Personalized renal failure chronic care systems and methods

Abstract

A personalized chronic care apparatus is disclosed herein. An example apparatus includes a server operating over a network, software stored on the server, and a compliance entry feature configured to receive compliance information related to a patient. The software includes an automated learning method for creating an overall kidney maintenance plan that specifies one or more controllable variables as actions performed by the patient to prevent or reduce complications associated with chronic kidney disease (“CKD”). The automated learning method is configured to perform an evaluation to determine whether a selected controllable variable is to be included in the overall kidney maintenance plan by confirming when (i) a worsening of kidney function is not determined between first evaluation data and second evaluation data over a testing period, and (ii) the compliance information provides a confirmation that the selected controllable variable was modified over the testing period.

The invention is claimed as follows: 
     
         1 . A personalized renal failure chronic care apparatus for a patient comprising:
 a server operating over a network;   software stored on the server, the software including an automated learning method for creating an overall kidney maintenance plan that specifies one or more controllable variables as actions performed by the patient to prevent or reduce complications associated with chronic kidney disease (“CKD”), the automated learning method configured to present a plurality of controllable variables for selection, and wherein a selected controllable variable is scheduled to be modified for the patient over a testing period; and   a compliance entry feature configured to receive compliance information related to the patient,   wherein the automated learning method is configured to perform an evaluation to determine whether the selected controllable variable is to be included in the overall kidney maintenance plan, the evaluation including:
 receiving, in the server, first evaluation data as a baseline, the first evaluation data related to a chronic kidney disease test of the patient performed during a first time of the testing period, 
 receiving, in the server, second evaluation data that is related to the chronic kidney disease test of the patient performed during a subsequent, second time of the testing period, 
 determining from the first evaluation data and the second evaluation data whether a kidney function worsens, 
 using the compliance information to confirm that the selected controllable variable was modified over the testing period as scheduled, 
 adding the selected controllable variable to the overall kidney maintenance plan as an approved controllable variable when (i) a worsening of kidney function is not determined between the first evaluation data and the second evaluation data, and (ii) the compliance information provides a confirmation that the selected controllable variable was modified over the testing period, and 
 omitting the selected controllable variable from the overall kidney maintenance plan when a worsening is determined between the first evaluation data and the second evaluation data, 
   wherein the server is configured to transmit the overall kidney maintenance plan including at least one approved controllable variable over the network.   
     
     
         2 . The apparatus of  claim 1 , wherein the server is configured to transmit the overall kidney maintenance plan to at least one of a patient device or a health care provider (“HCP”) device to implement or control adherence to the overall kidney maintenance plan. 
     
     
         3 . The apparatus of  claim 2 , wherein the compliance information is received from at least one of the patient device, the HCP device, or a website. 
     
     
         4 . The apparatus of  claim 1 , wherein the compliance information is received from at least one of a wristband sensor, a leg sensor, a camera, a heartrate sensor, a blood pressure sensor, a glucose sensor, a weight sensor, or a temperature sensor. 
     
     
         5 . The apparatus of  claim 1 , wherein the controllable variables for selection include at least one nutritional variable related to a dietary adjustment or a dietary restriction, at least one medicinal variable related to at least one of a blood pressure reducing drug or an appetite suppressing drug, and at least one lifestyle variable related to a lifestyle adjustment. 
     
     
         6 . The apparatus of  claim 5 , wherein the nutritional variable includes at least one of (i) phosphorous to be reduced in the patient's diet, (ii) calcium to be reduced in the patient's diet, (iii) sodium to be reduced in the patient's diet, (iv) alcohol consumption to be reduced, (v) water to be consumed in a prescribed amount, (vi) an antioxidant to be consumed in a prescribed amount, (vii) sugar consumption to be reduced, or (viii) a vitamin consumed in a prescribed amount. 
     
     
         7 . The apparatus of  claim 5 , wherein the lifestyle variable includes at least one of (i) going to sleep by a prescribed hour in a day, (ii) performing a certain amount of exercise, or (iii) eliminating food consumption after a certain time in a day. 
     
     
         8 . The apparatus of  claim 1 , wherein the chronic kidney disease test includes at least one of an albumin-to-creatinine ratio (“ACR”) test or a glomerular filtration rate (“GFR”) test performed on the patient, and
 wherein the evaluation causes the selected controllable variable to be included in the overall kidney maintenance plan when the at least one ACR or GFR test does not show worsening of kidney disease or loss of kidney function. 
 
     
     
         9 . The apparatus of  claim 1 , wherein the inclusion of the approved controllable variable in the overall kidney maintenance plan is performed to slow or stop a co-morbidity factor affected by the controllable variable, and wherein the evaluation includes determining an effect of the controllable variable on the co-morbidity factor relative to a desired value for the co-morbidity factor. 
     
     
         10 . The apparatus of  claim 9 , wherein a first co-morbidity factor is patient volume leading to heart failure, a second co-morbidity factor is patient blood pressure leading to heart failure or stroke, and a third co-morbidity factor is patient blood sugar leading to diabetes. 
     
     
         11 . The apparatus of  claim 9 , wherein the plurality of controllable variables for selection are associated with a co-morbidity factor selected from a plurality of co-morbidity factors. 
     
     
         12 . The apparatus of  claim 11 , wherein the selected co-morbidity factor is patient volume and the associated controllable variables include at least one of (i) limiting weight of food consumed, (ii) limiting weight of liquid consumed, (iii) limiting weight of food and liquid consumed, or (iv) regulating an amount of food and/or liquid consumed after treatment so that a greater percentage of food and/or liquid is consumed closer to or farther from a next dialysis treatment. 
     
     
         13 . The apparatus of  claim 11 , wherein the selected co-morbidity factor is patient blood pressure and the associated controllable variables include at least one of (i) limiting sodium intake, (ii) limiting a sodium level of dialysis fluid used during treatment, (iii) limiting fatty foods, or (iv) limiting alcohol consumption. 
     
     
         14 . The apparatus of  claim 11 , wherein the selected co-morbidity factor is patient blood sugar and the associated controllable variables include at least one of (i) limiting sugar intake, or (ii) limiting dextrose or glucose levels in peritoneal dialysis fluid. 
     
     
         15 . A personalized renal failure chronic care method for a patient comprising:
 storing within software of a server, an automated learning method for creating an overall kidney maintenance plan that specifies one or more controllable variables as actions performed by the patient to prevent or reduce complications associated with chronic kidney disease (“CKD”), the automated learning method configured to present a plurality of controllable variables for selection, and wherein a selected controllable variable is scheduled to be modified for the patient over a testing period; and   performing an evaluation to determine whether the selected controllable variable is to be included in the overall kidney maintenance plan by
 receiving, in the server, first evaluation data as a baseline, the first evaluation data related to a chronic kidney disease test of the patient performed during a first time of the testing period, 
 receiving, in the server, second evaluation data that is related to the chronic kidney disease test of the patient performed during a subsequent, second time of the testing period, 
 determining, via the server, from the first evaluation data and the second evaluation data whether a kidney function worsens, 
 receiving, in the server, compliance information related to the patient, 
 using, via the server, the compliance information to confirm that the selected controllable variable was modified over the testing period as scheduled, 
 adding, via the server, the selected controllable variable to the overall kidney maintenance plan as an approved controllable variable when (i) a worsening of kidney function is not determined between the first evaluation data and the second evaluation data, and (ii) the compliance information provides a confirmation that the selected controllable variable was modified over the testing period, and 
 omitting, via the server, the selected controllable variable from the overall kidney maintenance plan when a worsening is determined between the first evaluation data and the second evaluation data. 
   
     
     
         16 . The method of  claim 15 , further comprising transmitting, from the server to at least one of a patient device or a health care provider (“HCP”) device, the overall kidney maintenance plan including at least one approved controllable variable to implement or control adherence to the overall kidney maintenance plan. 
     
     
         17 . The method of  claim 15 , wherein the controllable variables for selection include at least one nutritional variable related to a dietary adjustment or a dietary restriction, at least one medicinal variable related to at least one of a blood pressure reducing drug or an appetite suppressing drug, and at least one lifestyle variable related to a lifestyle adjustment. 
     
     
         18 . The method of  claim 17 , wherein the nutritional variable includes at least one of (i) phosphorous to be reduced in the patient's diet, (ii) calcium to be reduced in the patient's diet, (iii) sodium to be reduced in the patient's diet, (iv) alcohol consumption to be reduced, (v) water to be consumed in a prescribed amount, (vi) an antioxidant to be consumed in a prescribed amount, (vii) sugar consumption to be reduced, or (viii) a vitamin consumed in a prescribed amount. 
     
     
         19 . The method of  claim 17 , wherein the lifestyle variable includes at least one of (i) going to sleep by a prescribed hour in a day, (ii) performing a certain amount of exercise, or (iii) eliminating food consumption after a certain time in a day. 
     
     
         20 . The method of  claim 1 , wherein the chronic kidney disease test includes at least one of an albumin-to-creatinine ratio (“ACR”) test or a glomerular filtration rate (“GFR”) test performed on the patient, and
 wherein the evaluation causes the selected controllable variable to be included in the overall kidney maintenance plan when the at least one ACR or GFR test does not show worsening of kidney disease or loss of kidney function.