PRIORITY CLAIM

The present application is a National Phase of International Application No. PCT/EP2018/065655, filed Jun. 13, 2018, which claims priority to SE Application No. 1750760-9, filed Jun. 15, 2017, the entire contents of each of which are incorporated herein by reference and relied upon.

TECHNICAL FIELD

The present disclosure relates to a water purification apparatus and to corresponding methods for controlling at least one fluid property in a water purification apparatus. The present disclosure also relates to a computer program and a computer program product implementing the method.

BACKGROUND

In treatment of patients suffering acute or chronic renal insufficiency, dialysis therapy is employed. Three general categories of dialysis therapy are hemodialysis, HD, peritoneal dialysis, PD, and continuous renal replacement therapy, CRRT.

In hemodialysis, the patient's blood is cleansed by passage through an artificial kidney in an extracorporeal membrane system, incorporated in a dialysis machine. The blood treatment involves extracorporeal circulation through an exchanger having a semipermeable membrane (dialyzer) in which the patient's blood is circulated on one side of the membrane and a dialysis fluid, comprising the main electrolytes of the blood in concentrations close to those in the blood of a healthy subject, is circulated on the other side. Furthermore, a pressure difference is created between the two compartments of the dialyzer which are delimited by the semipermeable membrane, so that a fraction of the plasma fluid passes by ultrafiltration through the membrane into the compartment containing the dialysis fluid.

CRRT is used as an alternative therapy for patients who are too ill or unstable for standard hemodialysis. It is similar to hemodialysis and makes use of a semipermeable membrane for diffusion and to some extent convection. It is however a slower form of blood treatment than hemodialysis, and may be continuously ongoing from a couple of hours up to several days.

In peritoneal dialysis, dialysis fluid is infused into the patient's peritoneal cavity. This cavity is lined by the peritoneal membrane which is highly vascularized. The metabolites are removed from the patient's blood by diffusion across the peritoneal membrane into the dialysis fluid. Excess fluid, i.e. water is also removed by osmosis induced by a hypertonic dialysis fluid. Through these two processes, diffusion and osmotic ultrafiltration, appropriate quantities of solute metabolites and fluid need to be removed to maintain the patient's body fluid volumes and composition within appropriate limits.

There are various types of peritoneal dialysis therapies, including continuous ambulatory peritoneal dialysis (“CAPD”), automated peritoneal dialysis (“APD”), including tidal flow APD, and continuous flow peritoneal dialysis (“CFPD”).

CAPD is a manual dialysis treatment. The patient connects manually an implanted catheter to a drain, allowing spent dialysate fluid to drain from the peritoneal cavity. The patient then connects the catheter to a bag of fresh dialysis fluid, infusing fresh dialysis fluid through the catheter and into the patient. The patient disconnects the catheter from the fresh dialysis fluid bag and allows the dialysis fluid to dwell within the peritoneal cavity, wherein the transfer of waste, toxins and excess water takes place.

Automated peritoneal dialysis (“APD”) is similar to CAPD in that the dialysis treatment includes drain, fill, and dwell cycles. APD machines, however, perform the cycles automatically, typically while the patient sleeps. APD machines free patients from having to manually perform the treatment cycles and from having to transport supplies during the day. APD machines connect fluidly to an implanted catheter, to a source or bag of fresh dialysis fluid and to a fluid drain. APD machines pump fresh dialysis fluid from the dialysis fluid source, through the catheter, into the patient's peritoneal cavity and allow the dialysis fluid to dwell within the cavity and the transfer of waste, toxins and excess water to take place. APD machines pump spent dialysate from the peritoneal cavity, through the catheter, to the drain. As with the manual process, several drain, fill and dwell cycles occur during APD. A “last fill” occurs often at the end of CAPD and APD, which remains in the peritoneal cavity of the patient until the next treatment.

Both CAPD and APD are batch type systems that send spent dialysis fluid to a drain. Tidal flow systems are modified batch systems. With tidal flow, instead of removing all the fluid from the patient over a longer period of time, a portion of the fluid is removed and replaced after smaller increments of time.

Continuous flow or CFPD systems clean or regenerate spent dialysate instead of discarding it. CFPD systems are typically more complicated than batch systems.

CAPD, APD (including tidal flow) and CFPD systems can employ a pumping cassette. The pumping cassette typically includes a flexible membrane that is moved mechanically to push and pull dialysis fluid out of and into, respectively, the cassette.

In one form of peritoneal dialysis, an automated cycler is used to infuse and drain dialysis fluid. This form of treatment may be done automatically at night while the patient sleeps. The cycler measures the amount of fluid infused and the amount removed to compute the net fluid removal. The treatment sequence usually begins with an initial drain cycle to empty the peritoneal cavity of spent dialysate. The cycler then performs a series of fill, dwell, and drain cycles, typically finishing with a fill cycle.

Peritoneal dialysis generally requires large volumes of dialysis fluid. Generally, at each application, or exchange, a given patient will infuse 2 to 3 liters of dialysis fluid into the peritoneal cavity. The dialysis fluid is allowed to dwell for approximately 1 to 3 hours, at which time it is drained out and exchanged for fresh dialysis fluid. Generally, four such exchanges are performed daily. Therefore, approximately 8 to 20 liters of dialysis fluid is required per day, 7 days a week, 365 days a year for each patient.

Dialysis fluids, for use in the above-mentioned treatments, have traditionally been provided in sealed container bag, ready for use. For example, peritoneal dialysis is typically performed using bags with three different concentration of dextrose. The bags are being delivered to a patient's home as 1 liter to 6 liter bags with different dextrose concentrations. A normal daily consumption is around 8 to 20 liters of PD dialysis fluid. The fluid is provided in sterilized bags of sizes up to six liters, which are packed into boxes and delivered, e.g., monthly, for use to the patient's home. The boxes of fluid may be cumbersome and heavy for PD patients to handle, and consume a substantial space in a room of their homes. The bags and boxes also produce a relatively large amount of waste disposed of on a weekly or monthly basis.

In light of above, several problems become apparent. Shipping and storage of the sheer volume of fluids required is space consuming. Additionally, the use of multiple prefilled bags produces waste materials in the form of empty containers and packaging.

Sub-systems for an overall peritoneal dialysis, PD, system that creates dialysis solution at the point of use, e.g., at the PD machine are therefore needed.

PD dialysis fluid is delivered directly to the patient's peritoneal cavity. PD fluid therefore needs to have a level of sterilization suitable for being introduced into the patient's peritoneum. PD dialysis fluid is accordingly premixed and sterilized typically prior to delivery to the location of use, usually the patient's home.

Also, in hemodialysis and CRRT, systems that create dialysis solution at the point of use, e.g., at the hemodialysis machine or CRRT machine, are therefore needed.

An overall system for hemodialysis, PD or CRRT, in some embodiments, include three primary components, namely a dialysis machine, a water purifier and a disposable set operating with both the dialysis machine and the water purifier. The dialysis machine is e.g. a PD cycler, a hemodialysis machine or a CRRT machine. The dialysis machine prepares dialysis fluid from purified water from the water purifier and concentrates.

The water purifier produces purified water from e.g. tap water, at the point of use of the purified water.

SUMMARY

Under certain circumstances, it is desirable to deliver a product water flow rate of a certain size. For example, to timely be able to deliver a certain amount of purified water, or to overcome a pressure-drop caused by filters positioned downstream the water purification apparatus. However, the hardware of the water purification apparatus and filters may deteriorate over time. For example, sterilizing grade filters may be blocked by bacteria and endotoxins, and possibly other material. This may affect the product water flow rate from the water purification apparatus. Consequently, the throughput for a constant pressure, will become less over time. Thus, the amount of purified water produced by the water purification apparatus may be uncertain. Hence, one object of the disclosure is to control properties of the product water flow to e.g. maintain a constant (or fairly constant) flow rate or pressure. Another object is to keep the working point (e.g. pressure, temperature or flow rate) components in the water purification apparatus within certain intervals.

These objects and others are at least partly achieved by the apparatuses and methods according to the independent claims, and by the embodiments of the dependent claims.

According to a first aspect, the disclosure relates to a water purification apparatus for producing purified water. The water purification apparatus comprises a Reverse Osmosis, RO, device, a RO-pump, a recirculation path, a purified water path, a purified water path, a control device, at least one detector and a control unit. The Reverse Osmosis, RO, device is arranged to produce a purified water flow, the RO-device comprising a feed inlet arranged to receive feed water and a purified water outlet and the RO-pump is arranged to pump feed water to the feed inlet. Furthermore, the recirculation path is arranged to recirculate a proportion of the purified water flow from a first point downstream the RO-device to a second point upstream the RO-device and the purified water path is arranged to transport purified water from the purified water outlet to a product water port. The purified water path comprises a product water path arranged downstream the recirculation path to transport product water to the product water port. The control unit is configured to control the control device to regulate a flow rate of the purified water in the recirculation path, based on the fluid property detected by the at least one detector. At least one detector is arranged to detect a product fluid property of product water in the product water path. The control unit is also configured to control the control device to control a product fluid property of the product water in the product water path to fulfill one or more predetermined product water criteria, based on the product fluid property detected by the at least one detector. The at least one detector comprises a flow sensor, and the product fluid property detected by the flow sensor is a flow rate of product water in the product water path. Also, the one or more predetermined product water criteria comprises that the flow rate of product water in the product water path corresponds to a predetermined flow rate.

Hence, one or several fluid properties in the purified water path of the water purification apparatus may be controlled. More specifically, one or more product fluid properties of the product water the dialysis machine may be controlled, such that desirable product fluid properties are maintained throughout the production and also e.g. during start-up and shut-down. Here, a desired flow rate of the product water may be maintained over time.

According to some embodiments, wherein the at least one detector comprises a pressure sensor, wherein the product fluid property detected by pressure sensor is a pressure of fluid in the product water path, and wherein the one or more predetermined product water criteria comprises that the pressure of the product water in the product water path stays below a predetermined upper pressure level and/or that the pressure of the product water in the product water path corresponds to a predetermined pressure. Hence, the pressure of the product water in the product water path may be controlled to stay within a range that is desirable for optimal operation. Hence, it may be avoided that components break or become deteriorated due to a too high pressure in the product water path.

According to some embodiments, the at least one filter is arranged to filter product water flowing through the product water path and wherein the predetermined upper pressure level corresponds to a pressure tolerance level of the at least one filter or of any other component arranged in the product water path.

As water is pumped through the filters, bacteria and endotoxins, and possibly other material may reduce the permeability of filters arranged in connection with the product water path. This means that the throughput, for a given pressure, will become less over time. By using the proposed technique, the pressure the product water in the product water path can be increased, up to the maximum allowed level, to compensate for such behavior.

According to some embodiments, the control unit is configured to activate an alarm function in response to a change of the at least one product fluid property detected by the at least one detector. Hence, the operator or patient may be warned if a suspected error is detected.

According to some embodiments, the control unit is configured to control the control device to obtain a predetermined flow rate through the product water port during a pre-determined time period, in order to produce a predetermined amount of water. Hence, an amount of product requested by the dialysis machine may be produced. The requested amount is typically between 0.5 and 400 liters, e.g. 1, 2, 5, 10, 20, 50, 70, 90, 150, 200 or 300 liters.

According to some embodiments, the water purification apparatus comprises a heater, arranged to heat the product water flowing in the product water path. Hence, product water having a temperature requested by the dialysis machine may be produced. The heater may also be used to control the temperature of a RO-membrane of the RO-device.

According to some embodiments, the water purification apparatus comprises a temperature sensor arranged to measure a temperature of water in the purified water path downstream the heater. According to these embodiments, the control unit is configured to control the control device to control the temperature of water flowing through a RO-membrane of the RO-device, based on the temperature detected by the temperature sensor. Hence, the temperature of the RO-membrane may be kept fairly constant, which may be desirable for operation.

According to some embodiments, the water purification apparatus comprises a tank arranged to receive water from an external water source and to provide water to the feed inlet.

According to some embodiments, the water purification apparatus comprises a polisher device arranged downstream the recirculation circuit in the purified water path. The polisher device for example comprises an Electro-deionization, EDI, device.

According to some embodiments, the water purification apparatus comprises a permeate water path arranged to transport purified water from the purified water outlet of the RO-device to an inlet of the polisher device.

According to some embodiments, the product water path is arranged to transport purified water from an outlet of the polisher device to the product water port.

According to a second aspect, the disclosure relates to a corresponding method for controlling at least one fluid property in a water purification apparatus producing purified water. The water purification apparatus comprises a reverse osmosis device, RO-device, producing a purified water flow, and a recirculation path arranged to recirculate a proportion of the purified water flow from a point downstream the RO-device to a point upstream the RO-device. The method comprises detecting at least one fluid property of purified water in a purified water path, including detecting at least one product fluid property of product water in a product water path of the purified water path, wherein the product water path is arranged downstream the recirculation path, and regulating a flow rate of water in the recirculation path to fulfill one or more predetermined criteria of the purified water the purified water path, based on the at least one detected fluid property, including regulating a flow rate of water in the recirculation path to fulfill one or more predetermined product water criteria of the product water in the product water path, based on the at least one detected product fluid property. The at least one product fluid property comprises a flow rate of product water in the product water path and wherein the one or more predetermined product water criteria comprises that the flow rate of water in the product water path corresponds to a predetermined flow rate.

Hence, as described above, the product fluid properties may be controlled to fulfill certain criteria that are e.g. defined by the manufacturer or user. Thus, the production of water may be more effective and dialysis treatment may be safer. The method also enables making smaller and faster changes to the product water flow rate than when only adjusting the pumping frequency used for feeding water to the RO-device.

According to some embodiments, the method comprises estimating an amount of product water produced during a production time period based on the duration of the production time period and a corresponding flow rate of the purified water detected during the production time period. The possibility of controlling the pressure makes it possible to avoid high pressure in the product water path, which in the worst case may cause break down.

According to some embodiments, the method comprises triggering a predetermined action when the amount reaches a pre-defined production volume. For example, an alert signal or action (e.g. a message being sent to the dialysis machine) may be triggered when a requested volume has been produced.

According to some embodiments, the at least one product fluid property comprises pressure in the product water path, and wherein the one or more predetermined product water criterion comprises that the pressure of the product water in the product water path stays below a predetermined upper pressure level.

According to some embodiments, the method comprises measuring a temperature of water in the purified water path downstream a heater arranged in the purified water path. According to these embodiments the regulating then comprises regulating a flow rate of the water in the recirculation path such that the temperature of water flowing through a RO-membrane of the RO-device fulfills a predetermined temperature criterion, based on the temperature detected by the temperature sensor.

Thereby, the temperature span of the water going into the RO membrane will be less dependent on the temperature of incoming water and the ambient temperature since a returning flow of heated purified water may be used to increase the temperature of water in the tank. Consequently, the filtration behavior of the membrane will be more stable.

According to some embodiments, the method comprises continuously performing the detecting and the regulating while the water purification apparatus is producing purified water.

According to some embodiments, the method comprises activating an alarm function in response to a change of the at least one detected product fluid property. Thus, the proposed method according to these embodiments also enables the water purifier to detect sudden changes in the pressure, such as breakthrough of a filter, which means a lower pressure drop, and thereby a lower pressure and an increased flow in the product water path. Alternatively, a leakage between the water purifier and the filters will also result in a pressure drop, which should cause the alarm to go off.

According to some embodiments, the predetermined upper pressure level corresponds to a pressure tolerance level of at least one filter arranged to filter product water downstream the product water path or of any other component arranged in, or within a predetermined distance from, the product water path.

According to some embodiments, the controlling comprises controlling the fluid property of the product water to obtain a predetermined flow rate during a pre-determined time period, in order to produce a predetermined amount of water. Furthermore, the water purifier may continue to deliver the required volume to the dialysis machine even if the communication to the dialysis machine is lost. The pre-determined amount is typically between 0.5 and 400 liters.

According to some embodiments, the method comprises controlling the temperature of the product water flowing in the product water path.

According to some embodiments, a polisher device is arranged downstream the recirculation circuit in the purified water flow and then the product water path is arranged to transport product water from an outlet of the polisher device to the product water port.

According to a third aspect, the disclosure relates to a computer program comprising instructions which, when the program is executed by a computer, cause the computer to carry out the method described above and below.

According to a fourth aspect, the disclosure relates to a computer-readable medium comprising instructions, which when executed by a computer, cause the computer to carry out the method described above and below.

