Automation of Ultrafiltration Rate Control by Glucose Concentration Regulation in Peritoneal Dialysis Solution

ABSTRACT Background Glucose absorption into the bloodstream and body tissues poses a significant challenge in peritoneal dialysis, resulting in a reduced ultrafiltration rate and requiring the use of a dialysate with a high initial glucose concentration. The goal of the presented study is to develop a system for controlling glucose concentration and ultrafiltration rate. Methods The paper proposes a method for the automatic control of glucose infusion to maintain a given glucose concentration and ultrafiltration rate. This method utilizes an optical glucose monitor and a control strategy that combines feedback with prediction of peritoneal volume. Computer simulations were conducted to evaluate the efficiency of the method under various conditions, including errors in the glucose monitor, inaccuracies in parameter determination, and drift in patient parameters. Additionally, the method was compared to an open loop. Results and Conclusions Our results demonstrate the feasibility of using noninvasive glucose monitoring systems and the proposed control strategy to maintain a given dialysate glucose concentration. The proposed closed loop provides more stable maintenance of glucose concentration and ultrafiltration rate for at least 12 h, even in the presence of significant glucometer errors, compared to continuous glucose infusion.