Development of a High-efficiency Peritoneal Dialysis system

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In order to improve solute removal efficiency in conventional peritoneal dialysis (CPD) , Continuous Recirculating Peritoneal Dialysis (CRPD) was newly introduced as a high-efficiency home dialysis system. In this research, we developed a CRPD system which consists of a double-lumen PD catheter, an extracorporeal dialyzer and a dialysis machine. Solute removal characteristics in CRPD were examined during a canine ex vivo study and a clinical study.1.Optimum design of the extracorporeal dialyzerWe carried out dialysis experiments for a test dialyzer using an aqueous solution involving several marker solutes. By analytical calculations, an optimum shape of dialyzer can be determined as an optimum from these results.2.Development of the dialysis machineThe dialysis machine for CRPD has (a) a glucose infuser, (b) a flushing equipment for dwelled dialysate and (c) several kinds of monitors. (a) For water removal from the patient, a 1.0-1.5 % of glucose was needed for the outer dialysate. The glucose infuser requires minimum amount of glucose for the dialysate. (b) Dwelled dialysate in the peritoneal cavity is not mixed well in PD treatments. It reduces solute removal efficiency of the treatment. In order to improve the mixing, a flushing machine was introduced to CRPD.(c) A bobble detector, a blood leakage monitor and a pressure gauge were equipped in this machine.3.Solute Removal Characteristics in CRPDRecirculation-dialysis experiments using over 60 dogs were done for the evaluation of CRPD.CRPD has a higher solute removal efficiency than in CPD.In the clinical study, CRPD treatments were applied to five renal failure patients. The patients tolerated the CRPD treatments well and solute efficiency was higher than with Conventional PD treatments. No fibrin formation occurred during the CRPD treatments.