an embodiment according to the present invention.

1 schematically shows a device according to the invention. The device has a first flow circuit 10 for dialysis fluid and a second flow circuit 12 for blood. The device according to this embodiment also has a conduit 14 for injection liquid. A drip chamber 16 is arranged as part of the second flow circuit 12. Conduit 14 also leads to drip chamber 16. The connections 18, 20 will be connected to the patient. The dialysis machine or hemofilter 21 is connected to the first flow circuit 10 and the second flow circuit 12. The semipermeable membrane 22 is installed in the dialysis machine or the blood filter 21. It should be noted that the device for peritoneal dialysis does not have any dialysis machine 21 as well, since the patient's peritoneum functions as the membrane of the dialysis machine.

Bypass conduit 25 is disposed between the valves 23, 24. Thus, the valves 23, 24 can be set such that the dialysis fluid passes through the bypass conduit 25 instead of passing through the dialyzer 21.

In the embodiment shown, the device has inlets 26, 28, 30, 32. The number of inlets may of course vary from device to device. Inlet 26 is an inlet for distilled water. The inlets 28, 30, 32 are inlets for the above-mentioned concentrate which will form a dialysis fluid with water. The exact composition of the dialysis fluid is prepared in advance in the preparation unit 34. The exit for dialysis is indicated by reference numeral 36. Reference numeral 38 denotes a process unit or computer for controlling the operation of the apparatus.

The dialysis device is a device well known to those skilled in the art, and detailed illustration of such a device is omitted here. Also, detailed functional descriptions of these devices have been omitted. Of course, these devices are made up of many components, including pumps and flow meters.

The apparatus described so far has a conventional structure known to those skilled in the art.

Various concentrates required for the dialysis fluid can be supplied to the apparatus from different containers. For example, it is known that at least some concentrates can be supplied from a container in the form of a fluid bag containing two or more compartments. 1 schematically shows that such a fluid bag 39 is connected to an inlet 32. Fluid bag 39 is usually suspended at a height above inlet 32 and is connected to inlet 32 via tube 40. According to the embodiment shown, the fluid bag 39 comprises two compartments 42, 44. One compartment, such as compartment 42, may comprise a glucose solution. Before the contents of the bag 39 are fed to the inlet 32, the contents of the two compartments 42, 44 will be mixed with each other. This is achieved by opening the connection in the seal 46 between the two compartments 42, 44. It is important that the seal 46 is actually destroyed so that the contents of the two compartments 42, 44 can be mixed before the concentrate is fed into the inlet 32, because if not correctly broken the correct concentrate will enter the inlet. This is because it cannot be supplied to (32). The concentration of glucose in compartment 42 can be, for example, 570 g / l. When the contents of the two compartments 42, 44 are mixed, the glucose concentration in the concentrate to be fed to the inlet 32 should be, for example, 400 g / l.

In order to actually measure the exact concentration of glucose to be fed to the device, the device according to the invention is equipped with a measuring unit 48. In this case, the measuring unit 48 is arranged at the inlet 32. It should be noted that the measuring unit 48 is also within the scope of the present invention, which is arranged in other parts of the apparatus. For example, the measuring unit 48 or additional measuring units can be positioned within the first flow circuit 10 or the conduit 14. However, it is advantageous to arrange the measuring unit 42 at the inlet 32 for at least two reasons. The first reason is that the concentration of glucose is much higher at the inlet 32 than at other parts of the device. Thus, when the measuring unit 48 is located at the inlet 32, the unit need not be so sensitive. Thus, the measuring unit 48 can be designed in a very simple and inexpensive manner. The second reason is that if the wrong glucose concentration is detected by the measuring unit 48, the supply of the concentrate from the fluid bag 39 can be stopped at an early stage, thus bringing the measuring unit 48 to the inlet 32. It is advantageous to position them.

The measurement unit 48 will be described in more detail with reference to FIG. 2. The measuring unit 48 is arranged to measure the optically active substance. According to this example, the optically active substance is glucose. The measuring unit 48 is arranged to measure the concentration of the optically active substance, ie glucose in this case by measuring the effect of the substance in the fluid on the polarized light transmitted through the fluid.

The theory of optical activity and measuring methods using polarized light are well known to those skilled in the art, and also such as in the Optics of Hecht and Zajec (published Addison-Wesley Publishing Comp., 1974, especially pages 255-260). As described in various textbooks, the detailed description of the theory and method will be omitted herein. Basically, measurements can be made by transmitting flat polarized light rays through the fluid in question. Thus, the plane of polarization will rotate as light passes through the fluid. The angle at which the plane of polarization will rotate depends on the concentration of the optically active material in the fluid as well as the distance through which the light has passed. By measuring the angle of rotation and knowing the distance through the fluid, one can calculate the concentration of the optically active substance in the fluid.

2 schematically shows an embodiment of the measuring unit 48 constituting part of the device according to the invention. The measuring unit 48 comprises a sample cell 50. The fluid to be measured is included in the sample cell 50. The sample cell 50 may be positioned such that all fluids to be measured pass through the sample cell 50. The inlet 51 facing the sample cell 50 can be connected to the tube 40 coming from the container 39 (see FIG. 1). This fluid exits the sample cell 50 via the outlet 32. Thus, this outlet 32 may be an inlet directed to the preparation unit 34 shown in FIG. 1. Thus, according to this embodiment, the measuring unit 48 is positioned in the device to measure the concentration of glucose before the fluid from the fluid bag 39 is mixed with any other material to be included in the dialysis fluid. do. The sample cell 50 has a transparent first window 54 and a transparent second window 56. Thus, the sample cell 50 is designed to allow light rays to pass through the sample cell 50 and through the fluid in the sample cell 50. The first and second windows 54, 56 are preferably constructed of a predetermined material without internal birefringence such that these windows 54, 56 do not affect the measurement results.

The measuring unit also includes a light source 58 for generating light rays passing through the sample cell 50. This light source 58 should be monochromatic or almost monochromatic. Low cost light emitting diodes (LEDs) can be used as the light source 58. This light source 58 should produce sufficient collimated light rays. If desired, the collimation lens 60 may be positioned within the ray path exiting the light source 58. Most of the light passes through the beam splitter 62, while the tubular line passes through the beam splitter 62 where it is desirable to reflect only a small amount of light. Light rays that pass through the light splitter 62 also pass through a first polarizer 61 that produces a planar polarized light beam. It should be noted that the beam splitter 62 does not necessarily need to be located between the light source 58 and the polarizer 61. Ray splitter 62 may also be positioned between polarizer 61 and sample cell 50. In Fig. 2, light rays are indicated by arrows in the plane of this figure. As this planar polarized light passes through the sample cell 50, the plane of polarization is rotated according to the distance between the first and second windows 54, 56 and the concentration of the optically active material in the sample cell 50. will be.

The light beam passes through the second polarizer 63 after passing through the sample cell 50. For example, the second polarizer 63 may be disposed such that the polarization direction of the second polarizer 63 is perpendicular to the polarization direction of the first polarizer 61. In FIG. 2, this is indicated by the symbol after polarizer 63. According to another possible embodiment, the second polarizer 63 (or with the photodetector 64) can be arranged to be able to rotate around the optical axis. In this case, the angle at which the plane of polarization of the polarized light beam rotates when the light beam passes through the fluid is determined by the second polarizer 63 until the maximum (or alternatively minimum) light intensity is detected by the photodetector 64. Can be measured by rotating. Then, the rotation angle of the polarizer 63 is represented by the angle at which the polarization plane is rotated.

Light rays that pass through the second polarizer 63 impinge on the first photodetector 64. Thus, photodetector 64 measures the strength of the steel impinging upon it. If no optically active material is present in the sample cell 50, the polarization plane of the light beam will not change as it passes through the sample cell 50. If the second polarizer 63 is arranged as shown in FIG. 2, the photodetector 64 will detect the minimum light intensity. On the other hand, if an optically active material is present in the sample cell 50 at such a concentration that the polarization plane is rotated 90 ° while passing through the sample cell 50, the photodetector 64 will detect the maximum light intensity. When the optically active material in the sample cell 50 is at such concentration that the polarization plane will rotate between 0 ° and 90 °, the photodetector 64 will detect the intensity of the light according to the rotation angle of the polarization plane. The detected light intensity at photodetector 64 is proportional to sin ² θ, where θ is the angle of rotation of the polarization plane. By detecting the light intensity in the first photodetector, an indication of the concentration of the optically active substance of the fluid in the sample cell 50 is obtained. The length of the sample cell 50, ie the spacing between the first window 54 and the second window 56, should be chosen such that proper rotation of the polarization plane is obtained for the concentration normally measured by the measuring unit 48. . For this application, it has been found that when the concentration of glucose to be measured is higher than 100 g / l, preferably 300 g / l, the length of the sample cell 50 is suitably between 5 mm and 60 mm, preferably between 10 mm and 40 mm. lost.

In the embodiment shown, the measurement unit 48 also includes a second photodetector 66 which detects the light rays reflected by the light splitter 62. The second photodetector 66 is used to detect a change in light intensity emitted from the light source. Thus, the measured value detected by the first photodetector 64 can be corrected for this deviation. The first and second photodetectors are preferably connected to a process unit, for example the process unit 38 described with reference to FIG. 1. The concentration of the optically active substance in the fluid can be measured continuously while the fluid flows through the sample cell 50. However, it is possible to measure this concentration intermittently and also when there is no flow through the sample cell 50.

Since the first photodetector 64 and the second photodetector 66 are connected to the process unit 38, the process unit 38 generates a warning signal when the measured concentration of the substance deviates from a preset requirement. May be arranged to occur. The warning signal makes it possible to stop the dialysis process, for example by setting the valves 23 and 24 such that the dialysis fluid flows through the bypass conduit 25. Signals, such as sound or light signals, may also be generated to alert the person who operated the device that the concentration of the fluid is wrong.

Another embodiment of the measuring unit 48 is shown schematically in FIG. 3. The same reference numerals are used to indicate the same components shown in FIG. According to this embodiment, there is no ray separator 62 in front of the sample cell 50. The second polarizer 63 of FIG. 2 is replaced by a polarized light splitter 68. The beam splitter 68 that polarizes the light polarized in the plane of the figure while the light polarized perpendicular to the beam splitter 68 is reflected by the beam splitter 68 toward the second photodetector 66. It is designed to transmit through the ray separator 68. Thus, the ratio between the intensities detected by the photodetector 64 and the photodetector 66 is determined by the rotation of the polarization plane and further by the concentration of the optically active material in the sample cell 50. In the embodiment of Fig. 3, since the ratio between the intensity detected by the photodetector 64 and the photodetector 66 is analyzed, and the variation in the intensity of the light emitted from the light source 58 does not affect the detection, It is advantageous. Moreover, the opacity of the fluid in the sample cell 50 does not affect the measurement results. It should be noted that two possible embodiments of the measuring unit 48 are schematically illustrated in FIGS. 2 and 3. Modifications and variations of these embodiments will be apparent to those skilled in the art without departing from the scope of the invention.

The system according to the invention comprises the device described above with a container containing a fluid to be analyzed, such as a container in the form of a fluid bag 39. 1 also shows an embodiment of a system according to the invention. As noted above, the fluid bag 39 may include a plurality of compartments 42, 44. The concentration of substance such as glucose to be supplied to the device in the fluid bag 39 is at least 100 g / l, preferably at least 300 g / l. The measuring unit 48 included in the present invention is particularly advantageous for measuring the relatively high concentrations described above because they can be constructed in a simple and inexpensive manner.

4 shows the present invention for measuring the concentration of optically active substances of dialysis fluid and / or injection fluid arranged to be supplied to and / or through a device for hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis. A flowchart of the method according to the drawings is schematically shown. According to the example for carrying out the method, the method includes the following steps.

The container 39 is prepared. This container 39 is a flexible fluid bag 39 having at least two compartments 42, 44. The contents of the two compartments 42, 44 are such that the fluid can mix before leaving the container 39. The concentration of the fluid substance at the location where the measurement will be made is at least 100 g / l. The fluid is supplied from the container 39 to the device. This fluid passes through the conduit 50, preferably at least partially through the inlet 32, into the device. Generate planar polarized light rays. The planar polarized light beam is transmitted through the fluid. There is a measurement that displays using the angle at which the plane of polarization of the polarized light passes as it passes through the fluid. Thus, an indication of the concentration of the substance is obtained.

It is not intended to be limited to the foregoing embodiments of the invention, but may be changed and modified within the scope of the following claims.

Claims (27)

Hemodialysis, hemodialysis comprising at least one conduit (10, 14) for flowing at least one of the dialysis fluid and the infusion fluid, and comprising a measuring unit (48) for measuring at least one substance in the fluid In the device for filtration, hemofiltration or peritoneal dialysis, The substance to be measured is an optically active substance, and the measuring unit 48 is arranged to measure the concentration of a substance in the fluid by measuring the effect of the substance in the fluid on the polarized light transmitted through the fluid. Characterized in that the device. The device of claim 1, comprising a plurality of inlets 26, 28, 30, 32 for different materials, wherein the device comprises a plurality of materials injected via the inlets 26, 28, 30, 32. Are arranged to mix with each other, and the measuring unit 48 is such that its final form is obtained in the apparatus by mixing with all the other substances injected with fluid through the inlets 26, 28, 30, 32. Wherein the concentration of the substance in the fluid is positioned within or in the device so as to be measured. 3. The apparatus of claim 2, wherein the plurality of inlets (26, 28, 30, 32) includes a first inlet (32) through which the fluid to be measured is introduced into the device via the first inlet. The unit 48 may be configured to allow the fluid injected via the first inlet 32 to be mixed with any other material injected via the other inlets 26, 28, 30 of the plurality of inlets in the device. Wherein the concentration of substance in the fluid is positioned in or at the device such that the concentration of the substance is measured. The device according to claim 1, wherein the measuring unit is configured to measure the concentration of the substance that is at least 100 g / l. The device according to claim 1, wherein the measuring unit is configured to measure the sugar concentration in the fluid. 6. The device of claim 5, wherein the sugar is glucose. 7. The device of claim 1, comprising means 38 arranged to generate a warning signal if the measured concentration of the substance in the fluid does not meet a preset requirement. Device. 8. The device of claim 1, comprising at least partially transparent conduit 50 provided in the device or at an inlet 32 facing the device, wherein the fluid to be measured is the transparent conduit 50. And the measuring unit (48) is positioned and arranged to produce polarized light passing through the fluid to be measured in the at least partially transparent conduit (50). The device according to claim 1, wherein the measuring unit is arranged to provide planar polarized light rays. 10. The measuring unit (48) according to claim 9, wherein the measuring unit (48) measures measuring entities (38, 64, 66) for displaying an object displayed by using an angle of rotation of the polarization plane of the polarization beam when the polarization beam passes through the fluid. Device arranged together with. Device according to claim 10, wherein the measuring means (38, 64, 66) comprise a light intensity detector. 12. A system comprising a container (39) containing fluid and a device according to any one of the preceding claims, wherein the container (39) is such that the fluid in the container (39) is supplied to the device. And measuring unit (48) arranged to measure the concentration of the substance in the fluid from the container (39). 13. The system of claim 12, wherein the container 39 comprises at least two compartments 42, 44, wherein the contents of the compartments 42, 44 are mixed before the fluid leaves the container 39. . The system according to claim 12 or 13, wherein the container (39) is a flexible fluid white. The system according to claim 12, wherein the concentration of the substance in the container is at least 100 g / l. A method for measuring the concentration of an optically active substance in a dialysis fluid and / or infusion fluid arranged to be supplied to and / or through a device for hemodialysis, hemodiafiltration, hemofiltration or peritoneal dialysis, Providing a polarized light beam; Transmitting the polarized light beam through the fluid; Detecting the effect of a substance in the fluid on the polarized light rays passing through the fluid to indicate the concentration of the substance in the fluid Method comprising a. The method of claim 16, wherein the substance is a sugar. The method of claim 17, wherein the sugar is glucose. 19. The method of any one of claims 16-18, wherein the fluid is a concentrate that is mixed and / or diluted with other materials in the device, wherein the measurement is through mixing with other materials and / or through dilution. And run in the fluid prior to obtaining a final form of fluid in the device. 20. The method according to any one of claims 16 to 19, wherein the fluid is supplied from the container (39) to the device. 21. The method of claim 20, wherein the container (39) comprises at least two compartments (42, 44), wherein the contents of the compartments (42, 44) are mixed before the fluid leaves the container (39). 22. The method of claim 20 or 21, wherein the container (39) is a flexible fluid white. 23. The method of any one of claims 16 to 22, wherein the concentration of substance in the fluid at the location where the measurement is performed is at least 100 g / l. 24. The method according to any one of claims 16 to 23, wherein means (38) are provided for generating a warning signal if the measured concentration of the substance in the fluid does not meet a preset requirement. 25. The fluid of any one of claims 16 to 24, wherein the fluid is supplied through at least partially transparent conduit 50 provided in or in the inlet 32 towards the device, the measurement being at least partially By passing polarized light through the fluid in a transparent conduit (50). 26. The method of any one of claims 16-25, wherein the polarized light rays are planar polarized light rays. 27. The method of claim 26, wherein the detection of the effect of a substance in the fluid on the polarized light is performed by measuring an entity that displays using the angle at which the polarized plane of the polarized light is rotated when the polarized light passes through the fluid. How.

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