JP4093695B2 - Dialysis treatment device - Google Patents

Description

[0001]
The present invention relates to an apparatus for dialysis treatment by extracorporeal blood circulation to which a dialyzer divided into a blood chamber and a dialysate chamber is connected by a semipermeable membrane. The present invention further relates to a method for adjusting the dialysate flow rate in the same type dialysis treatment apparatus to be small.
[0002]
Conventional dialysis machines generally include a bypass line that branches off from a supply line coupled to the dialysate chamber inlet and leads to a lead-out line coupled to the dialyzer outlet. A shut-off valve that is opened and closed by a control system is attached to the supply line, the discharge line, and the bypass line. In the operating mode, the control system separates the dialysate chamber of the dialyzer from the dialysate line. In that mode, the supply and discharge lines are closed while the bypass line closing valve is opened.
[0003]
Further, conventional dialysis machines also include a volume balance device. The balance device can be switched between supply and discharge lines as required, and has two chambers divided by movable elements each time. To balance the unused dialysate against the used dialysate, half of each balance chamber is alternately filled with unused and used dialysate. DE-A-28 38 414 is known as an example of a dialysis machine having this type of balance device.
[0004]
In order to optimize dialysis treatment, certain parameters need to be measured during extracorporeal blood treatment. Various methods are known as hemodialysis parameter measurement methods by measuring substance concentrations in circulating blood and dialysate lines. When the dialysate flow rate through the dialysate chamber decreases to a certain value, it has been shown that the substance concentration in the dialysate line is substantially the same as the substance concentration in the circulating blood regardless of the treatment method. This is beneficial in that no blood side measurement is required.
[0005]
In a dialysis machine having a balance chamber, a decrease in dialysate flow rate is a major problem. As the number of balance chamber switching cycles decreases, the fluid flow through the dialysate chamber becomes discontinuous. In such a state, the temperature of the dialysis fluid fluctuates inappropriately due to cooling in the stationary phase, and the distribution of the electrolyte in the dialysis fluid also becomes nonuniform, with the result that the conductivity varies greatly. This situation is inconvenient for the accuracy of the sensor in the dialysate circulation, regardless of the treatment.
[0006]
An object of the present invention is to complete a dialysis treatment device that reduces the dialysate flow rate by a simple method without requiring a large-scale device, and a method for controlling the reduced dialysate flow rate in the dialysis treatment device. Is to provide.
[0007]
This problem is solved by the features of claims 1 to 17.
[0008]
In the apparatus of the present invention, the apparatus cost is low because the apparatus is used in the bypass line of the conventional dialysis apparatus and the supply and / or discharge line in order to reduce the dialysate flow rate. Kept.
[0009]
In the case of the above apparatus, in the operation mode in which the dialysate flow rate is reduced, the dialysate is adjusted to flow in the supply line and the discharge line connected to the bypass line and the dialysate chamber. By doing so, the amount of fluid flowing through the dialysate chamber is reduced and a portion of the dialysate is diverted to the bypass line. Since dialysate continuously flows through the dialysate chamber, there is no temperature control problem. In addition, the composition and uniformity of the dialysate accurately corresponds to the condition during dialysis treatment. When the main liquid flow is constant, the flow can be switched to a slow flow without causing a delay due to a transient phenomenon. After measuring the hemodynamic parameters with the dialysate flow rate decreased, the treatment can be immediately proceeded at the normal flow rate without adjusting the steady-state conductivity again.
[0010]
The bypass line branched from the supply line upstream of the dialysate chamber leads to the discharge line downstream of the dialyzer. However, the bypass line can also be connected to the drain hole. The liquid in the line can be controlled by a flow-through sensor and / or a pump.
[0011]
If the dialysate flow control device includes a bypass valve in the bypass line and a dialyzer valve in the dialyzer in the supply line and / or drain line, there is no need to change the line arrangement of the conventional dialyzer. When the dialyzer valve attached to the bypass valve and the supply line and the discharge line is opened, the main flow is divided, and the dialysate flow rate passing through the dialysate chamber is reduced, and the dialysate flow rate is reduced in the dialyzer. Depends on flow conditions.
[0012]
As a means for controlling the dialysate flow rate, not only a valve but also a pump can be used. When the pump is stationary, no liquid flows, while when the pump is operating, the liquid flows in the line.
[0013]
In a preferred embodiment, a second bypass line is provided that bypasses the bypass valve in the first bypass line, wherein a second bypass valve and a throttle valve are mounted inside the second bypass. When decreasing the dialysate flow rate, the first bypass valve is closed and the second bypass valve and the dialyzer valve installed in the supply and drain lines are opened. This embodiment has the advantage that when the dialysate flow rate in the dialyzer is adjusted to be too small by the flow path system in the dialyzer, the flow rate of fluid passing through the dialysate chamber can be increased by the slot valve. Have.
[0014]
When the dialyzer valve is actually opened, the dialysate flow rate passing through the dialysate chamber is adjusted by simply opening the first bypass valve based on the fluid flow resistance of the dialyzer valve. It has been shown to be sufficient to correct the dialysate concentration relative to the concentration.
[0015]
In a further preferred embodiment, in order to finely adjust the dialysate flow rate, a dialyzer valve installed in the supply line or the discharge line is bypassed, and a second bypass valve and a throttle valve are installed therein. Bypass is provided. In this embodiment, the first and second bypass valves are open and the dialyzer valves attached to the supply and drain lines are closed. In this case, the dialysate flow rate through the dialysate chamber is determined by the fluid flow resistance of the throttle valve in the second bypass branch.
[0016]
An embodiment that bypasses the dialyzer valve located upstream of the dialysate chamber is particularly useful because the dialyzer is on the side of the throttle valve where the pressure is low and the risk of “back filtration” is low.
[0017]
The throttle valve in the second bypass line may be a liquid flow resistance fixed type throttle valve or a liquid flow resistance variable type throttle valve.
[0018]
In a further preferred embodiment, the fluid flow resistance of the throttle valve is variable, where the dialysate flow rate through the dialysate chamber is measured. The flow resistance of the throttle valve is adjusted so that the dialysate flow rate through the dialysate chamber in the main flow is constant.
[0019]
When the dialysate flow rate is reduced, sampling is preferably performed by sucking dialysate from the downstream of the dialysate chamber using a sample collection pump and returning it to the balance system. In order to divert dialysate, the first sample collection line exits the discharge line upstream of the dialyzer valve attached in it and reaches the connection point of the sample collection pump, and the second sample line is the other sample line. Out of the connection point, down to the dialyzer valve mounted in it. The second sample collection line can also be routed to any other line connected to the bypass line or the discharge line downstream of the dialyzer valve. Since the dialysate in the balance system is refluxed, the balance is not disturbed. After adjusting the dialysate to an equilibrium state, a certain amount of dialysate is collected via a third sample collection line connected to the first or second sample collection line and sent to the hemodynamic parameter measurement device. For example, the concentration is measured as the hemodynamic parameter. When balancing, the amount of dialysate collected is taken into account.
[0020]
The sample collection pump allows the dialysate to pass through the dialyzer at low speed, regardless of the speed of the dialysate flow rate in the flow path, and sufficiently accurately regardless of the pressure, dialyzer type, and dialyzer equipment. A certain amount can be delivered accurately. The pump can be used not only for normal dialysate sample delivery but also for washing and rinsing the flow path.
[0021]
The sample collection pump and the components connected to the pump can be contained in a pluggable cassette unit that can be coupled to the flow path of a conventional dialysis machine. In the event of a failure, the valve can be used to isolate the pump or other components from the flow path and dialysis can continue without any effect.
[0022]
In a further preferred embodiment, only two connection lines are provided in order to simplify the cassette unit connection to the flow path of conventional dialysis machines.
[0023]
Hereinafter, some embodiments of the present invention will be described in detail with reference to the drawings.
[0024]
In FIG. 1, only the main components of the hemodialysis machine are depicted. The dialyzer shows a dialyzer 1 that is divided into a blood chamber 3 and a dialysate chamber 4 by a semipermeable membrane (semipermeable membrane) 2. An arterial blood line 5 to which a blood pump 6 is attached is connected to the inlet of the blood chamber 3. A venous blood line 7 is led to the patient from the outlet of the blood chamber.
[0025]
A fresh dialysate is prepared in the dialysate supply source 8. The first line portion 9a of the dialysate supply line 9 coming out of the dialysate supply source 8 is led to the entrance in the balance device 10 divided into two balance half chambers 10a and 10b, and is used for the used dialysate. The unused dialysate is balanced. In a volume balance type dialysis apparatus, two balance chambers mounted in parallel are generally used, but only one of them is shown in FIG. The second line portion 9b of the supply line 9 exiting from the outlet of the first balance chamber is divided into two chambers 11a and 11b by a bacteria trapping membrane 11c connected to the dialysis fluid path in order to remove bacteria from the dialysis fluid. The divided sterilization filter 11 reaches the entrance of the first chamber 11a. A third line portion 9 c of the supply line that exits from the outlet of the second chamber 11 b of the sterilizing filter 11 reaches the inlet of the dialysate chamber 4. The first line portion 12a of the dialysate discharge line 12 coming out from the exit of the dialysate chamber 4 reaches the entrance of the second chamber 10b of the balance device. The line exiting from the second balance chamber 10b passes through the second line portion 12b of the discharge line and is connected to the discharge port 13. A dialysate pump 29 is attached to the first line portion 12a of the dialysate discharge line. Upstream of the dialysate pump 29, an ultrafiltration line 30 branches from the first line portion 12a, and this line reaches the second line portion 12b of the dialysate discharge line 12. An ultrafiltration pump 31 is attached to the ultrafiltration line 30.
[0026]
In order to separate the dialysate chamber 4 of the dialyzer from the dialysate flow path, the dialyzer uses a bypass line 14 that exits from the outlet of the first chamber 11a of the sterilizing filter 11 and reaches the first line portion 12a of the discharge line. . An electromagnetically driven bypass valve 15 is attached to the bypass line 14, but a first dialyzer valve 16 is provided in the third line portion 9c of the supply line, and a second dialyzer is provided in the first line portion 12a of the discharge line. A valve 17 is attached. The dialyzer valves 16 and 17 are similarly electromagnetically driven. The bypass valve 15 and both dialyzer valves 16 and 17 are controlled by a central control system connected to each valve via control lines 15a, 16a and 17a.
[0027]
The central control system 18 determines various operation modes. In order to separate the dialyzer 1 from the dialysate flow path, the control system performs control by a method of opening the bypass valve 15 with the dialyzer valves 16 and 17 closed. In addition, the control system also provides a mode of operation that reduces the dialysate flow rate to measure hemodynamic parameters in the dialysate flow path.
In this mode of operation, the control system controls the valves to open the bypass valve 15 and dialyzer valves 16, 17 so that dialysate flows through the bypass line 14 and the dialysate chamber 4.
[0028]
The embodiment of FIG. 2 differs from the embodiment of FIG. 1 in that it has a separate bypass line with a second bypass valve and a throttle valve. Each part of the dialysis machine of FIG. 2 corresponding to each part of the apparatus of FIG. The second bypass line 19 branches from the first bypass line 14 upstream of the first bypass valve 15 and reaches the line portion of the first bypass line downstream of the bypass valve. The second bypass line 19 has an electromagnetically driven second bypass valve 20 and a throttle valve 21, and the liquid flow cross-sectional area can be adjusted. The second bypass line 20 and the throttle valve are controlled by the control system 18 via the control lines 20a and 21a. In addition, the dialyzer also utilizes a flow meter 22 mounted downstream of the second dialyzer valve in the first line portion 12a of the discharge line. However, it is also possible in principle to attach the flow meter to the third line portion 9c of the supply line 9 in order to monitor the amount of dialysate flowing through the dialysate chamber of the dialyzer. A flow meter can also be arranged in the first bypass line 14, in which case the dialysate flow rate is calculated from the difference produced between the main fluid flow and the first bypass line fluid flow. The flow meter 22 is connected to the control system 18 by a data line 22a.
[0029]
In the mode of operation where the dialysate flow rate is reduced, the control system 18 closes the first bypass valve 15 while opening both the second bypass valve 20 and the dialyzer valves 16 and 17. The dialysate flows not in the first bypass but in the second bypass line, and the flow rate is determined by the cross-sectional area of the throttle valve 21. The control system 18 controls the flow cross-sectional area of the throttle valve so that the dialysate passage flow rate of the dialysate chamber 4 becomes a predetermined value, and the flow rate is monitored by the flow meter 22.
[0030]
FIGS. 3 and 4 show another embodiment in which a second bypass branch is provided that straddles the first or second dialyzer valve rather than the first bypass valve 15. In this example, the same number is assigned to each part of the corresponding dialysis machine.
[0031]
In the embodiment of FIG. 3, the second bypass line 23 branches off from the third line portion 9c of the supply line 9 upstream of the first dialyzer valve and to the third supply line portion 9c downstream of the dialyzer valve 16. It reaches. The second bypass valve and the throttle valve are indicated by 24 and 25 in the figure. These are controlled via control lines 24a and 25a.
[0032]
In the embodiment of FIG. 4, the second bypass line 26 branches from the first line portion 12 a upstream of the second dialysis valve 17 and reaches the discharge line portion 12 a downstream of the dialysis valve 17. The second bypass valve and throttle valve are indicated by 27 and 28, and the control line is indicated by 27a and 28a.
[0033]
In the mode of operation where the dialysate flow is reduced, the control system 18 opens the first bypass valve 1 and closes one of the dialyzer valves 16, 17 but opens the bypass valves 24 and 27. In this case, the dialysate flow rate is set by the flow path cross-sectional area of the throttle valves 25-28. The control system adjusts the cross-sectional area of the flow path so that the dialysate flow rate becomes a predetermined value, and the liquid flow rate is monitored by the flow meter 22 in this example as well.
[0034]
In principle, only one dialyzer valve can be installed upstream or downstream of the dialysate chamber 4. Furthermore, a fixed liquid flow cross-sectional area throttle valve can be used instead of the variable liquid flow cross-sectional area throttle valve. In this case, naturally the liquid flow cannot be controlled, but is sufficient for the necessary measurements.
[0035]
FIG. 5 shows the analysis unit formed as a removable cassette unit with the main elements of the dialysis machine. The dialyzer utilizes a dialyzer 32 having a blood chamber 33 and a dialysate chamber 34 separated by a semipermeable membrane 35. Through the blood supply line 36, the blood flows into the blood chamber 33, passes through the blood discharge line 37 and exits from the blood chamber 33. The dialysate exits the unillustrated balance device, flows into the dialysate chamber 34 through the dialysate supply line 38, exits the dialysate chamber 34 through the dialysate discharge line 39, and returns to the balance device. A first dialyzer valve 40 is attached to the supply line 38, and a second dialyzer valve 41 is attached to the discharge line. A bypass line 42 in which a bypass valve 43 is attached connects the supply line 38 and the discharge line 39. The used dialysate is discharged through a discharge line 44. The supply line, discharge line and bypass line together with the valve and balance device form a dialyzer channel 45.
[0036]
The replaceable cassette unit 46 includes a sample collection pump 47 and a hemodynamic parameter measurement device in, for example, dialysate, for example, an analyzer A with a sensor for measuring the concentration of a urine related substance such as urea. The first sample collection line 48 branches from the discharge line 39 upstream of the dialyzer valve 41 to reach the connection 47a of the sample collection pump 47, where it is connected to the bidirectional membrane pump. A second sample collection line 49 exits from the other connection portion 47 b of the pump 47 and reaches the bypass line 42 downstream of the bypass valve 43. Sample collection valves 50 and 51 are attached to the first and second discharge paths 48 and 49, respectively. From the first collection line 48ab, a third sample collection line 52 in which another sample collection valve 53 is attached branches and reaches the entrance of the analyzer A. The discharge line 54 exits from the outlet of the analyzer A and reaches the drain line 44. Each of the sample collection line and the discharge line is composed of two line portions, which are connected to each other by connectors 55, 56, and 57, and the cassette unit 46 can be separated from the dialyzer flow path 45. . In order to control the electromagnetically driven valve, a control system 58 is provided which is coupled to the valve via control lines S1 to S6.
[0037]
During dialysis operation, the control system 58 opens the first and second dialyzer valves 40, 41 and closes the bypass valve 43 and the sample collection valves 50, 51, 53. When collecting a sample, the bypass valve 43 is opened, the second dialyzer valve 41 is closed, and the first and second sample collection valves 50 and 51 are alternately opened. With the first sample collection valve open and the second sample collection valve closed, the pump 47 pumps a certain amount of the dialysate discharged, opens the second valve, and balances the spent dialysate with the first valve closed. Return to the system. After reaching the equilibrium state, the third valve is opened with the first and second sampling valves 50 and 51 closed, and the dialysate sample flows through the analyzer A. Thereafter, the sample leaving the analyzer A is led to the outlet. When unused dialysate flows through the bypass line 42, the reduced dialysate flow rate in the dialyzer can be adjusted without adversely affecting the flow control of the dialyzer. At this time, the conductivity and temperature are constant. Since the pump operates in both directions, the sample can be taken from unused dialysate after the sample collection valve has been switched appropriately to reverse the fluid flow. When balancing, take into account that the amount of sample liquid collected is constant.
[0038]
FIG. 6 shows an embodiment which differs from the embodiment described in FIG. 5 in that the sampling pump is one-way actuated. In this embodiment, an unused sample can be collected without reversing the flow path direction. Corresponding parts in the embodiment according to FIGS. 5 and 6 are assigned the same symbols. In the embodiment of FIG. 6, the fourth sample collection line 60 branches off from the supply line 38 and reaches the first collection line upstream of the collection pump 47 '. A fourth sample collection valve 59 is attached to the fourth sample collection line 60. Furthermore, the third sample collection line 52 is different from the second collection line 49 in that it is not the first collection line. The fourth sample collection valve 59 is connected to the control system 58 by another control line S7 and is closed by the control system 58 during dialysis operation and during sample collection from the dialysate that has flowed out. The other valves are controlled as in the embodiment according to FIG. When a sample is collected from the unused dialysate, the first sample collection valve 50 is closed, the fourth collection valve 59 is opened, and the unused dialysate is pumped by the collection pump 47.
[0039]
FIG. 7 shows another embodiment in which the replaceable cassette unit can be coupled with only two connecting lines in the flow path section of the dialyzer. Each part of the embodiment of FIG. 7 corresponding to each part of the embodiment of FIGS. 5 and 6 is also given the same symbol. The flow path part 45 has a first dialyzer valve 40, a supply line 38 leading to the dialyzer 32, a second dialyzer valve 41, a discharge line 39 exiting from the dialyzer and a bypass line having a bypass valve 43. 42. A third dialyzer valve 61 is mounted in the discharge line 39 between the first dialyzer valve 41 and the dialyzer 32.
[0040]
During dialysis, the first, second and third dialyzer valves are opened while the bypass valve 43 is closed.
[0041]
The first sample collection line 48 branches from the discharge line upstream of the third dialyzer 61 and reaches a one-way actuated collection pump 47 ', which is a membrane pump. The second sample collection line 49 exiting from the collection pump 47 ′ reaches the discharge line 39 downstream of the third dialyzer valve 61. The third sampling line 52 branched from the second sampling line 49 reaches the analyzer A, and the discharge line 54 branches therefrom. First, second, and third sample collection valves 50, 51, and 53 are attached to the first, second, and third sample collection lines. FIG. 7 does not show the control system and control lines.
[0042]
During sample collection, the third dialyzer valve 61 is closed so that the dialysate flows through the first and second sample collection lines 48 and 49. The first and second sample collection valves 50 and 51 are alternately opened and closed, whereupon the sample collection pump 47 ′ sends out a certain amount of dialysate and adjusts it to an equilibrium state, then closes the collection valves 50 and 51 and opens the valve 53. Send to open analyzer A.
[Brief description of the drawings]
FIG. 1 is a simplified schematic diagram of a first embodiment of a hemodialysis apparatus.
FIG. 2 is a second embodiment of a dialysis machine.
FIG. 3 is a third embodiment of a dialysis machine.
FIG. 4 is a fourth embodiment of a dialysis machine.
FIG. 5 is a simplified schematic diagram of a first embodiment of a dialysis unit with the main components of the dialysis machine.
FIG. 6 is a simplified schematic diagram of a second embodiment of a dialysis unit with the main components of the dialysis machine.
FIG. 7 is a simplified schematic diagram of a third embodiment of a dialysis unit.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Dialyzer 2 Semipermeable membrane 3 Blood chamber 4 Dialysate chamber 5 Arterial blood line 6 Blood pump 7 Venous blood line 8 Dialysate supply source 9 Dialysate supply line 9a First line portion 9b of 9 9 Second line portion 9c of 9 9 third line portion 10 balance device 10a balance chamber 10b balance chamber 11 sterilization filter 11a chamber 11b chamber 11c capture membrane 12 dialysate discharge line 12a 12 first line portion 12b 12 second line portion 13 discharge port 14 first Bypass line 15 First bypass valve 15a Control line 16 First dialyzer valve 16a Control line 17 Second dialyzer valve 17a Control line 18 Central control system 19 Second bypass line 20 Electromagnetically driven second bypass valve 21 Throttle valve 22 Flow rate Measuring device 23 second bypass In 24 Second bypass valve 25 Throttle valve 26 Second bypass line 27 Second bypass valve 28 Throttle valve 29 Dialysis pump 30 Ultrafiltration line 31 Ultrafiltration pump 32 Dialyzer 33 Blood chamber 34 Dialysate chamber 35 Semipermeable membrane 36 Blood supply line 37 Blood discharge line 38 Supply line 39 Dialysate discharge line 40 Dialyzer valve 41 Dialyzer valve 42 Bypass line 43 Bypass valve 44 Discharge line 45 Dialyzer flow path 46 Cassette unit 47 Sample collection pump 47a Connection part 47b Connection part 47 'collection pump 48 first sample collection line 48a first collection line 48b first collection line 49 second sample collection line 50 sample collection valve 51 sample collection valve 52 third sample collection line 53 sample collection valve 54 discharge line 55 connection 56 Connector 57 Connector 58 Control system 59 Fourth sampling valve 60 Fourth sampling line 61 Third dialyzer valve

Claims (16)

The semipermeable membrane (2) to bind the extracorporeal blood circulation circuit including the blood chamber of the blood chamber (3) and divided dialyzer dialysate chamber (4) (1), an inlet of the dialysate chamber dialysate line of the dialysis fluid supply line (9), wherein the dialysate discharge line coupling the outlet of the dialysis chamber (12), and balancing device (10), branches from the supply line in the dialysate chamber upstream pass a line (14), the dialysate flow control device mounted in said bypass line and said supply line and / or the discharge in the lines (15, 16, 17; 20, 21; 24; 25; 27, 28) When the control unit (18) and Bei of the dialysate flow rate adjusting device of the bypass line and the supply line and / or the discharge in the line A to have dialysis treatment apparatus,
The dialysate flow rate adjusting device control device (15, 16, 17; 20, 21; 24; 25 27, 28) (18), Ru reduce the dialysate flow the through the dialysate chamber (4) are formed the operation mode so as settable for, in the operating mode the dialysate flow rate adjusting device of the bypass line (14) as well as in the supply line and / or the discharge line (9, 12) in the Passing through the bypass line and both the supply line and the discharge line so that the flow of the dialysate is at least partially passed through the bypass line (14). A device for dialysis treatment, characterized in that it is configured to control such that it is discharged . The dialysate flow rate adjusting device, the bypass line bypass valve mounted in (15) and said supply line (9) dialyzer valve mounted in (16) and / or the discharge line (12) Device according to claim 1, characterized in that it comprises a dialyzer valve (17) attached. Wherein comprising a device control system for controlling the dialysate flow rate control device (18), wherein the operation mode at the time of the dialysate flow rate reduction is attached to the bypass valve (15) and the supply line or the exhaust in the line the dialyzer valve (16, 17) the apparatus of claim 2, wherein the formed and Tei Rukoto characterized as to be opened. The first bypass valve and branched from the first bypass line (14) upstream of (15), the second bypass line (19) is provided leading to the first bypass line with the first bypass valve downstream, the 3. The device according to claim 2, wherein a second bypass valve (20) and a throttle valve (21) are mounted in the second bypass line. Includes a device controller for controlling the dialysate flow rate adjusting device, the dialysate flow rate reduction during the operation mode the first bypass valve closed (15), the second bypass valve (20) and said supply the apparatus of claim 4, wherein Tei Rukoto formed so as to open the dialyzer valve attached to the line or the discharge in the line (16, 17). The branched from the supply line upstream of the supply line (9) the dialyzer valve mounted in (16), the second bypass line leading to the dialyzer valve downstream supply line (23) 3. The device as claimed in claim 2, wherein a second bypass valve (24) and a throttle valve (25) are provided in the second bypass line. Wherein comprising a means control system for controlling the dialysate flow rate control device (18), open the dialysate flow rate the first bypass valve at the operating mode at the time of reduction and the second bypass valve (15, 24), the apparatus of claim 6 wherein said dialyzer valve (16), characterized in Tei Rukoto formed so as to close the attached to the supply line. The branched from said exhaust line upstream of said mounted in the discharge in line dialyzer valve (17), the second bypass line leading to the dialyzer valve downstream of the exhaust in the line is provided, the second 3. A device according to claim 2, wherein a second bypass valve (27) and a throttle valve (28) are installed in the bypass line. Wherein comprising a means control system for controlling the dialysate flow rate control device (18), open the dialysate flow rate the first bypass valve at the operating mode at the time of reduction and the second bypass valve (15, 27), the apparatus of claim 8, characterized in that it is formed to close the dialyzer valve attached to the exhaust in the line (17). Control means of said dialysis fluid flow rate adjusting device, any one of claims 4 to 9, characterized in that it comprises a dialysate flow measuring device (22) having a throttle valve with adjustable fluid cross-sectional area 1 The device according to item. First sampling line (48) reaches the upstream at exits the discharge line (39) connecting portion of the sampling pump (47) of the said dialyzer valve mounted inside (41) (47a), Furthermore, the second sampling line (49) is out than another connection portion of the sampling pump (47b), downstream of the dialyzer valve mounted therein (41) or the bypass line (42) wherein characterized in that it is configured to reach the discharge line (39), device of any one of up to claim 2-10. Third sampling line (52) is branched from the minute the first sampling line and the second sampling line (48, 49), that is configured to reach the haemodynamic parameter measuring device (48) The apparatus of claim 11. 13. A device according to claim 11 or 12, characterized in that the sampling pump (47) is a bidirectional pump. Wherein a sampling pump (47) is unidirectional pump, the first collection line (48) leads to the suction connection section, the second sample line (49) leads to the pressure connection part, further a fourth sample claim 11 or 12, wherein collection line (60) is characterized by being configured so as to extend to the suction connection of the sampling pump out from the supply line (38) or the bypass line (42) Equipment. The apparatus of claim 14, wherein said first sampling line and the fourth sampling line (48, 60) sampling valve in each (50, 59) is mounted. The dialysate flow rate control device provided with means control system for controlling (58), said dialysate said bypass line (43) in the flow rate reduction during the operation mode of and said dialyzer mounted to the supply line (38) in open the valve (40), the apparatus of claim 11, wherein the said dialyzer valve attached to the discharge line (40) (41) is formed to close, characterized in Tei Rukoto.

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