JPH11137672A - Method for recovering and regenerating peritoneal dialyzane and apparatus therefor - Google Patents

Method for recovering and regenerating peritoneal dialyzane and apparatus therefor

Info

Publication number
JPH11137672A
JPH11137672A JP9302388A JP30238897A JPH11137672A JP H11137672 A JPH11137672 A JP H11137672A JP 9302388 A JP9302388 A JP 9302388A JP 30238897 A JP30238897 A JP 30238897A JP H11137672 A JPH11137672 A JP H11137672A
Authority
JP
Japan
Prior art keywords
solution
molecular weight
solute
peritoneal
dialysate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP9302388A
Other languages
Japanese (ja)
Inventor
Shingo Takezawa
真吾 竹沢
Kazuo Kumano
和雄 熊野
Akira Sakai
旭 酒井
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ASA SANGYO KK
Original Assignee
ASA SANGYO KK
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by ASA SANGYO KK filed Critical ASA SANGYO KK
Priority to JP9302388A priority Critical patent/JPH11137672A/en
Publication of JPH11137672A publication Critical patent/JPH11137672A/en
Pending legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/282Operational modes
    • A61M1/284Continuous flow peritoneal dialysis [CFPD]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1694Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
    • A61M1/1696Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid with dialysate regeneration

Landscapes

  • Health & Medical Sciences (AREA)
  • Urology & Nephrology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Emergency Medicine (AREA)
  • Anesthesiology (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

PROBLEM TO BE SOLVED: To prevent the side effect by glucose and to easily regenerate a waste peritoneal dialyzate of a renal function insufficiency patient by obtaining the state of a thick suspension from the high-polymer solute soln. obtd. from the waste dialyzate, redissolving this suspension to obtain a high-cocn. soln. and mixing electrolyte salts therewith, thereby regenerating the dialyzate. SOLUTION: The waste dialyzate discharged from the patient's abdominal cavity 1 is subjected to sepn. and filtratio of solid foreign matter by primary and secondary filters 7, 8 from a waste liquid catheter 2. A low-polymer material is removed by using a semi-permeable membrane and the high-polymer solute soln. is concd. at a concentrating column 12. Part of the solute is deposited by a deposition device 14. The dialyzate concentrated after separating the excess solvent is preserved in the state of the thick suspension in a suspension storage tank 17. The preserved thick suspension is redissolved in a redissolving vessel 18 when in use and thereafter the respective electrolytic salts ought to be included in the regenerated dialyzate are added to the suspension and are mixed therewith from an electrolyte salt storage tank 22 so as to attain a prescribed concn. in a concn. adjusting tank 21. The regenerated dialyzate is heated up to the body temp. and is injected into the abdominal cavity by a catheter 27 to be exclusively used for injection.

Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【0001】[0001]

【発明の属する技術分野】本発明は腎機能不全患者に対
する慢性透析治療法の一つである腹膜透析における腹膜
透析液回収・再生方法及び装置に関する。更に詳しくは
腹膜透析に用いる透析液の成分のグルコースによる副作
用を改善する目的で改良した回収・再生方法及び装置に
関する。
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method and an apparatus for collecting and regenerating a peritoneal dialysate in peritoneal dialysis, which is one of chronic dialysis treatment methods for renal insufficiency patients. More specifically, the present invention relates to a method and apparatus for recovering and regenerating a dialysate used for peritoneal dialysis, which is improved for the purpose of improving the side effects of glucose.

【0002】[0002]

【従来の技術】腎不全疾患の患者に対する有効な治療法
の一つとして腹膜透析法がある。腹膜透析法において
は、腎不全患者の腹腔内へカテーテルを留置し、これを
通じ透析液バッグより腹膜透析液を腹腔内へ注入し、一
定時間貯留した後、同カテーテルを通じ体外へ排出する
操作を一日数回繰り返す。
2. Description of the Related Art Peritoneal dialysis is one of effective treatments for patients with renal failure. In the peritoneal dialysis method, a catheter is placed in the peritoneal cavity of a patient with renal insufficiency, peritoneal dialysate is infused into the peritoneal cavity from the dialysate bag through the peritoneal cavity, stored for a certain period of time, and then discharged out of the body through the catheter. Repeat several times a day.

【0003】この腹膜透析法は常時連続的に、腹膜とい
う生体膜を通して血液浄化ができるので、人工膜による
透析よりも生理的にすぐれ、患者の社会活動も可能にな
るという利点があり、広く用いられている。
[0003] This peritoneal dialysis method has the advantage that it is always physiologically superior to dialysis using an artificial membrane because it enables blood purification through a biological membrane called the peritoneum, and that it enables the social activities of patients. Have been.

【0004】余剰の水分を体外に排出する際、血液を体
外循環して半透膜を用いて透析する血液透析と異なり、
腹膜透析においては、血液回路と透析液回路の間に圧力
差を与えることができないため、透析液に浸透圧を高め
る溶質を加え体液より高い浸透圧の透析液を腹腔内へ注
入し、腹膜へ接触させる事により限外濾過を促進させ体
内の余剰な水分を除去している。従来この目的のため、
溶質としてグルコースが用いられて来たが、数年以上も
長期間腹膜透析を続けた患者の多くに腹膜機能不全、特
に除水不全の症状が認められ、これはグルコースの大量
体内吸収がその原因と見做されている。
When excess water is discharged outside the body, unlike hemodialysis, in which blood is circulated extracorporeally and dialyzed using a semipermeable membrane,
In peritoneal dialysis, since a pressure difference cannot be given between the blood circuit and the dialysate circuit, a solute that increases the osmotic pressure is added to the dialysate, and a dialysate having a higher osmotic pressure than the body fluid is injected into the peritoneal cavity, and the peritoneal dialysis is performed. The contact promotes ultrafiltration and removes excess water in the body. Traditionally for this purpose,
Glucose has been used as a solute, but many patients who have been on peritoneal dialysis for many years or more have symptoms of peritoneal insufficiency, especially inadequate water removal, which is caused by massive absorption of glucose in the body. Is considered to be.

【0005】そのためアミノ酸、グルコースポリマー等
多くの代替浸透圧剤が研究されて来たが生体内代謝系へ
の影響やアシドーシス、高マルトース血症等の問題が懸
念され、まだ本格的に用いられていない。
For this reason, many alternative osmotic agents such as amino acids and glucose polymers have been studied, but there are concerns about their effects on metabolic systems in the living body and problems such as acidosis and hypermaltosis, and they are still being used in earnest. Absent.

【0006】上記の問題を解決するために本発明の発明
者はグルコースの代替として、アルブミン、グロブリン
等、最も生理的に安全な血漿蛋白を用いてこの問題を解
決すべく、透析患者の体内から腹膜を通って透析液内へ
浸み出てきた血漿蛋白を回収・精製し高濃度溶液として
再使用する方法及び装置を提案した。すなわち半透膜を
用いて、特定の条件で透析液の濃縮を行い、ついでこれ
に水または電解質溶液を添加して希釈し、この工程を繰
り返し、最終回の再生液組成を所定の水準に調整する方
法である(特願平8−150930)。
[0006] In order to solve the above problems, the present inventor tried to solve this problem by using the most physiologically safe plasma proteins such as albumin and globulin as a substitute for glucose. A method and apparatus for recovering and purifying plasma proteins that have permeated into the dialysate through the peritoneum and reusing them as a high-concentration solution were proposed. That is, using a semi-permeable membrane, the dialysate is concentrated under specific conditions, and then water or an electrolyte solution is added to dilute the dialysate, and this process is repeated to adjust the final regenerating solution composition to a predetermined level. (Japanese Patent Application No. 8-150930).

【0007】[0007]

【発明が解決しようとする課題】しかしながら、前記発
明においても (1)半透膜による濃縮で得られる濃度の上限から高浸
透圧液の調製が困難な場合がある。 (2)長期間保存している間の蛋白変性を最小限に抑え
る必要がある。 (3)回路の接続箇所が多く、取りはずす際の細菌の侵
入する機会が多い。 (4)排液中のフィブリノーゲンがプレフィルター透過
後も引き続きフィブリンを析出させ、濃縮膜の目詰まり
を起こす。 (5)細菌、ウイルスを除去あるいは不活性化する必要
がある。 等の問題が残されていた。
However, even in the above invention, (1) it may be difficult to prepare a high osmotic pressure liquid from the upper limit of the concentration obtained by concentration using a semipermeable membrane. (2) It is necessary to minimize protein denaturation during long-term storage. (3) There are many connection points of the circuit, and there are many opportunities for bacteria to enter when removing. (4) The fibrinogen in the drainage continues to precipitate fibrin even after passing through the pre-filter, causing clogging of the concentrated membrane. (5) It is necessary to remove or inactivate bacteria and viruses. And other problems remained.

【0008】[0008]

【課題を解決するための手段】そこで本発明の発明者ら
は、前記発明を更に改良し、下記の手段を講ずることに
より上記問題点を解決することができることを見出し、
本発明を完成した。 (1)必要に応じて半透膜により濃縮・希釈を少なくと
も1回以上行い、低分子量の尿毒素の大部分を分離精製
した後、最終回の濃縮液から蛋白等の高分子量溶質成分
を析出させ、て濃厚な懸濁液状とし、使用前に再溶解
し、高濃度蛋白溶液を得る。 (2)または上記濃縮・希釈工程で得られた濃縮液を冷
却し、溶媒の一部を凍結させ、残りの母液を凍結分画と
分離し、該母液に電解質塩を添加し、透析液を再生する (3)細菌、ウイルスの侵入を阻止するフィルターを使
用し、これらを死滅させるための厳しい環境条件を設定
することを必ずしも必要としないで、緩和な条件で保存
することを可能とする。併せて低温化により蛋白の分解
を抑制する。さらに安定剤を添加し分解を防止する。 (4)回路、バッグ、側鎖の一体化を行い、包装滅菌し
て装置を出荷することにより取りはずす個所を最小限に
減少させる。 (5)プレフィルターで固形異物を濾別する前に、フィ
ブリノーゲン凝固剤を加え、プレフィルターで除去す
る。
The inventors of the present invention have found that the above problems can be solved by further improving the above-mentioned invention and taking the following measures.
The present invention has been completed. (1) Concentration / dilution is performed at least once using a semi-permeable membrane, if necessary, to separate and purify most of the low molecular weight urexin, and then to precipitate high molecular weight solute components such as proteins from the final concentrate. To make a thick suspension, and redissolve before use to obtain a high concentration protein solution. (2) Alternatively, the concentrated solution obtained in the above concentration / dilution step is cooled, a part of the solvent is frozen, the remaining mother solution is separated from the frozen fraction, an electrolyte salt is added to the mother solution, and the dialysate is diluted. Regenerate (3) It is possible to use a filter for preventing the invasion of bacteria and viruses, and it is not always necessary to set harsh environmental conditions for killing them, but it is possible to store them under mild conditions. In addition, the degradation of protein is suppressed by lowering the temperature. Further, a stabilizer is added to prevent decomposition. (4) The circuits, bags, and side chains are integrated, and the number of parts to be removed is reduced to a minimum by shipping the device after packaging and sterilizing it. (5) Before the solid foreign matter is filtered off by the prefilter, a fibrinogen coagulant is added and removed by the prefilter.

【0009】すなわち本発明の第1の発明は、腎機能不
全患者の腹膜透析排液より、(1)固形異物を濾別、分
離し、(2)得られた高分子量溶質溶液より溶質の一部
を析出させて濃厚懸濁液の状態とし、(3)該懸濁液を
再溶解して該高分子量溶質の高濃度溶液とし、(4)電
解質塩を混合し、透析液を再生することを特徴とする腹
膜透析液回収・再生方法であり、また第2の発明は、腎
機能不全患者の腹膜透析排液より、(1)固形異物を濾
別、分離し、(2)得られた高分子量溶質溶液を半透膜
を用いて低分子量物質を除去するとともに高分子量溶質
を濃縮し、(3)該濃縮液を冷却し、溶媒の一部を凍結
させ、(4)残りの母液を凍結分画と分離し、(5)該
母液に電解質塩を添加し、透析液を再生することを特徴
とする腹膜透析液回収・再生方法である。また本発明は
上記腹膜透析液回収・再生方法を実施するための装置で
ある。
That is, the first invention of the present invention provides (1) filtering and separating solid foreign matter from peritoneal dialysis effluent of a patient with renal insufficiency, and (2) one solute from the obtained high molecular weight solute solution. (3) redissolving the suspension to form a high-concentration solution of the high-molecular-weight solute; (4) mixing an electrolyte salt to regenerate the dialysate. The second invention is a method for collecting and regenerating a peritoneal dialysis solution, characterized in that (1) solid foreign substances are separated and filtered from peritoneal dialysis effluent of a patient with renal insufficiency, and (2) obtained. The high molecular weight solute solution is removed using a semipermeable membrane to remove low molecular weight substances and the high molecular weight solute is concentrated. (3) The concentrated solution is cooled, a part of the solvent is frozen, and (4) the remaining mother liquor is removed. (5) a peritoneal dialysis solution characterized by adding an electrolyte salt to the mother liquor and regenerating the dialysis solution It is a collection and reproduction method. The present invention is also an apparatus for performing the above-mentioned method for collecting and regenerating peritoneal dialysate.

【0010】[0010]

【発明の実施の態様】本発明方法を図1により説明す
る。図1において、排液カテーテル2及び注入カテーテ
ル27が腹腔1に貯留され、注入カテーテルより腹膜透
析液が腹腔内に注入、貯留される。
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The method of the present invention will be described with reference to FIG. In FIG. 1, a drainage catheter 2 and an infusion catheter 27 are stored in the abdominal cavity 1, and a peritoneal dialysate is infused and stored in the abdominal cavity from the infusion catheter.

【0011】腹膜透析液を数時間腹腔内に貯溜すると尿
素、クレアチニン等尿毒素の他にアルブミン等高分子量
の血漿蛋白も腹膜を通って滲出して来る。本発明におい
てはこの血漿蛋白を濃縮・精製して浸透圧剤として利用
するのであるが、その量は個々の患者の腹膜の溶質透過
能により可成り差があるが、約5から15グラム/日程
度であるので、2乃至3ケ月従来通りの透析液で透析を
続けその排液を回収すれば300から1,500グラム
の血漿蛋白が蓄積される。
When the peritoneal dialysate is stored in the peritoneal cavity for several hours, high-molecular-weight plasma proteins such as albumin in addition to urea toxins such as urea and creatinine exude through the peritoneum. In the present invention, this plasma protein is concentrated and purified and used as an osmotic agent. The amount varies depending on the solute permeation capacity of the peritoneum of each patient, but is about 5 to 15 g / day. If the dialysis is continued with a conventional dialysate for two to three months and the drainage is collected, 300 to 1,500 grams of plasma protein will be accumulated.

【0012】排液カテーテル2は逆止弁3、接続部4を
介してプレフィルターと接続している。患者の腹腔内か
ら排出された透析排液中には析出したフイブリン、腹膜
中皮細胞白血球等が含まれているのでプレフイルターに
よりこれら固形異物を分離濾別する。プレフィルターは
一次フィルター7、二次フィルター8からなる。
The drainage catheter 2 is connected to a pre-filter via a check valve 3 and a connection portion 4. The dialysis effluent discharged from the patient's abdominal cavity contains precipitated fibrin, peritoneal mesothelial cell leukocytes, etc., and these solid foreign substances are separated and filtered by a prefilter. The pre-filter comprises a primary filter 7 and a secondary filter 8.

【0013】先ず排液を一次フイルター(孔径:200
ミクロン)及び二次フイルター(孔径5ミクロン)を通
し細胞、フイブリン等固形異物を除く。これらは目詰ま
りを起すので頻回交換する事を原則とする。
First, the drainage liquid is supplied to a primary filter (pore diameter: 200).
Micron) and a secondary filter (pore size 5 micron) to remove solid foreign substances such as cells and fibrin. Since these may cause clogging, they should be replaced frequently.

【0014】しかし排液中にはフィブリンの他にフィブ
リノーゲンが含まれており、これはプレフィルターを透
過し、透過後引き続きフィブリンを析出させ、濃縮膜の
目詰まりを起こすので、プレフィルターを通す前にフィ
ブリノーゲン凝固器5において腹膜透析排液にフィブリ
ノーゲン凝固物質を添加した後、固形異物を濾別、分離
するのが好ましい。フィブリノーゲン凝固物質としては
トロンビン及びカルシウムイオン等を用いることができ
る。
However, the drainage contains fibrinogen in addition to fibrin, which permeates through the prefilter, deposits fibrin continuously after permeation, and causes clogging of the concentrated membrane. It is preferable to add a fibrinogen coagulation substance to the peritoneal dialysis effluent in a fibrinogen coagulator 5 and then filter and separate solid foreign matter. Thrombin and calcium ions can be used as the fibrinogen coagulation substance.

【0015】排液を排液カテーテルから、各装置ユニッ
トを経て注入カテーテル27に送るには送液ポンプ(図
示せず)を用いる。送液ポンプは各所に多数配置されて
いる。
A liquid pump (not shown) is used to send drainage from the drainage catheter to the infusion catheter 27 via each device unit. A number of liquid feed pumps are arranged at various places.

【0016】 固形異物を濾別、分離した後、細菌及び
ウイルスの侵入を阻止する無菌フィルター10、ウイル
ス阻止フィルター11を設け、これを透過させることが
望ましい。このようなフィルターを設けることにより、
これらを死滅させるため、透析液回路を厳しい条件に設
定しなくても済むので、温和な条件で保存することがで
きる。また低温にすることにより蛋白の分解を抑制する
ことができる。これらのフィルターは、最大口径が細菌
用として100〜300ナノメーター、ウイルス用とし
て10〜100ナノメーターのものを用いるのが望まし
い。
After the solid foreign matter is filtered and separated, it is desirable to provide a sterile filter 10 for preventing bacteria and viruses from entering and a virus blocking filter 11 to allow the permeation. By providing such a filter,
In order to kill them, it is not necessary to set the dialysis fluid circuit under strict conditions, so that it can be stored under mild conditions. By lowering the temperature, the decomposition of the protein can be suppressed. These filters preferably have a maximum diameter of 100 to 300 nanometers for bacteria and 10 to 100 nanometers for viruses.

【0017】血漿成分中の分子量が10万〜150万の
各種グロブリンの中には、間接リューマチ、重症筋無力
症、全身性ループス等の疾患の起因物質と見られる自己
免疫体、補体、リポ蛋白が存在することがあり、回収・
再生工程中に蓄積される恐れがある。もしこれらの有害
物質が高濃度で再生腹膜透析液中に含まれ、腹腔内で腹
膜と接すると、体内より排出され難くなる。したがって
これらの高分子分画成分を除去するために、回収腹膜透
析液が最初の濃縮工程に入る前に、回収腹膜透析液中の
高分子溶質の一部分を、吸着剤により吸着する吸着カラ
ム(図示せず)を設けるのが好ましい。またはこれら高
分子分画成分を阻止分画分子量10万〜100万の半透
膜を用いて濾別してもよい。吸着カラムで使用する具体
的な吸着剤としては、例えばメチルメタクリレート・ジ
ビニルベンゼン共重合体、エポキシ化セルロースのゲ
ル、アスパルチルフェニルアラニンメチルエステルの固
定化物、スチレン・ジビニルベンゼン共重合体の多孔質
などを用いることができる。
Among various globulins having a molecular weight of 100,000 to 1,500,000 in plasma components, autoimmune bodies, complements, liposomes, etc. which are considered to be the causative agents of diseases such as indirect rheumatism, myasthenia gravis, systemic lupus, etc. The protein may be present,
It may be accumulated during the regeneration process. If these harmful substances are contained in the regenerated peritoneal dialysate at a high concentration and come into contact with the peritoneum in the abdominal cavity, it is difficult to be excreted from the body. Therefore, in order to remove these high molecular fraction components, before the collected peritoneal dialysate enters the first concentration step, a part of the polymer solute in the collected peritoneal dialysate is adsorbed by the adsorbent (see FIG. (Not shown). Alternatively, these high molecular fraction components may be filtered off using a semipermeable membrane having a molecular weight cut off of 100,000 to 1,000,000. Specific adsorbents used in the adsorption column include, for example, methyl methacrylate / divinylbenzene copolymer, gel of epoxidized cellulose, immobilized product of aspartylphenylalanine methyl ester, and porous material of styrene / divinylbenzene copolymer. Can be used.

【0018】また、高分子量溶質の析出工程に先立っ
て、白血球増殖因子(Colony Stimulating Factor,略称
CSF)、悪性腫瘍細胞壊死因子(Tumor Necrosis Fac
tor,略称TNF)赤血球増殖因子(Erethropoietin、略
称EPO)などの生理活性物質と親和性のあるもの、又
はこれらの抗体を固定化したクロマトグラム、又はイム
ノクロマトグラムを通すことにより、これらを回収し、
医薬品原料とすることができる。
Prior to the step of depositing a high molecular weight solute, leukocyte growth factor (abbreviated as CSF), malignant tumor cell necrosis factor (Tumor Necrosis Fac
tor, abbreviated as TNF) erythrocyte growth factor (Erethropoietin, abbreviated as EPO) or a substance having an affinity for a physiologically active substance, or a chromatogram or an immunochromatogram in which these antibodies are immobilized, and collected.
It can be used as a pharmaceutical raw material.

【0019】プレフィルターを通った濾液は、高分子量
物質を溶質として溶解した溶液であり、これから溶質の
一部を析出させるのであるが、濾液中には大量の尿素、
クレアチニン、尿酸等***起因物質が含まれているの
で、それらを分離除去し、かつアルブミン等高分子量の
血漿蛋白を循環利用するため、プレフィルター通過後の
濾液を、濃縮カラム12において、半透膜を用いて低分
子量物質を除去するとともに高分子量溶質を濃縮し、次
いで希釈液により希釈する記濃縮・希釈を行い、低分子
量の尿毒素の大部分を分離精製した後、得られた高分子
量溶質溶液より溶質の一部を析出させるのが好ましい。
上記濃縮・希釈工程は数回繰り返してもよい。
The filtrate passed through the prefilter is a solution in which a high molecular weight substance is dissolved as a solute, and a part of the solute is precipitated from the filtrate.
Since uremic substances such as creatinine and uric acid are contained, they are separated and removed, and the filtrate after passing through the pre-filter is semi-permeable in the concentration column 12 in order to circulate and use high-molecular-weight plasma proteins such as albumin. The high molecular weight solute is removed using a membrane, and the high molecular weight solute is concentrated.Then, dilution and dilution are performed using a diluent, and most of the low molecular weight uretoxin is separated and purified. It is preferable to precipitate a part of the solute from the solute solution.
The above concentration / dilution step may be repeated several times.

【0020】濃縮カラムはカットオフポイント500〜
30,000ダルトン、好ましくは5,000−30,
000ダルトンの範囲内で、これ以下の低分子量の有害
成分を除去することができ、アルブミン収率の最も高い
ものを選んで用いる。
The concentration column has a cut-off point of 500-
30,000 daltons, preferably 5,000-30,
Within the range of 000 daltons, harmful components of low molecular weight or less can be removed, and those having the highest albumin yield are selected and used.

【0021】濃縮カラムとつながる循環回路内に希釈器
13が設置され、濃縮カラムで濃縮された高分子量溶質
濃縮液に希釈液を加えて希釈する。このような濃縮カラ
ムにおける半透膜による血漿蛋白の濃縮と、希釈器にお
ける希釈液添加による希釈を繰り返すことにより、保存
液中に血漿蛋白が蓄積し、これによってグルコース含有
透析液と同様の浸透圧を高める効果が得られる。
A diluter 13 is provided in a circulation circuit connected to the concentration column, and a diluent is added to the high molecular weight solute concentrate concentrated in the concentration column to dilute the solute concentrate. By repeating the concentration of the plasma protein by the semipermeable membrane in such a concentration column and the dilution by adding the diluent in the diluter, the plasma protein accumulates in the preservation solution, whereby the osmotic pressure is the same as that of the glucose-containing dialysate. Is obtained.

【0022】濃縮カラムで処理後も透析液中には尿毒素
成分が残存しているが、これが数パーセント以内であれ
ば、次回の透析液に含まれて腹腔内へ入っても透析効率
を著しく低下させる恐れは無い。
The urinary toxin component remains in the dialysate even after the treatment with the concentration column. If the urinary toxin component is within a few percent, the dialysis efficiency is remarkably increased even if it is contained in the next dialysate and enters the peritoneal cavity. There is no danger of lowering.

【0023】濃縮カラムで血漿蛋白が濃縮された透析液
は、希釈および洗浄されるが、希釈・洗浄液として、逆
浸透水生成装置で生成した純粋な水を用いることができ
るが、希塩酸液または少量の電解質塩を加えた液を用い
るのが好ましい。希釈・洗浄液として純水を用いた場
合、蛋白の溶解度が低いため、精製工程中は少量の電解
質塩および酸を加えた方が安定な溶液状態を維持でき
る。希釈液としては無菌且つ無パイロジェン(発熱性毒
素)または低パイロジェンであることが必要である。
The dialysate in which the plasma protein is concentrated in the concentration column is diluted and washed. Pure water generated by a reverse osmosis water generator can be used as the diluting / washing solution. It is preferable to use a solution to which an electrolyte salt of (1) is added. When pure water is used as the diluting / washing solution, the solubility of the protein is low. Therefore, a stable solution state can be maintained by adding a small amount of an electrolyte salt and an acid during the purification step. The diluent must be sterile and pyrogen-free (pyrogenic toxin) or low pyrogen.

【0024】かくして得られた高分子量溶質溶液より、
第1の発明においては、析出器14において溶質の一部
を析出させる。析出は、高分子量溶質溶液に大量の塩、
酸またはアルコール、あるいはこれらの混合物を添加す
ることにより行われる。添加する塩、酸またはアルコー
ルとしては硫酸ソーダ、硫酸アンモニウム、クエン酸ソ
ーダ、りん酸ソーダのような塩類、塩酸、過塩素酸、ス
ルホサリチル酸、ピクリン酸のような酸、エタノールの
ようなアルコール類、ポリエチレングリコールのような
ポリマー、あるいはプロタミン、2−エトキシ−6,9
ジアミノアクリジンラクテート等を例示することができ
る。
From the high molecular weight solute solution thus obtained,
In the first invention, a part of the solute is precipitated in the precipitator 14. Precipitation is a large amount of salt in the high molecular weight solute solution,
It is performed by adding an acid or an alcohol, or a mixture thereof. Salts, acids or alcohols to be added include salts such as sodium sulfate, ammonium sulfate, sodium citrate, and sodium phosphate, acids such as hydrochloric acid, perchloric acid, sulfosalicylic acid, picric acid, alcohols such as ethanol, and polyethylene. A polymer such as glycol, or protamine, 2-ethoxy-6,9
Examples thereof include diaminoacridine lactate.

【0025】また高分子量溶質溶液を、析出させる該溶
質の主成分の等電点近傍のpHに近づけることにより溶
質を析出させることができる。例えばアルブミンを析出
させる場合、pH5〜5.2近傍でアルブミンの大部分
が析出してくる。pH調節のためには酸を添加すればよ
く、酸としては有機酸または鉱酸に中から選ぶことがで
きるが、塩酸または乳酸を用いればそれが溶液中に少量
残存した場合でも、中和時にナトリウムの塩酸塩または
乳酸塩となり、透析液とともに腹腔内へ注入されても差
し支えない。
The solute can be precipitated by bringing the high molecular weight solute solution close to the pH near the isoelectric point of the main component of the solute to be precipitated. For example, when albumin is precipitated, most of the albumin is precipitated at around pH 5 to 5.2. To adjust the pH, an acid may be added, and the acid can be selected from organic acids and mineral acids.If hydrochloric acid or lactic acid is used, even if a small amount thereof remains in the solution, the acid may be added during neutralization. It becomes sodium hydrochloride or lactate, and may be injected into the peritoneal cavity together with the dialysate.

【0026】pHを溶質の等電点に近づける手順とし
て、中性からpHを下げていく方法と、一旦等電点より
低いpHまで下げた後、析出器においてpHを上げてい
く方法があり、後者の場合、過剰の酸を除いてpHを上
げる方法として、水または弱酸水による希釈・洗浄・濾
過により、あるいは半透膜を介して脱酸透析を行う方法
を用いることができる。この方法を行うことにより、緻
密で比重の大きい析出物を得ることができ、余剰の溶媒
を分離することが容易となる。さらにこの方法によれば
最初の酸の添加により高分子量溶質より遊離してきた色
素や臭気成分を洗浄、除去し無色で清澄な上澄液と白色
の沈殿物を得ることができるという利点がある。
As a procedure for bringing the pH closer to the isoelectric point of the solute, there are a method of lowering the pH from neutral and a method of once lowering the pH to a value lower than the isoelectric point and then increasing the pH in a precipitator. In the latter case, as a method of removing excess acid and raising the pH, a method of diluting with water or weak acid water, washing and filtering, or performing deoxidation dialysis through a semipermeable membrane can be used. By performing this method, a dense precipitate having a large specific gravity can be obtained, and it becomes easy to separate an excess solvent. Further, according to this method, there is an advantage that the color and the odor component released from the high molecular weight solute by the first addition of the acid can be washed and removed to obtain a colorless and clear supernatant and a white precipitate.

【0027】溶質の一部を析出させ、余剰の溶媒を分離
し濃縮された透析液は濃厚懸濁液の状態で懸濁液貯槽1
7に保存される。保存液には酸例えば塩酸または乳酸を
添加してもよい。
The concentrated dialysate, in which a part of the solute is precipitated, the excess solvent is separated and concentrated, is stored in a suspension tank 1 in the form of a concentrated suspension.
7 is stored. An acid such as hydrochloric acid or lactic acid may be added to the storage solution.

【0028】また分解反応を抑制する添加剤として、多
価アルコール、脂肪酸塩、例えばカプリル酸ソーダ、あ
るいはアミノ酸、例えばN−アセチルトリプトファン等
を加えることが有効である。
It is effective to add a polyhydric alcohol, a fatty acid salt such as sodium caprylate, or an amino acid such as N-acetyltryptophan as an additive for suppressing the decomposition reaction.

【0029】血漿蛋白は保存中、酸および体内より滲出
した蛋白分解酵素により分解反応が進行することがあり
得る。そのため、分解反応の反応速度を低下させる手段
を講ずることが望ましい。反応速度低下の方法として、
例えば、保存容器を冷却するのが有効である。
During storage, the degradation reaction of plasma proteins may proceed due to acids and proteolytic enzymes exuded from the body. Therefore, it is desirable to take measures to reduce the reaction rate of the decomposition reaction. As a method of reducing the reaction rate,
For example, it is effective to cool the storage container.

【0030】冷却温度は分解反応を抑制するためには低
温の方が望ましい。一般に高濃度蛋白溶液は氷点降下に
より、約−5℃以下でも凍結しないので、この付近の温
度で保存することが望ましい。
The cooling temperature is desirably low to suppress the decomposition reaction. Generally, a high-concentration protein solution does not freeze even at about −5 ° C. or less due to freezing point depression. Therefore, it is desirable to store the protein solution at a temperature around this temperature.

【0031】溶質の一部を析出させ、保存された濃厚懸
濁液、または使用時に再溶解槽18において再溶解す
る。再溶解は、析出の際に添加した添加剤の種類に応じ
て、半透膜を介して脱塩、脱酸透析または脱アルコール
し、必要に応じ、その後溶質を溶解する良溶媒中に再溶
解する。このような良溶媒としては、アルカリ金属塩を
主体とし、少量のアルカリ土類金属塩を含む水溶液を用
いることができる。
A part of the solute is precipitated and redissolved in the stored concentrated suspension or in the redissolution tank 18 at the time of use. Depending on the type of additive added during the precipitation, desalting, deacidification dialysis or dealcoholation is performed through a semi-permeable membrane, and if necessary, re-dissolved in a good solvent that dissolves the solute. I do. As such a good solvent, an aqueous solution mainly containing an alkali metal salt and containing a small amount of an alkaline earth metal salt can be used.

【0032】高分子量溶質溶液成分を高濃度に濃縮する
方法として、本発明の第2の発明においては、半透膜に
より濃縮した溶液を冷却し、溶媒の一部を凍結させ、残
りの母液中に高分子量溶質成分を高濃度に残す方法が用
いられる。凍結した溶媒は少量の溶質を含むため、母液
を分離した後解凍し、次のロットの希釈に用いる。
As a method for concentrating a high molecular weight solute solution component to a high concentration, in the second invention of the present invention, a solution concentrated by a semipermeable membrane is cooled, a part of the solvent is frozen, and the remaining mother liquor is dissolved. A method of leaving a high-molecular-weight solute component at a high concentration is used. Since the frozen solvent contains a small amount of solute, it is thawed after separating the mother liquor and used for dilution of the next lot.

【0033】その後、濃度調整槽21において、再生透
析液に含まれるべき各電解質塩、例えば塩化ナトリウ
ム、塩化カルシウム、塩化マグネシウム及び必要に応じ
て乳酸ソーダ、重炭酸ソーダを電解質塩貯槽22から所
定に濃度になるように添加、混合する。
Thereafter, in the concentration adjusting tank 21, each electrolyte salt to be contained in the regenerated dialysate, for example, sodium chloride, calcium chloride, magnesium chloride and, if necessary, sodium lactate and sodium bicarbonate are adjusted to a predetermined concentration from the electrolyte salt storage tank 22. Add and mix as needed.

【0034】本発明では析出器、懸濁液貯槽、再溶解
器、濃度調整槽等における析出用添加剤、酸、電解質塩
等、腹膜透析液回路への外部からの添加物を外気に触れ
ずに添加・混合出来るようにすることが必要であり、こ
のような添加方法として、例えば、図2に示すような混
合・保存容器を用いる。図2において、混合・保存容器
31はプラスチック製軟質素材32から成り、その内部
に予め内ポケット33を設け、添加物を封入・滅菌し濃
縮排液を送り込む際、所定量の添加物を容器の外部よ
り、ピストン式プレスシリンダー34を用いて部分的に
圧迫する事により開封混合する。
In the present invention, additives from the outside, such as additives for precipitation, acids, electrolyte salts, etc., in the peritoneal dialysate circuit in the precipitator, suspension storage tank, re-dissolver, concentration adjusting tank, etc., are not exposed to the outside air. It is necessary to be able to add and mix to the mixture. As such an addition method, for example, a mixing and storage container as shown in FIG. 2 is used. In FIG. 2, a mixing / preservation container 31 is made of a soft plastic material 32, and an inner pocket 33 is previously provided therein. When the additive is enclosed and sterilized and a concentrated waste liquid is sent, a predetermined amount of the additive is added to the container. Opening and mixing are performed by applying partial pressure from outside using a piston type press cylinder 34.

【0035】このようにして再生された透析液にアミノ
酸、ペプチド、アルブミン或は糖類等を添加し、所定の
浸透圧液を調製することもできる。これらの物質の添加
は前記の濃度調整槽内で、それぞれの物質を別の内ポケ
ット内に分包・滅菌して前記アルカリ添加と同じ方法
で、開封・混合することができる。
An amino acid, peptide, albumin, saccharide, or the like can be added to the dialysate thus regenerated to prepare a predetermined osmotic pressure solution. The addition of these substances can be carried out by separating and sterilizing each substance in another inner pocket in the above-mentioned concentration adjusting tank, and then opening and mixing in the same manner as in the above-mentioned alkali addition.

【0036】透析液は、最後に加温器により体温まで加
温し、接続部25及び無菌フィルター26を経て、注入
専用カテーテル27より腹腔内へ注入される。加温器は
回路内に別途設置することもできるが、混合器の外部に
外熱式の加温器を設けてもよい。
The dialysate is finally warmed to body temperature by a warmer, and is injected into the abdominal cavity through the connection portion 25 and the sterile filter 26 from the catheter 27 exclusively for injection. The heater can be separately installed in the circuit, or an externally heated heater may be provided outside the mixer.

【0037】加温は直接体温まで加温してそのまま腹腔
内へ注入してもよいが、一旦55℃〜85℃に加熱した
後、35〜40℃に冷却することもできる。このように
一旦体温よりも高温に加熱すると、ウイルスを不活性化
することができるので有利である。
The heating may be carried out by directly heating the body to the body temperature and injecting it directly into the abdominal cavity, but it is also possible to once heat the mixture to 55 to 85 ° C. and then cool it to 35 to 40 ° C. Thus, once heated to a temperature higher than body temperature, the virus can be inactivated, which is advantageous.

【0038】上記腹膜透析液回収・再生方法を行なうた
めの本発明の腹膜透析液回収・再生装置は (1)固形異物分離用フィルター (2)高分子量溶質析出装置 (3)高分子量溶質懸濁液の再溶解槽 (4)電解質塩混合器 (5)これらを連結する回路・弁・及び送液ポンプ を必須成分として構成される。
The peritoneal dialysate recovery / regeneration apparatus of the present invention for performing the above-mentioned peritoneal dialysate recovery / regeneration method includes: (1) a filter for separating solid foreign matter; (2) a high molecular weight solute precipitation apparatus; and (3) a high molecular weight solute suspension. Liquid re-dissolution tank (4) Electrolyte salt mixer (5) A circuit, valve, and liquid feed pump connecting these components are essential components.

【0039】上記本発明装置は長期に亘り衛生的で無菌
状態を維持することが重要である。そのため毎日定期的
に容器、フイルター、回路を殺菌・消毒する必要があ
る。殺菌・消毒剤として強酸電解水または強酸を用いる
ことができる。殺菌・消毒液貯蔵容器(図示せず)と注
入・循環ポンプを接続し、殺菌・消毒液循環回路によ
り、殺菌・消毒が行われる。また無菌水も大量に消費す
るため、逆浸透膜水生成装置を組み込むことが望まし
い。
It is important that the device of the present invention be kept sanitary and sterile for a long period of time. Therefore, it is necessary to regularly sterilize and disinfect containers, filters, and circuits every day. Strong acid electrolyzed water or strong acid can be used as a disinfectant. A sterilizing / disinfecting solution storage container (not shown) is connected to an injection / circulation pump, and sterilizing / disinfecting is performed by a sterilizing / disinfecting solution circulation circuit. Since a large amount of sterile water is also consumed, it is desirable to incorporate a reverse osmosis membrane water generator.

【0040】頻回の消毒薬処理により材質劣化の恐れが
ある為、一定期間使用したら交換する事が望ましい。そ
のため前記容器、フイルター、回路を好ましくは、プラ
スチックでライニングされているかプラスチックから成
るもので一体化製作、滅菌し、一定期間用いた後、新し
い物と一括して交換できるようにしたキットとするのが
好ましい。それによりバクテリアやウイルスの汚染・侵
入を最小限に抑え、無菌状態を維持することができる。
Since the material may be deteriorated due to frequent disinfectant treatments, it is desirable to replace it after a certain period of use. Therefore, the container, the filter, and the circuit are preferably made of a plastic-lined or made of plastic, integrally manufactured, sterilized, used for a certain period of time, and then replaced with a new kit at a time. Is preferred. Thereby, contamination and invasion of bacteria and viruses can be minimized, and an aseptic state can be maintained.

【0041】再生腹膜透析液を処方通りの時刻に注入或
いは排出する技術は既に自動腹膜透析機で実用化されて
いるが、本発明の装置でも類似の機能を組み込み日中の
時間再生した透析液を夜間患者が睡眠中に自動的に注入
・排出することができる。すなわち 1) 各容器内の液面、圧力、重量、溶液の温度、粘
度、電導度、pH、比重、浸透圧、患者腹腔内圧等を計
測し 2)計測値に基き弁の開閉、ポンプの起動・停止を指令
する機能を備えた装置とし、更にこの計測値を離れた場
所のコンピューターへ転送し、遠隔監視及び制御する機
能を備えることによって、自動的注入・排出が可能とな
る。
The technique of injecting or discharging the regenerated peritoneal dialysate at the prescribed time has already been put to practical use in an automatic peritoneal dialyzer, but the apparatus of the present invention incorporates a similar function and regenerates the dialysate during daytime. Can be automatically infused and discharged during the night when the patient sleeps. 1) Measure the liquid level, pressure, weight, solution temperature, viscosity, conductivity, pH, specific gravity, osmotic pressure, patient intraperitoneal pressure, etc. in each container. 2) Open / close valves, start pump based on measured values. -Automatic injection / discharge is possible by using a device with a function to instruct a stop, and further having a function to transfer the measured value to a computer at a remote location, and to remotely monitor and control the measured value.

【0042】例えば、夜間就寝前にサイクラーと接続し
た排液カテーテルを通じて日中腹腔内に貯留した腹膜透
析液の体外への排出・回収、再生透析液の注入、数時間
後に新鮮透析液注入、の各工程を予めコンピューターに
組み込まれたプログラムの指令またはホストコンピュー
ターからのプログラム変更指令に従って弁の開閉とポン
プの作動を自動灌流装置(サイクラー)に自動的に行わ
せることができる。かくして、再生処理を行って浸透圧
を高めた高浸透圧腹膜透析液は、患者が日常生活をする
べき時間帯に用いることも、夜間にサイクラーを使用し
ている時間帯に用いることもできる。
For example, before going to bed at night, the peritoneal dialysate stored in the abdominal cavity during the day is drained and collected through a drainage catheter connected to the cycler, the regenerated dialysate is injected, and after several hours, the fresh dialysate is injected. In each step, an automatic perfusion device (cycler) can automatically open and close the valve and operate the pump in accordance with a program command previously incorporated in the computer or a program change command from the host computer. Thus, the hyperosmotic peritoneal dialysate, which has been subjected to the regeneration treatment to increase the osmotic pressure, can be used in a time zone in which the patient should perform daily life or in a time zone in which the cycler is used at night.

【0043】[0043]

【実施例】[実施例1] (血漿蛋白濃厚液の調製)高分子量溶質溶液(A液)
と、ヒト血液(B液)間の限外濾過能を測定するため、
本発明による高分子量溶質溶液(A1)として、腹膜透
析患者の透析排液を半透膜を用い濃縮・希釈を複数回繰
り返し、塩酸を加え、pH1に下げた後、脱酸透析法に
より等電点までpHを上げ、高分子量溶質を析出させ、
余剰の溶媒を分離した後、再溶解して得られた血漿蛋白
濃厚液を塩化カルシウム、塩化マグネシウム、塩化ナト
リウムと混合し乳酸塩と少量の重炭酸ソーダで中和した
溶液を調製した。また比較のため、上記血漿蛋白液と同
じ電解質塩とアルカリを同量含有するグルコース溶液
(A2)を調製した。両者の組成を下記表1に示す。
[Example 1] (Preparation of plasma protein concentrate) High molecular weight solute solution (solution A)
And to measure the ultrafiltration ability between human blood (Solution B)
As the high molecular weight solute solution (A1) according to the present invention, the dialysis effluent of a peritoneal dialysis patient is repeatedly concentrated and diluted using a semi-permeable membrane a plurality of times, and hydrochloric acid is added to lower the pH to 1, and then subjected to deacidification dialysis. Raise the pH to the point to precipitate the high molecular weight solute,
After the excess solvent was separated, the redissolved plasma protein concentrate was mixed with calcium chloride, magnesium chloride, and sodium chloride to prepare a solution neutralized with lactate and a small amount of sodium bicarbonate. Further, for comparison, a glucose solution (A2) containing the same amount of the same electrolyte salt and alkali as the plasma protein solution was prepared. The composition of both is shown in Table 1 below.

【0044】[0044]

【表1】 [Table 1]

【0045】(限外濾過試験)矩形箱型容器内で平膜状
半透膜を介し片側にA液、もう一方側にB液を入れ開始
時の液面の高さを同一(600mL)にし240分間撹
拌し、開始時と240分後のA液側の液量を測定した。
結果を表2に示す。表2から明らかなように、本発明の
血漿蛋白濃厚液を含む液は、従来用いられてきたグルコ
ースを浸透圧剤とする液にほぼ匹敵する限外濾過能を示
した。
(Ultrafiltration test) In a rectangular box-shaped container, liquid A was placed on one side and liquid B was placed on the other side via a flat membrane-like semipermeable membrane, and the liquid level at the start was the same (600 mL). The mixture was stirred for 240 minutes, and the liquid amount on the liquid A side at the start and after 240 minutes was measured.
Table 2 shows the results. As is evident from Table 2, the solution containing the plasma protein concentrate of the present invention exhibited an ultrafiltration ability almost comparable to a conventionally used solution using glucose as an osmotic agent.

【0046】[0046]

【表2】 [Table 2]

【0047】[0047]

【発明の効果】本発明の腹膜透析液回収・再生方法及び
装置を用いることにより、血液中の血漿蛋白自身を回収
・精製し高濃度溶液として、膠質浸透圧剤として腹膜透
析液を繰り返し使用することができ、その結果、浸透圧
剤としてグルコースを使用した従来法におけるグルコー
スによる副作用を防止でき、しかもその際、 (1)高濃度の高分子量溶質溶液を簡便に再生できる。 (2)添加物を分別包装し混合容器内に内蔵・滅菌し使
用前に容器の外部より圧迫することにより開封・混合出
来、外気に触れることなく細菌の侵入が防止できるよう
になった。 (3)回路・フイルター・容器を定期的に一括交換する
ことによりシステムの安全性を簡便に維持・管理出来る
ようになった。
According to the method and apparatus for recovering and regenerating peritoneal dialysate of the present invention, plasma protein itself in blood is recovered and purified, and the peritoneal dialysate is repeatedly used as a colloid osmotic agent as a high-concentration solution. As a result, it is possible to prevent the side effects of glucose in the conventional method using glucose as an osmotic agent, and at that time, (1) a high-concentration high-molecular-weight solute solution can be easily regenerated. (2) The additives are separately packaged, built-in and sterilized in a mixing container, and can be opened and mixed by pressing from outside the container before use, so that bacteria can be prevented from entering without contacting the outside air. (3) The safety of the system can be easily maintained and managed by periodically replacing the circuits, filters, and containers collectively.

【図面の簡単な説明】[Brief description of the drawings]

【図1】 本発明の腹膜透析液回収・再生装置。FIG. 1 shows a peritoneal dialysate collection / regeneration device of the present invention.

【図2】 本発明において、添加剤を添加するための混
合器。
FIG. 2 is a mixer for adding an additive in the present invention.

【符号の説明】[Explanation of symbols]

1 腹腔 2 排液カテーテル 3 逆止弁 4 接続部 5 フィブリノーゲン凝固器 6 フィブリノーゲン凝固物質貯槽 7 一次フィルター 8 二次フィルター 9 接続部 10 無菌フィルター 11 ウイルス阻止フィルター 12 濃縮カラム 13 希釈器 14 析出器 15 析出用添加物貯槽 16 濾過器 17 懸濁液貯槽 18 再溶解槽 19 再溶解用溶媒荘槽 20 接続部 21 濃度調整槽 22 電解質塩貯槽 23 加温器 24 温度調整部 25 接続部 26 無菌フィルター 27 注入カテーテル 31 混合容器 32 軟質プラスチック製バッグ 33 内ポケット 34 ピストン式プレスシリンダー DESCRIPTION OF SYMBOLS 1 Peritoneal cavity 2 Drainage catheter 3 Check valve 4 Connection part 5 Fibrinogen coagulator 6 Fibrinogen coagulation substance storage tank 7 Primary filter 8 Secondary filter 9 Connection part 10 Sterile filter 11 Virus prevention filter 12 Concentration column 13 Diluter 14 Precipitator 15 Precipitation Additive storage tank 16 Filtration device 17 Suspension storage tank 18 Reconstitution tank 19 Reconstitution solvent tank 20 Connection 21 Concentration control tank 22 Electrolyte salt storage tank 23 Heater 24 Temperature control unit 25 Connection 26 Sterile filter 27 Injection Catheter 31 Mixing container 32 Soft plastic bag 33 Inner pocket 34 Piston press cylinder

Claims (21)

【特許請求の範囲】[Claims] 【請求項1】 腎機能不全患者の腹膜透析排液より、
(1)固形異物を濾別、分離し、(2)得られた高分子
量溶質溶液より溶質の一部を析出させて濃厚懸濁液の状
態とし、(3)該懸濁液を再溶解して該高分子量溶質の
高濃度溶液とし、(4)電解質塩を混合し、透析液を再
生することを特徴とする腹膜透析液回収・再生方法。
Claims: 1. From the peritoneal dialysis drainage of a patient with renal insufficiency,
(1) A solid foreign matter is separated by filtration, and (2) a part of the solute is precipitated from the obtained high molecular weight solute solution to form a concentrated suspension. (3) The suspension is redissolved. (4) a method for collecting and regenerating a peritoneal dialysate, which comprises regenerating a dialysate by mixing a high-concentration solution of the high-molecular-weight solute with (4) an electrolyte salt.
【請求項2】固形異物を濾別分離した後の濾液より、半
透膜を用いて低分子量物質を除去するとともに高分子量
溶質を濃縮し、次いで希釈液により希釈する濃縮・希釈
工程を少なくとも1回実施した後、得られた高分子量溶
質溶液より溶質の一部を析出させることを特徴とする請
求項1記載の腹膜透析液回収・再生方法。
2. At least one concentration / dilution step of removing low molecular weight substances and concentrating high molecular weight solutes from a filtrate obtained by separating solid foreign matters by filtration using a semipermeable membrane, and then diluting with a diluent. 2. The method for recovering and regenerating a peritoneal dialysate according to claim 1, wherein a part of the solute is precipitated from the obtained high molecular weight solute solution after the repetition.
【請求項3】 高分子量溶質溶液よりの溶質の析出を、
高分子量溶質溶液に塩、酸またはアルコール、あるいは
これらの混合物を添加することにより行うことを特徴と
する請求項1または2に記載の腹膜透析液回収・再生方
法。
3. The method of depositing a solute from a high molecular weight solute solution,
3. The method for collecting and regenerating a peritoneal dialysate according to claim 1, wherein the method is performed by adding a salt, an acid or an alcohol, or a mixture thereof to a high molecular weight solute solution.
【請求項4】 高分子量溶質溶液を、析出させる該溶質
の主成分の等電点近傍のpHに調整して溶質を析出させ
ることを特徴とする請求項3記載の腹膜透析液回収・再
生方法。
4. The method for recovering and regenerating a peritoneal dialysis solution according to claim 3, wherein the high molecular weight solute solution is adjusted to a pH near the isoelectric point of the main component of the solute to be precipitated to precipitate the solute. .
【請求項5】 高分子量溶質溶液に一旦等電点より低い
pHになるまで酸を加えた後、水または弱酸水による希
釈洗浄・濾過により、または半透膜を介して脱酸透析を
行うことによりpHを等電点近傍に調整することを特徴
とする請求項4記載の腹膜透析液回収・再生方法。
5. Deoxidizing dialysis by adding an acid to a high molecular weight solute solution until the solution has a pH lower than the isoelectric point, and then diluting and washing with water or a weak acid solution, or through a semipermeable membrane. 5. The method for collecting and regenerating peritoneal dialysate according to claim 4, wherein the pH is adjusted to a value near the isoelectric point by the method.
【請求項6】 腹膜透析液回路に外部から添加する添加
物を、1ロットずつ予め分包、滅菌したものを容器内に
密封し外気に触れることなく高分子量溶質溶液と混合す
ることを特徴とする請求項1〜5のいずれかに記載の腹
膜透析液回収・再生方法。
6. An excipient to be added to the peritoneal dialysis fluid circuit from the outside is pre-packaged in lots, sterilized, sealed in a container, and mixed with a high molecular weight solute solution without being exposed to outside air. The method for collecting and regenerating peritoneal dialysate according to any one of claims 1 to 5.
【請求項7】 腹膜透析排液にフィブリノーゲン凝固物
質を添加した後、固形異物を濾別、分離することを特徴
とする請求項1〜6のいずれかに記載の腹膜透析液回収
・再生方法。
7. The method for collecting and regenerating a peritoneal dialysate according to claim 1, wherein a solid foreign substance is separated by filtration after adding a fibrinogen coagulation substance to the peritoneal dialysate drainage.
【請求項8】 固形異物を濾別、分離した後、濾液を最
小の細菌を阻止するフィルター及び/又はウイルスを阻
止するフィルターを透過させることを特徴とする請求項
1または2に記載の腹膜透析液回収・再生方法。
8. The peritoneal dialysis according to claim 1, wherein the solid foreign matter is filtered off and separated, and then the filtrate is passed through a filter that blocks bacteria and / or a virus that minimizes bacteria. Liquid recovery and regeneration method.
【請求項9】 フィルターの最大口径がそれぞれ100
〜300ナノメーター及び10〜100ナノメーターで
あることを特徴とする請求項8記載の腹膜透析液回収・
再生方法。
9. The filter has a maximum aperture of 100
The peritoneal dialysate collection and recovery according to claim 8, wherein the peritoneal dialysis solution is 10 to 300 nanometers and 10 to 100 nanometers.
Playback method.
【請求項10】 再生透析液を55〜85℃に加熱した
後、35〜40℃に冷却することを特徴とする請求項1
〜9のいずれかに記載の腹膜透析液回収・再生方法。
10. The regenerated dialysate is heated to 55 to 85 ° C. and then cooled to 35 to 40 ° C.
10. The method for collecting and regenerating a peritoneal dialysate according to any one of claims 9 to 9.
【請求項11】 懸濁液に脂肪酸及び/またはアミノ酸
を添加することを特徴とする請求項1〜10のいずれか
に記載の腹膜透析液回収・再生方法。
11. The method for recovering / regenerating a peritoneal dialysate according to claim 1, wherein a fatty acid and / or an amino acid is added to the suspension.
【請求項12】 腎機能不全患者の腹膜透析排液より、
(1)固形異物を濾別、分離し、(2)得られた高分子
量溶質溶液を半透膜を用いて低分子量物質を除去すると
ともに高分子量溶質を濃縮し、(3)該濃縮液を冷却
し、溶媒の一部を凍結させ、(4)残りの母液を凍結分
画と分離し、(5)該母液に電解質塩を添加し、透析液
を再生することを特徴とする腹膜透析液回収・再生方
法。
12. Peritoneal dialysis drainage from a patient with renal insufficiency,
(1) The solid foreign matter is separated by filtration, and (2) the obtained high molecular weight solute solution is removed with a semi-permeable membrane to remove low molecular weight substances, and the high molecular weight solute is concentrated. Cooling, partially freezing the solvent, (4) separating the remaining mother liquor from the frozen fraction, (5) adding an electrolyte salt to the mother liquor, and regenerating the dialysate, wherein Collection and reproduction method.
【請求項13】(1)固形異物分離用フィルター (2)高分子量溶質析出装置 (3)高分子量溶質懸濁液の再溶解槽 (4)電解質塩混合容器 (5)これらを連結する回路・弁・及び送液ポンプ を必須構成要素として構成された腎機能不全患者の腹膜
透析液の回収・再生装置。
13. A filter for separating solid foreign matter (2) A high molecular weight solute precipitation apparatus (3) A re-dissolution tank for a high molecular weight solute suspension (4) An electrolyte salt mixing vessel (5) A circuit for connecting these A device for collecting and regenerating peritoneal dialysis fluid from patients with renal insufficiency, which is composed of a valve and a pump as essential components.
【請求項14】各分離器、容器、回路の部分がプラスチ
ックでライニングされ、またはプラスチックから成り、
予め一体成型、滅菌されたもので、一定期間使用後新し
い装置と交換できるようにしたことを特徴とする請求項
13に記載の腹膜透析液回収・再生装置。
14. Each separator, vessel, circuit part is lined with plastic or consists of plastic;
14. The peritoneal dialysate recovery / regeneration apparatus according to claim 13, wherein the apparatus is preliminarily molded and sterilized, and can be replaced with a new apparatus after a certain period of use.
【請求項15】 強酸あるいは強酸電解水を容器、回路
の消毒・殺菌用に循環する装置を組み込んだ請求項13
または14に記載の腹膜透析液回収・再生装置。
15. A device for circulating strong acid or strong acid electrolyzed water for disinfecting and sterilizing containers and circuits.
Or a peritoneal dialysate collection / regeneration device according to item 14.
【請求項16】水道水より無菌且つ無パイロジェン(発
熱性毒素)あるいは低パイロジェン水を得る精密濾過膜
を有する逆浸透膜水精製装置を組み込んだ請求項13〜
15のいずれかに記載の腹膜透析液回収・再生装置。
16. A reverse osmosis membrane water purification device having a microfiltration membrane for obtaining sterile and pyrogen-free (pyrogenic toxin) or low pyrogen water from tap water.
15. The apparatus for collecting and regenerating peritoneal dialysis solution according to any one of the above items 15.
【請求項17】 高分子量溶質溶液中のエンドトキシン
吸着カラムを備えた請求項13〜16のいずれかに記載
の腹膜透析液回収・再生装置。
17. The peritoneal dialysate collection / regeneration apparatus according to claim 13, further comprising an endotoxin adsorption column in a high molecular weight solute solution.
【請求項18】(1)再生された透析液または市販の透
析液を加温し (2)所定のプログラムに従いカテーテルを通じ患者の
腹くう内へ注入し (3)一定時間貯溜または連続循環した後 (4)排出・回収する機能を備えた請求項13〜17の
いずれかに記載の腹膜透析液回収・再生自動透析装置。
18. A regenerated dialysate or a commercially available dialysate is heated, (2) injected into a patient's abdomen through a catheter according to a predetermined program, and (3) stored or continuously circulated for a certain period of time. (4) The automatic peritoneal dialysate collection / regeneration apparatus according to any one of claims 13 to 17, which has a function of discharging and collecting.
【請求項19】(1) 各容器内の液面、圧力、重量、
溶液の温度、粘度、電導度、pH、比重、浸透圧、患者
腹腔内圧等を計測し (2)計測値に基き弁の開閉、ポンプの起動・停止を指
令する機能を備えた請求項13〜18のいずれかに記載
の自動腹膜透析液回収・再生装置。
(1) The liquid level, pressure, weight,
Claims 13 to 15 having a function of measuring the temperature, viscosity, conductivity, pH, specific gravity, osmotic pressure, intra-abdominal pressure of the patient, etc. of the solution, and (2) instructing opening / closing of the valve and starting / stopping of the pump based on the measured value. 19. The automatic peritoneal dialysis solution recovery / regeneration apparatus according to any of 18.
【請求項20】(1)計測機器のセンサーの部分を予め
回路または容器の内部に埋め込み滅菌処理を施し (2)前記高分子量溶質溶液を外気と接触させること無
く計測出来る請求項19に記載の自動腹膜透析液回収・
再生装置。
20. The method according to claim 19, wherein (1) the sensor portion of the measuring instrument is preliminarily embedded in a circuit or a container and sterilized. (2) The high molecular weight solute solution can be measured without coming into contact with outside air. Automatic peritoneal dialysate collection
Playback device.
【請求項21】(1)計測値を離れた場所のコンピュー
ターへ転送し、(2)遠隔監視及び制御する機能を備え
た請求項19または20に記載の自動腹膜透析液回収・
再生装置。
21. The automatic peritoneal dialysis solution collection / recovery device according to claim 19 or 20, wherein (1) the measured value is transferred to a computer at a remote place, and (2) a function of remote monitoring and control is provided.
Playback device.
JP9302388A 1997-11-05 1997-11-05 Method for recovering and regenerating peritoneal dialyzane and apparatus therefor Pending JPH11137672A (en)

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Publication Number Publication Date
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