JP6133134B2 - Dialysis system, adjustment device, and adjustment method - Google Patents

Description

  The present invention relates to a dialysis system that dissolves and dilutes a powder dialysis agent containing a sugar component and supplies it to one or more dialysis apparatuses for performing dialysis treatment on a patient, an adjustment apparatus incorporated in the dialysis system, and the dialysis The present invention relates to an adjustment method for adjusting components of dialysate used in a system.

  The dialysate used for the treatment of patients with renal failure in hospitals and the like includes two types of drugs, one that does not contain sodium bicarbonate (hereinafter referred to as “agent A”) and sodium bicarbonate (hereinafter referred to as “agent B”). It is adjusted by mixing. Conventionally, the A agent and the B agent have been provided as liquids having a predetermined concentration, that is, a liquid A agent and a liquid B agent, respectively. In dialysis facilities such as clinics and hospitals, the liquid A and liquid B are mixed and diluted as necessary to generate a dialysate.

  Such liquid A agent and liquid B agent are used in an amount of about 5 liters per dialysis of one patient. Therefore, in clinics and hospitals that handle a plurality of patients, it is necessary to store a large amount of liquid A agent and liquid B agent and transport them as needed, which causes problems such as transportation burden and storage space.

  Therefore, in recent years, from the viewpoint of improving transportability, these A agent and B agent powdered (hereinafter referred to as “powder A agent”, “powder B agent”) are dissolved before dialysis to form liquid A Attempts have been made to obtain an A agent concentrated solution and a B agent concentrated solution having the same concentration as the agent and liquid B agent (for example, Patent Documents 1 and 2). According to the technology using the powder A agent and the powder B agent, the storage space can be reduced and the transportation burden can be greatly reduced.

JP 2008-220774 A JP 2008-220784 A

  By the way, some isomers are known for the sugar component contained in the agent A, specifically, glucose. About 36% of the glucose contained in the liquid A agent, which has been frequently used in the past, is α-glucose shown in FIG. 9 (a), and about 64% is β-glucose shown in FIG. 9 (b). Yes. On the other hand, in the glucose contained in the powder A agent, β-glucose does not exist and α-glucose is 100%. When this powder A agent is dissolved in water, a part of α-glucose is changed to β-glucose with time, and finally about 36% is α-glucose, about 64%, which is the same as liquid A agent. % Reaches equilibrium in the state of β-glucose.

  However, when the powder A agent is dissolved and used, it is mixed with the solution of the powder B agent and water and diluted without confirming whether the glucose in the solution has reached equilibrium, thereby producing a dialysate. The patient was supplied to a dialysis machine for dialysis treatment. As a result, the composition of the dialysate, particularly the glucose ratio, may be different from the case where the liquid A agent is used. Regardless of whether the liquid A agent or the powder A agent is used, it is desirable that the composition of the finally obtained dialysate is substantially the same.

  Therefore, in the present invention, a dialysis system that can generate a dialysis fluid having the same composition as the dialysis fluid generated from the liquid A agent, even if the powder A agent is used, a regulator incorporated in the dialysis system, and components of the dialysis fluid It is an object of the present invention to provide an adjustment method for adjusting the above.

The dialysis system of the present invention is a dialysis system in which a powder dialysis agent containing a sugar component is dissolved and diluted and then supplied to one or more dialysis machines for performing dialysis treatment on a patient. A storage part for temporarily storing a concentrated liquid obtained or a target liquid that is a dialysis liquid obtained by mixing the concentrated liquid with at least dilution water, and the storage capacity of the storage part is the powder dialysis agent the waiting time from the dissolved to be supplied to the dialyzer through the reservoir is Ri capacity der isomer proportion becomes more equilibration time to reach the equilibrium constant of the sugar component, further And a confirmation / prediction means for confirming or predicting whether or not the target liquid stored in the storage part has reached equilibrium, and only storing the target liquid that has been predicted to be confirmed to have reached equilibrium. It is output from it, wherein To.

  In a preferred aspect, the apparatus further comprises temperature adjusting means for adjusting the temperature of the target liquid to a temperature that promotes equilibration of the sugar component. In this case, it is desirable that the temperature adjustment means adjust the temperature of the target liquid stored in the storage unit by heating to a temperature that promotes the equilibration of the sugar component.

In another preferred embodiment, the front Symbol reservoir comprises a plurality of reservoirs, among the plurality of reservoirs to another reservoir and the storage tank output of the target liquid is allowed, a new The target liquid is supplied and stored.

Another adjusting device according to the present invention is a dissolving device that dissolves a powder dialysis agent containing a sugar component to produce a concentrated solution, and mixes the concentrated solution with at least diluting water to produce a dialysate and the dialysis A supply device for supplying a liquid to one or more dialysis devices for performing dialysis treatment on a patient, and a regulating device incorporated in a dialysis system connected by piping, obtained by dissolving the powder dialysis agent A reservoir for temporarily storing a target liquid, which is a concentrated liquid or a dialysate obtained by mixing the concentrated liquid with at least dilution water, and the storage capacity of the storage section dissolves the powder dialysis agent wait before supplied to the dialyzer through the reservoir from the found Ri capacity der isomer proportion becomes more equilibration time to reach the equilibrium constant of the sugar component, further, the Pairs stored in the reservoir Liquid is, the check-prediction means for confirming or predict whether equilibrium is reached, with which to output the only confirmation expected object liquid reaches the equilibrium the reservoir, characterized in that .

In another adjustment method according to the present invention, a dialysis fluid component used in a dialysis system is supplied to one or more dialysis machines for dissolving and diluting a powder dialysis agent containing a sugar component to perform dialysis treatment on a patient. An adjustment method for adjusting, wherein a target liquid which is a concentrated liquid obtained by dissolving the powder dialysis agent or a dialysate obtained by mixing the concentrated liquid with at least dilution water is temporarily stored in a storage section. A waiting time until the storage capacity of the storage part is dissolved in the powder dialysis agent and is supplied to the dialysis machine through the storage part, and the ratio by isomer of the sugar component is constant. capacity der become more equilibration time to reach the composed equilibrium is, further, the target liquid stored in the storage unit includes a check-prediction step of confirming or predict whether the host vehicle has reached the equilibrium, the equilibrium The predicted pair was confirmed to have reached Comprising a step of outputting the liquid only from the reservoir, the. In a preferred aspect, the method further includes the step of adjusting the temperature of the target liquid to a temperature that promotes equilibration of the sugar component.

  According to the present invention, the waiting time from when the powder dialysis agent is dissolved to when it is supplied to the dialysis machine is equal to or longer than the equilibrium time until the equilibrium is reached at which the isomer ratio of the sugar component is constant. Since the target liquid is temporarily stored in the capacity storage section, the dialysate having the same composition as the dialysate generated from the liquid A agent can be generated even if the powder A agent is used.

It is a block diagram of the dialysis system which is embodiment of this invention. It is a figure which shows the structure of an adjustment apparatus. It is a graph which shows a time-dependent change of the abundance ratio of (alpha) -glucose and (beta) -glucose in A agent concentrated liquid. It is a graph which shows a time-dependent change of the abundance ratio of (alpha) -glucose and (beta) -glucose in A agent concentrated liquid. It is a figure which shows the structure of the A agent melt | dissolution apparatus incorporating the adjustment apparatus. It is a figure which shows the structure of the dialysate supply apparatus with which the adjustment apparatus was integrated. It is a figure which shows the structure of the other dialysate supply apparatus with which the adjustment apparatus was integrated. It is a figure which shows the structure of the dialysis system incorporating the adjustment apparatus. It is a structural formula of α-glucose and β-glucose.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a configuration block diagram of a dialysis system 10 according to an embodiment of the present invention. The dialysis system 10 dissolves, mixes, and dilutes two types of powder dialysis agents (powder A agent and powder B agent) to generate a dialysis solution, and uses the generated dialysis solution for dialysis treatment to a patient. This is a system for supplying to a dialysis machine 20 (also referred to as “dialysis monitoring device”).

  The dialysis system 10 includes a reverse osmosis device 12 (hereinafter referred to as “RO device 12”), a dissolution device 14, 16 and a dialysate supply device 18 installed in a machine room, and a dialysis room isolated from the machine room. And a plurality of dialyzers 20 installed in the main body.

  The RO device 12 removes impurities from water using a reverse osmosis membrane (RO membrane), and generates high purity RO water. The generated RO water is supplied to the A agent dissolving device 14, the B agent dissolving device 16, and the dialysate supply device 18 through the water supply lines 22 and 24. In this embodiment, high-purity water is generated using the RO device 12, but other devices may be used as long as high-purity water is obtained.

  The agent A dissolving device 14 and the agent B dissolving device 16 respectively dissolve the corresponding powder dialysis agent with RO water. Here, the agent A is an agent containing an electrolyte component (for example, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, sodium acetate), a pH adjuster (for example, acetic acid), a sugar (for example, glucose) and the like. Moreover, B agent is a chemical | medical agent containing sodium bicarbonate etc. The liquids obtained by dissolving the powder A agent and the powder B agent are supplied to the dialysate supply device 18 through the concentrate supply lines 26 and 28 as the agent A concentrated solution and the agent B concentrated solution, respectively. . The dialysate supply device 18 mixes the agent A concentrated solution, the agent B concentrated solution, and the RO water at a predetermined ratio to generate a dialysate having a predetermined concentration. The generated dialysate is subjected to concentration measurement or the like, if necessary, and then supplied to a plurality of dialyzers 20, and each patient is subjected to dialysis treatment by each dialyzer 20.

  By the way, as already described, in this embodiment, the dialysate is generated by dissolving the powder A agent and the powder B agent, mixing and diluting. The reason for using such powdery (solid) agent A and agent B is to improve transportability and reduce storage space. That is, instead of dissolving the powder A agent and the powder B agent to produce a dialysate, a dialysate is produced by using a liquid A agent (liquid A agent) and a B agent (liquid B agent) in advance. An embodiment is also known. However, since one dialysis of one patient requires 5 liters of liquid A agent and liquid B agent, when using liquid A agent and liquid B agent, a large amount of liquid A agent and liquid B agent are used. Need to be transported and stored. In particular, in facilities such as clinics and hospitals that handle a plurality of patients, the burden of transporting liquid A agent and liquid B agent is large, and a large storage space is required.

  On the other hand, in the case of using the powder A agent and the powder B agent, since it is lighter and smaller than the liquid A agent and the liquid B agent, the burden of transportation is small and the storage space may be small. . On the other hand, if powder A agent and powder B agent are melt | dissolved as needed, the chemical | medical solution (A agent concentrated liquid, B agent concentrated liquid) substantially the same as liquid A agent and liquid B agent will be obtained.

  However, the composition of the A agent concentrated solution in which the powder A agent was dissolved and the liquid A agent were not necessarily the same. For example, the A agent contains glucose as a sugar component, and this glucose has several isomers. About 36% of glucose contained in the liquid A agent is α-glucose (FIG. 9A), and about 64% is β-glucose (FIG. 9B). This is almost the same as the isomer ratio of glucose in the body fluid. On the other hand, in the powder A agent, β-glucose does not exist, and only α-glucose exists. When this powder A agent is dissolved in water, a part of α-glucose is changed to β-glucose. Finally, the same as the liquid A agent, about 36% is α-glucose, about 64%. Becomes an equilibrium state where β becomes glucose. However, it takes some time from the dissolution of the powder A agent to the equilibrium state, although it depends on the liquid temperature. Conventionally, the dialysate was produced by mixing and diluting without considering whether the glucose in the A agent concentrated solution in which the powder A agent was dissolved reached equilibrium. Therefore, the composition of the resulting dialysate (particularly the isomer ratio of glucose) sometimes differs from the composition of the dialysate produced using the liquid A agent or the like.

  Therefore, in the present embodiment, the dialysis system 10 has the same composition as that of the dialysis fluid generated using the powder A agent, so that the A agent is the same as the dialysis fluid generated using the liquid A agent or the like. An adjustment device 50 for adjusting the concentrate or dialysate is incorporated.

  The basic configuration concept and specific configuration of the adjusting device 50 will be described with reference to FIG. FIG. 2 is a diagram illustrating the configuration of the adjustment device 50. First, a basic configuration concept of the adjustment device 50 will be described. The adjustment device 50 is a device that temporarily stores the A-agent concentrated solution or the dialysate generated from the A-agent concentrated solution and adjusts the temperature to a predetermined temperature. In the following, the concentrated solution A or dialysate stored and adjusted by the adjusting device 50 is referred to as “target solution”.

  In order to ensure that the glucose in the dialysate supplied to the dialyzer 20 has reached equilibrium, the time T1 (hereinafter referred to as “waiting”) from when the agent A is dissolved until the dialysate is supplied to the dialyzer 20. The time T1 ”) needs to be equal to or longer than the time T2 until the glucose in the target solution reaches equilibrium (hereinafter referred to as“ equilibration time T2 ”).

  The waiting time T1 is obtained by dividing the storage volume Va of the target liquid by the usage amount Vb of the target liquid per unit time (T1 = Va / Vb). If the waiting time T1 is equal to or greater than the equilibration time T2, that is, Va / Vb ≧ T2, and if Va ≧ T2 * Vb, then when the dialysate is supplied to the dialyzer 20, dialysis is performed. The glucose in the liquid has reached equilibrium. Therefore, in the present embodiment, the adjustment device 50 is provided with a storage unit 52 that stores the target liquid, and the storage capacity Va of the storage unit 52 is set to Va ≧ T2 * Vb. By temporarily storing the target fluid in the reservoir 52, when the dialysate reaches the dialyzer 20, the glucose in the dialysate has reached equilibrium, and the dialysate generated from the liquid A agent It becomes the same composition.

  In addition, the adjusting device 50 of the present embodiment is also provided with a temperature adjustment unit 56 that adjusts the liquid temperature of the agent A concentrated liquid. This is to promote glucose equilibration. According to the applicant's experiment, since the equilibration time T2 becomes shorter as the liquid temperature becomes higher, the equilibration time T2 becomes shorter by increasing the liquid temperature of the agent A concentrated liquid by the temperature adjustment unit 56. As a result, the storage capacity Va of the storage unit 52 can also be reduced. This will be described with reference to FIGS. 3 and 4 are graphs showing the change over time of the abundance ratio of α-glucose and β-glucose in the concentrated agent A solution. FIG. 3 (a) shows the liquid temperature at 20 ° C. and FIG. ) Shows the case where the liquid temperature is kept at 30 ° C., FIG. 4A shows the case where the liquid temperature is kept at 35 ° C., and FIG. 4B shows the case where the liquid temperature is kept at 40 ° C. In each figure, the solid line indicates the abundance ratio of α-glucose, and the broken line indicates the abundance ratio of β-glucose.

In this experiment, the powder A agent was dissolved in RO water at a predetermined temperature (20 ° C., 30 ° C., 35 ° C., 40 ° C.) to prepare a 9 L A agent concentrated liquid and kept at a predetermined temperature. In addition, the glucose concentration in the agent A concentrated solution is 0.035 g / ml, and the pH is about 4.9. Further, in the experiment, the optical rotation and the optical rotation angle are measured every 5 minutes, and the measurement results are applied to the following formulas 1 and 2, and the abundance ratio Y of α-glucose in the concentrated agent A, and The abundance ratio Z of β-glucose is calculated.
Y = (X−B) / (A−B) Formula 1
Z = 100-Y Formula 2

  In Equation 1, X is the measurement result of optical rotation, A is the theoretical optical rotation in the case of 100% α-glucose, B is the theoretical optical rotation in the case of 100% β-glucose, and A, B As the values of A = 112 ° and B = 18.7 °. Further, the optical rotation means the optical rotation when measured at a predetermined temperature using specific monochromatic light. In this experiment, a necessary amount of concentrated agent A at a predetermined temperature is put in a measurement container, and a polarimeter (made by HORIBA: Model SEPA-300) is set at a predetermined temperature, a predetermined concentration, a wavelength sodium D line, a layer length of 100 mm. Under these conditions, the optical rotation and optical rotation angle are measured every 5 minutes. If the optical rotation is 53.2 ° or less, it is determined that glucose has reached equilibrium.

  As shown in FIGS. 3 and 4, the dissolved agent A has a shorter equilibration time T2 as the liquid temperature increases. Specifically, when the liquid temperature is 20 ° C., the equilibration time T2 needs 170 minutes. On the other hand, if the liquid temperature is increased to 30 ° C., 35 ° C., and 40 ° C., the equilibration time T2 is shortened to 50 minutes, 40 minutes, and 25 minutes. That is, according to these experiments, it can be seen that the equilibration time T2 depends on the liquid temperature, and can be shortened as the liquid temperature increases. In particular, if the liquid temperature is 20 ° C. and 30 ° C., the equilibration time T2 is shortened to 1/3 or less, and it can be seen that the shortening effect is great. It can also be seen that if the liquid temperature is 40 ° C., the equilibration time T2 can be significantly suppressed to about 1/7 as compared with the liquid temperature of 20 ° C.

  Next, a specific example is given and the storage capacity Va of the storage part 52 actually required is demonstrated. For example, consider a dialysis system 10 that simultaneously supplies dialysis fluid 500 ml / min to 50 patients. In this case, the usage amount Vb1 of the concentrate A per minute is 715 ml, and the usage amount Vb2 of the dialysate per minute is 25000 ml.

  In such a dialysis system 10, when the agent A concentrated solution is stored at a liquid temperature of 20 ° C., the equilibration time T2 is 170 minutes, and thus the capacity Va of the storage unit 52 needs to be 170 * 715 = 1121550 ml or more. In addition, when the dialysate is stored instead of the concentrated agent A, the capacity Va of the storage unit 52 is required to be 170 * 25000 = 4250,000 ml or more.

  Similarly, when the agent A concentrated liquid is stored at a liquid temperature of 30 ° C., the equilibration time T2 is 50 min. Therefore, the capacity Va of the storage unit 52 is required to be 50 * 715 = 35750 ml or more. Moreover, when storing dialysate instead of the agent A concentrate, the capacity Va of the reservoir 52 is required to be 50 * 25000 = 12500000 ml or more.

  When the agent A concentrated liquid is stored at a liquid temperature of 35 ° C., the equilibration time T2 is 40 min. Therefore, the capacity Va of the storage unit 52 needs to be 40 * 715 = 28600 ml or more. Moreover, when storing dialysate instead of the concentrate of agent A, the capacity Va of the storage unit 52 is required to be 40 * 25000 = 1000000 ml or more.

  When the agent A concentrated liquid is stored at a liquid temperature of 40 ° C., the equilibration time T2 is 25 min. Therefore, the capacity Va of the storage unit 52 is required to be 25 * 715 = 17875 ml or more. Moreover, when storing dialysate instead of the concentrate of agent A, the capacity Va of the reservoir 52 is required to be 25 * 25000 = 625000 ml or more.

  As is clear from the above description, by increasing the temperature of the target liquid, the storage capacity of the storage unit 52 can be kept small, and the size of the storage unit 52 and thus the adjustment device 50 can be significantly reduced. In particular, if the liquid temperature is 30 ° C., the necessary storage capacity Va can be reduced to 1/3 or less compared to the liquid temperature 20 ° C. Further, if the liquid temperature is 40 ° C., the storage capacity can be greatly reduced to about 1/7 compared with the liquid temperature 20 ° C. Therefore, the liquid temperature of the target liquid is not particularly limited, but it is desirable that the target liquid be temperature-controlled within a range of 20 ° C to 100 ° C. In view of the capacity of the reservoir 52, the size reduction of the adjusting device 50, and the stability of the subsequent dialysis fluid, it is more desirable that the target liquid is conditioned in the range of 30 ° C to 40 ° C.

  Next, a specific configuration of the adjusting device 50 will be described with reference to FIG. As described above, the adjustment device 50 includes the storage unit 52 that stores the target liquid (A agent concentrated solution or dialysate) and the temperature control unit 56 that controls the temperature of the target liquid, as well as the confirmation / prediction unit 58, A determination unit 60 and the like are also provided.

  The storage part 52 is a part for temporarily storing the agent A concentrated liquid, and in this embodiment, the storage part 52 is constituted by two storage tanks 54. A water level sensor 62 such as a float switch is provided in the storage tank 54, and when the target liquid stored in the storage tank 54 reaches a specified capacity, the supply of the target liquid is stopped. That is, the target liquid is supplied to each storage tank 54 from the upstream side through the target liquid supply line 72 connected to the upper side thereof. If the water level sensor 62 detects that the water level of the target liquid has reached the specified position, the electrically driven valve 66 provided on the target liquid supply line 72 is closed, and the supply of the target liquid is stopped. Further, a target liquid output line 74 for outputting the target liquid is connected to the bottom of each storage tank 54, and an electrically driven valve 68 and a transfer pump 70 are provided on the target liquid output line 74. It has been. Then, by driving the electrically driven valve 68 and the transfer pump 70, the target liquid stored in the storage tank 54 is output downstream.

  The capacity of each storage tank 54 is equal to or greater than the value (Va / N) obtained by dividing the storage capacity Va required for the entire storage section 52 by the number N of storage tanks 54 (N = 2 in this embodiment). Thus, when the storage part 52 is comprised with the several storage tank 54, the new target liquid which has not progressed equilibration is supplied to the storage tank 54 different from the storage tank 54 in which the output of the target liquid was permitted. . By adopting such a configuration, it is possible to prevent mixing of the target liquid that has been stored and has been equilibrated with the target liquid that has been newly supplied from the upstream side and has not been equilibrated. As a result, the target liquid that has not reached equilibrium is prevented from being output downstream.

  A temperature adjustment unit 56 is provided around the storage unit 52. The temperature adjustment unit 56 raises, maintains, and in some cases cools the target liquid stored in the storage unit 52 to a predetermined temperature, and includes a temperature raising unit, a maintaining unit, a cooling unit, and the like. By this temperature control unit 56, the target liquid stored in the storage unit 52 is continuously maintained at a temperature specified in the range of 20 ° C to 100 ° C, and is cooled as necessary.

  As the temperature raising means, a mechanism capable of heating the target liquid, for example, a heating mechanism using an electric heater, hot water, steam, microwave, or the like can be used. In addition, examples of the maintaining means include a heat insulating chamber that covers the entire storage tank 54, PID operation control that controls driving of the heating mechanism, ON / OFF operation control, proportional operation control, integral operation control, differential operation control mechanism, and the like. . As the cooling means, a cooling mechanism such as a water cooling method such as cold water, an air cooling method such as natural air cooling and forced air cooling, a gas cooling method using a refrigerant gas, or the like can be used.

  In the temperature adjustment unit 56, the temperature of the target liquid is increased, whereby the glucose equilibration can be promoted, and consequently the necessary capacity of the storage unit 52 can be reduced. In addition, the target liquid is cooled in the temperature control unit 56 in order to suppress the generation of carbon dioxide gas and to set the target liquid to a temperature equivalent to that of the body fluid. That is, when the target liquid is the A agent concentrated liquid, the A agent concentrated liquid (target liquid) is mixed with the B agent concentrated liquid on the downstream side of the adjustment device 50. At this time, if the A agent concentrated liquid (target liquid) is at a high temperature, the decomposability of sodium hydrogen carbonate, which is a component of the B agent concentrated liquid, increases, and carbon dioxide gas may be generated. Therefore, it is desirable that the agent A concentrated liquid is cooled to about room temperature before mixing with the agent B concentrated liquid. When the target liquid is a dialysate, the dialysate (target liquid) is supplied to the dialyzer 20 on the downstream side of the adjustment device 50. At the time of supply, it is desirable that the temperature of the dialysate is equivalent to the body temperature. Therefore, the dialysate is preferably cooled to the body temperature before being supplied to the dialyzer 20.

  The confirmation / prediction unit 58 is a part that determines or predicts in real time whether or not the target liquid stored in each storage tank 54 has reached equilibrium. The confirmation / prediction unit 58 includes, for example, optical rotation measurement, NMR spectrum measurement, Raman spectrum measurement, gas chromatography, high performance liquid chromatography, enzyme electrode method such as GOD method, GDH method, HX method, GOD / POD method, etc. A detector using the enzyme colorimetric method or the like is provided, and it is determined whether or not it is in an equilibrium state from the detection result of the detector. In addition, the confirmation / prediction unit 58 does not clearly determine whether or not the state is in an equilibrium state. For example, the confirmation / prediction unit 58 includes a sensor that detects the temperature of the target liquid that is stored, and a timer that measures the storage time. In addition, it may be predicted from the measurement time whether or not the target liquid stored has reached equilibrium. In FIG. 2, the confirmation / prediction unit 58 is arranged in the storage tank 54, but some components of the confirmation / prediction unit 58 such as a timer may be provided outside the storage tank 54. Good. In any case, the confirmation result in the confirmation / prediction unit 58 is sent to the determination unit 60.

  Based on the confirmation / prediction result detected in real time by the confirmation / prediction unit 58, the determination unit 60 determines whether the target liquid has reached equilibrium for each storage tank 54. When it is determined that the equilibrium is reached, the determination unit 60 transmits a signal that allows the output of the target liquid to the drive source of the electrically driven valve 68 and the transfer pump 70 corresponding to the determined storage tank 54. When receiving this signal, the electrically driven valve 68 and the transfer pump 70 output the target liquid to the downstream side as necessary, as usual. On the other hand, when determining that the equilibrium has not been reached, the determination unit 60 sends an error signal to the drive source of the electrically driven valve 68 and the transfer pump 70 corresponding to the determined storage tank 54. When this error signal is received, the electrically driven valve 68 and the transfer pump 70 do not output the target liquid.

  In the present embodiment, since the two storage tanks 54 are provided, even if the target liquid in one storage tank 54 is unbalanced and the target liquid cannot be output from the one storage tank 54, the other storage tank 54 If the target liquid has reached equilibrium in 54, there is no problem because the target liquid can be output from the other storage tank 54. However, when none of the two storage tanks 54 has reached equilibrium, or when there is only one storage tank 54 and the equilibrium has not been reached in the one storage tank 54, the target liquid is not at all. It becomes a problem because it cannot output. Therefore, in such a case, the determination unit 60 temporarily outputs the target liquid while outputting an instruction to increase the temperature rise to the temperature adjustment unit 56 in order to promote equilibration, An alarm or the like may be sounded to prompt the operator to inspect the system.

  As described above, by providing the dialysis system 10 with the adjusting device 50 having the storage unit 52 having a sufficient capacity, the glucose in the dialysate has reached equilibrium when supplied to the dialysis device 20, and is liquid. A dialysis fluid having the same composition as the dialysis fluid produced using agent A is obtained. Moreover, it can prevent that the storage part 52 and by extension, the adjustment apparatus 50 become large too much by providing the temperature control part 56 which temperature-controls the target liquid stored in the storage part 52. FIG. Further, since the temperature of the target liquid is positively adjusted using the heating mechanism, it is difficult to be affected by the external environment temperature, and the glucose equilibration can be stably advanced.

  The adjusting device 50 as described above may be incorporated in the agent A dissolving device 14 or the dialysate supply device 18, or may be incorporated in the dialysis system 10 as an individual device independent of these devices. For example, FIG. 5 is a configuration diagram of the agent A dissolving device 14 in which the adjusting device 50 is incorporated.

  As described above, the agent A dissolving apparatus 14 is an apparatus that dissolves the powder A agent with RO water to generate an agent A concentrated liquid. The agent A dissolving device 14 incorporating the adjusting device 50 includes an agent A dissolving tank 32 and an adjusting device 50 connected to the agent A dissolving tank 32. The agent A dissolution tank 32 is a tank for dissolving the powder A agent, and is connected to the RO device 12 via the water supply line 24. The agent A dissolution tank 32 is provided with a water level sensor 34 such as a float switch, a stirring device (not shown), and the like. A predetermined volume of the powder A agent and RO water are charged into the A agent dissolution tank 32 and stirred, whereby a solution of the powder A agent, that is, a concentrated agent A is generated. The produced A agent concentrated liquid is transferred to the storage tank 54 of the adjusting device 50 by the transfer pump 36 through the A agent concentrated liquid supply line 26 a connected to the bottom of the A agent dissolving apparatus 14. The adjusting device 50 stores and adjusts the temperature of the transferred agent A concentrated liquid as a target liquid in the storage unit 52 until glucose reaches equilibrium.

  The existing A agent dissolving apparatus 14, that is, the A agent dissolving apparatus 14 in which the adjusting device 50 is not incorporated, is also provided with an A agent concentrated liquid storage tank for temporarily storing the A agent concentrated liquid. However, the agent A concentrated liquid storage tank in the conventional agent A dissolving apparatus 14 does not take into consideration any equilibrium of glucose, and has insufficient capacity to store glucose until equilibrium is reached. There was no function to adjust the temperature of the concentrated solution A for promoting the conversion. Instead of the agent A concentrated liquid storage tank, an adjusting device 50 capable of storing and adjusting the temperature of the agent A concentrated liquid having a sufficient capacity is provided, so that glucose is generated from the dialysate that has reached equilibrium, that is, the liquid A agent. A dialysate having the same composition as the dialysate can be supplied to the dialyzer. Moreover, since the adjusting device 50 is provided instead of separately providing the adjusting device 50 instead of the agent A concentrated liquid storage tank that originally existed, the size increase of the entire dialysis system 10 can be suppressed to a relatively small size. .

  Further, the adjusting device 50 may be incorporated in the dialysate supply device 18. FIG. 6 is a diagram illustrating an example of the dialysate supply device 18 in which the adjustment device 50 is incorporated. The dialysate supply device 18 is a device that mixes agent A concentrate, agent B concentrate, and RO water at a predetermined ratio to generate a dialysate and supplies the dialysate 20 to the dialysate 20. The dialysate supply device 18 is connected to a water supply line 22 provided with a water measuring device 38 for measuring the amount of water while RO water flows, and a metering pump 42 and is connected to an A agent concentrate. A liquid supply line 26 and a metering pump 40 are connected, and a B agent concentrated liquid supply line 28 through which the B agent concentrated liquid flows, a dialysate storage tank 44, a liquid feed pump 48, and the like are provided. The agent A concentrated liquid supply line 26 and the agent B concentrated liquid supply line 28 finally communicate with the water supply line 22. After the RO water in the water supply line 22 passes through the water meter 38, it is mixed with the agent A concentrated solution and the agent B concentrated solution at a predetermined ratio, thereby generating a dialysate having a predetermined concentration. The generated dialysate is temporarily stored in the dialysate storage tank 44.

  The dialysate storage tank 44 is provided with water level sensors 46h and 46L such as float switches, and it is possible to detect that the dialysate level in the dialysate storage tank 44 has reached the upper limit or the lower limit. The dialysate storage tank 44 is configured to separate and remove gas and the like generated from the dialysate (not shown), and the dialysate from which the gas and the like has been separated and removed is driven by a feed pump 48. It is supplied to each dialysis machine 20 via the dialysate supply line 30.

  When the adjustment device 50 is incorporated in the dialysate supply device 18, it may be disposed on the agent A concentrated solution supply line 26 as shown in FIG. In this case, the adjustment device 50 stores and adjusts the temperature in the storage unit 52 until the glucose reaches equilibrium, with the agent A concentrated solution flowing through the agent A concentrated solution supply line 26 as the target solution. As a result, the dialysate in which glucose has reached equilibrium is supplied to the dialyzer 20.

  FIG. 7 is a view showing another example of the dialysate supply device 18 in which the adjustment device 50 is incorporated. In the dialysate supply device 18, an adjustment device 50 is provided instead of the dialysate storage tank 44. In this case, the adjustment device 50 stores and adjusts the temperature in the storage unit 52 until the glucose reaches equilibrium, using the dialysate obtained by mixing and diluting the agent A concentrated solution and the agent B concentrated solution as the target solution. Therefore, in this case, the storage unit 52 of the adjustment device 50 also functions as the dialysate storage tank 44. Thus, the dialysate in which glucose has reached equilibrium can be supplied to the dialyzer 20.

  In addition, when supplying the dialysate 20 to the dialysate 20, the dialysate needs to be adjusted to the body temperature. In order to promote glucose equilibration, the temperature of the dialysate or the concentrated concentrate of agent A is hardly required, so that there is almost no need for additional heating. As a result, it is possible to reduce the power consumption required for adjusting the temperature to the body temperature. In particular, when the adjustment device 50 is provided instead of the dialysate storage tank 44 (in the case of FIG. 7), the temperature adjustment unit 56 of the dialyzer adjusts the temperature for promoting glucose equilibration and adjusting the temperature to match the body temperature. Since both can be performed, a temperature raising mechanism or the like can be simplified separately for temperature adjustment to match the body temperature. Further, when the adjusting device 50 is provided on the agent A concentrated solution supply line 26 (in the case of FIG. 6), the adjusting device 50 stores and adjusts the temperature of the agent A concentrated solution before being diluted and mixed. Compared with the case where the adjustment device 50 is provided instead of the storage tank 44 (in the case of FIG. 7), the capacity of the storage unit 52 can be reduced, and consequently the size of the adjustment device 50 can be reduced.

  In the description so far, the example in which the adjusting device 50 is incorporated into the existing devices (the agent A dissolving device 14 and the dialysate supply device 18) has been described. However, the adjusting device 50 is incorporated into the dialysis system 10 as an independent device. May be. That is, as shown in FIG. 8, the adjusting device 50 may be provided on the piping line of the agent A dissolving device 14 and the dialysate supply device 18, that is, on the agent A concentrated solution supply line 26. In this case, the adjustment device 50 stores and adjusts the temperature in the storage unit 52 until the glucose reaches equilibrium, using the agent A concentrated solution output from the agent A dissolving device 14 as a target solution. Thereby, it can prevent effectively that the dialysate with which glucose is unbalanced is supplied to a dialyzer. In this case, the adjustment device 50 is not incorporated into another device, but is configured as an independent device. Therefore, in a facility that already has the existing agent A dissolving device 14 and dialysate supply device 18, the adjustment device 50 can be incorporated into the dialysis system 10 without changing or replacing these devices. The cost of introduction can be reduced.

  Moreover, in the example mentioned so far, in the adjustment apparatus 50, not only the target liquid which is an A agent concentrated liquid or a dialysis liquid was stored, but temperature control was also performed. However, the temperature adjustment unit 56 may be omitted if the storage capacity in the storage unit 52 is sufficiently large and the target liquid is allowed to wait for a sufficient time until the glucose reaches equilibrium. Not only the temperature adjustment unit 56 but also the confirmation / prediction unit 58 and the determination unit 60 may be omitted as appropriate. In addition, the temperature adjustment unit 56 may heat the target liquid at another position instead of heating the target liquid stored in the storage unit 52. For example, the temperature control unit 56 may be configured to heat RO water supplied to the agent A dissolving device 14 in order to dissolve the powder agent A. In this case, since powder A agent is melt | dissolved with relatively high temperature RO water, the obtained agent A concentrated liquid also becomes comparatively high temperature. As a result, the equilibration of glucose is promoted, and as a result, the time required to reach the equilibrium is shortened, so that the capacity required for the reservoir 52 can be reduced.

In the examples so far, the storage capacity Va of the storage unit 52 of the adjustment device 50 is set to Va ≧ T2 * Vb (T2 is the equilibration time, and Vb is the amount of the target liquid used per unit time). However, the storage capacity Va of the storage section 52 may be less than T2 * Vb by the storage capacity of the target liquid other than the storage section 52. Specifically, in the dialysis system 10, in addition to the storage unit 52 of the adjustment device 50, there is a part that stores the target liquid that is the agent A concentrated liquid or the dialysis liquid. For example, the target solution is also applied to the agent A concentrated solution storage tank of the agent A dissolving apparatus 14 (without the adjustment device 50 incorporated), the dialysate storage tank 44 of the dialysate supply apparatus 18, and the piping lines 26 and 30 connecting the respective apparatuses. Stays temporarily and glucose equilibration proceeds. In order to make the glucose of the dialysate supplied to the dialyzer 20 reach an equilibrium state, the storage capacity V _other in the storage part of the target liquid other than the storage part 52 and the capacity Va of the storage part 52 are added. The storage volume V _all of the target liquid in the entire dialysis system 10 may be T2 * Vb or more (V _all = (Va + V _other ) ≧ T2 * Vb). Therefore, to be exact, the storage capacity Va of the storage unit 52 may be Va ≧ T2 * Vb−V _other .

  In any case, by providing the reservoir 52 having a capacity such that the time T1 from when the agent A is dissolved to the time when it is supplied to the dialyzer is equal to or longer than the time T2 until the glucose reaches equilibrium, It is effectively prevented that unbalanced dialysate is supplied to the dialyzer.

  DESCRIPTION OF SYMBOLS 10 Dialysis system, 12 RO apparatus, 14 A agent dissolution apparatus, 16 B agent dissolution apparatus, 18 Dialysate supply apparatus, 20 Dialysis apparatus, 22, 24 Water supply line, 26 A agent concentrated liquid supply line, 28 B agent concentrated liquid Supply line, 30 Dialysate supply line, 32A agent dissolution tank, 34,62 Water level sensor, 36,70 Transfer pump, 38 Water meter, 40,42 Metering pump, 44 Dialysate storage tank, 48 Feed pump, 50 Adjustment Device, 52 storage section, 54 storage tank, 56 temperature control section, 58 confirmation / prediction section, 60 determination section, 66, 68 electrically driven valve, 72 target liquid supply line, 74 target liquid output line.

Claims (7)

In a dialysis system in which a powder dialysis agent containing a sugar component is dissolved and diluted and supplied to one or more dialysis machines for performing dialysis treatment on a patient.
It has a reservoir for temporarily storing a target liquid which is a concentrated liquid obtained by dissolving the powder dialysis agent or a dialysate obtained by mixing the concentrated liquid with at least dilution water,
The storage capacity of the reservoir reaches an equilibrium where the isomer ratio of the sugar component is constant after the powder dialysis agent is dissolved and supplied to the dialysis machine via the reservoir. Ri capacity der that equal to or greater than the equilibrium time of up to,
Furthermore, a confirmation / prediction means for confirming or predicting whether or not the target liquid stored in the storage unit has reached equilibrium is provided,
Only the target liquid that is predicted to have reached the equilibrium is output from the reservoir.
A dialysis system characterized by that. The dialysis system according to claim 1, further comprising:
A dialysis system comprising temperature control means for adjusting the temperature of the target liquid to a temperature that promotes equilibration of the sugar component. A dialysis system according to claim 2,
The dialysis system characterized in that the temperature control means warms the target liquid stored in the storage section to a temperature that promotes equilibration of the sugar component. The dialysis system according to any one of claims 1 to 3 ,
The storage unit includes a plurality of storage tanks,
A dialysis system, wherein a new target liquid is supplied to and stored in a storage tank different from the storage tank in which the output of the target liquid is permitted among the plurality of storage tanks. A dissolving device for dissolving a powder dialysis agent containing a sugar component to produce a concentrated liquid; and for mixing the concentrated liquid with at least diluting water to produce a dialysate and performing dialysis treatment on the patient with the dialysate A supply device that feeds one or more dialysis machines, and an adjustment device incorporated in a dialysis system connected by piping,
It has a reservoir for temporarily storing a target liquid which is a concentrated liquid obtained by dissolving the powder dialysis agent or a dialysate obtained by mixing the concentrated liquid with at least dilution water,
The storage capacity of the reservoir reaches an equilibrium where the isomer ratio of the sugar component is constant after the powder dialysis agent is dissolved and supplied to the dialysis machine via the reservoir. Ri capacity der that equal to or greater than the equilibrium time of up to,
Furthermore, a confirmation / prediction means for confirming or predicting whether or not the target liquid stored in the storage unit has reached equilibrium is provided,
Only the target liquid that is predicted to have reached the equilibrium is output from the reservoir.
An adjusting device characterized by that. An adjustment method for adjusting the components of a dialysis fluid used in a dialysis system for dissolving and diluting a powder dialysis agent containing a sugar component and supplying it to one or more dialysis machines for performing dialysis treatment on a patient,
A step of temporarily storing in the reservoir a target liquid that is a concentrated liquid obtained by dissolving the powder dialysis agent or a dialysis liquid obtained by mixing the concentrated liquid with at least dilution water;
The storage capacity of the reservoir reaches an equilibrium where the isomer ratio of the sugar component is constant after the powder dialysis agent is dissolved and supplied to the dialysis machine via the reservoir. Ri capacity der that equal to or greater than the equilibrium time of up to,
Furthermore, a confirmation / prediction step for confirming or predicting whether the target liquid stored in the storage unit has reached equilibrium;
Outputting only the target liquid that is predicted to have reached the equilibrium from the reservoir;
Comprising
An adjustment method characterized by that. The adjustment method according to claim 6 , further comprising:
An adjustment method comprising adjusting the temperature of the target liquid to a temperature that promotes equilibration of the sugar component.

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