[Allient Sorbent] New Website Launched

Discussions for Patients, Family, and Friends HD For Patients
1

If you haven’t been keeping track of the Allient System well you should! Just recently they re-launched their website with new information including some training tool section…

http://www.renalsolutionsinc.com

http://www.renalsolutionsinc.com/home/p/InfusateMix_Instructions.pdf
http://www.renalsolutionsinc.com/home/p/DialysateMix_Instructions%20-%20CLIN.pdf

What do you think? Will this technology catch on? I predict that this system will come 2nd to NxStage in design and innovation for the reason of weight, size and simplicity…

2

The sorbent system is pretty interesting. As I’ve mentioned before, it’s a re-incarnation of the old Redy system which faded away because it was limited by the inability to adsorb urea adequately. Glad to see they’ve persisted with it and perfected it since then. I only started dialysis in 2002, but, it could just as easily have been in 1980 or even earlier, given the unpredictable nature of the kidney disease I know I’ve had since at least 1977. So, I’ve always kept an eye on the evolution of dialysis technology in case I should need it.
Pierre

3

Pierre, if you had the opportunity to try it would you be willing to do it?

4

I might in the context of a clinical trial. Two and a half years ago, I would have jumped at the opportunity to get in on the clinical trial of a small hemofiltration machine which required only a daily 2 hour treatment. The Kidney Research Centre at the Ottawa Hospital / University of Ottawa was part of the trial. It may have been the NxStage machine in its hemofiltration configuration, I don’t know for sure. I was rejected at the time because I didn’t have sufficient time on hemodialysis yet. I was on conventional hemo at the time, so anything would have been a step up :slight_smile:
Pierre

5

Hey quite cool, maybe you can do it this time…

The sorbent system from Allient interests me alot and have the itch of wanting to try it. However, I have not looked into it yet with with WellBound nor the company.

Though, their still in their study and the technology has already been around there shouldn’t be any fear in getting into that research study analysis.

6

They tend to be a little cautious about these things here. I suspect that if they trialed it, they wouldn’t do it with patients at home.
Pierre

7

Good thought there, but who knows…in my clinic they offered both Aksys and NxStage, wouldn’t they want to offer the new Allient Sorbent?

If this is research I think they would…NxStage Systrem One was research and now they have their FDA clearance…Allient Sorbent is research and I think to they would weclome patients to try it for their IDE study, but behind my head I wonder…how would NxStage feel if I’d want to to something like that? Would I be treated the same? :roll:

8

Speaking about joining the Allient Sorbent research study the company is welcoming patients to join this FDA study.

If your interested, all you do is talk to your Nephrologist and clinic about and tell them your interested. If you need more information just seek the information first before deciding…you can also contact the company directly… 8)

read More Here…
http://www.renalsolutionsinc.com/home/training_whitepapers.html

9

I am keeping an eye on this also. I would prefer a machine where the OPTION is available for either short or long treatments. transportable, and less time with preparation and teardown. In the brief summary given on the machine it sounds as though this fits the criteria. However, the drawbacks haven’t been listed yet and there is usually something.

10

This machine does allow that, you have both options of short-daily and nocturnal, you even do both types…some days nocturnal and some days short-daily 2 hour…

However, we will never know the drawbacks of this machine if we don’t participate in the study… :?

For me, things like you just stated…setup time, tear down time, and of course support…

Does or will the company replace the machine when there are problems…or is it left all to the clinic? That’s just one of the things I ask myself…

I know there are other un-answered questions, but again we’ll never know until patients show interest in the study and am sure there are plenty patients already on the waiting list…

11

I read all of the information they provide on their website. But one thing I never understood (which is obviously fundamental to their machine) - is what does the term “sorbent” mean and does anyone know if that is a better method of dialyzing or not?

12

Hi y’all,

EstonB wrote:

what does the term “sorbent” mean and does anyone know if that is a better method of dialyzing or not?

I am NOT an expert on the sorbent system by any stretch, but I think I understand it well enough to give you the basics. Folks–please jump in and correct me here, if I get any of this wrong.

A sorbent is a material that either absorbs or adsorbs another substance. To absorb is to soak up. To adsorb is to attract and hold–like a magnet might hold iron filings. The Allient Sorbent machine by RenalSystems uses a cartridge that has several layers, each made of a different material. Each layer absorbs and/or adsorbs certain substances out of the water that is used for dialysate.

During a treatment the water passes through the cartridge over and over again–getting “cleaner” with each pass. Only about 6 liters of water is needed for dialysate in a treatment–much less than is used by most machines, which means a lot less exposure to substances like bacteria and endotoxin in dialysate (read this month’s “Topic of the Month” story on ultrapure dialysate to learn more about this http://www.homedialysis.org/v1/rotating/0905topicofthemonth.shtml)

Each of the machines that is now on the market for home treatment has some pluses and some minuses, and which one will best suit your needs, your home set-up, etc. is something you need to work out with your care team.

13

Dori writes:
Each of the machines that is now on the market for home treatment has some pluses and some minuses, and which one will best suit your needs, your home set-up, etc. is something you need to work out with your care team.

Please correct me if I am wrong, but the case that was made for the Aksys PHD by the poster named NephNurse, was a compelling argument for the most technologically advanced machine available. As she pointed out, the leading competitor, NxStage, may be more convenient, and patients have the right to choose convenience over quality of txs. But she stated if one wants the best txs available, they will choose the machine that doctors on dialysis choose, PHD. Just repeating her argument and wonder if others felt that PHD stands above the rest as the best clinical choice for home hemo.

14

Hi y’all,

Jane wrote:

But she stated if one wants the best txs available, they will choose the machine that doctors on dialysis choose, PHD.

In all fairness, Nephnurse (who never identified her(?)self) wrote that message before the Allient Sorbent system was approved by the FDA.

From my perspective as Executive Director of the Medical Education Institute (which created this site)–and I’ve shared this with ALL of the folks who make these machines–I’m glad they’re all on the market, because I want patients to have the widest possible choice of modalities and equipment. And anything I write below is solely based on my current knowledge of each system–which is not perfect. (So, folks, if I get a detail wrong, please feel free to correct me).

People’s situations vary quite a bit. If you rent a large apartment and have plenty of storage space–but can’t change the plumbing or wiring, then PD with or w/o a cycler or the NxStage machine might be the best fit for your life. The same is true if you plan to travel & want to be able to put your machine in the car & ship your supplies. Or, if you want a system that will only take a couple of weeks to learn.

If you live in your own home & can change plumbing & wiring, then you might be very happy with the BBraun, Fresenius 2008 K series, or the Aksys PHD, all of which can offer you excellent treatment. The Aksys system uses fewer supplies, because it disinfects with heat & reuses the dialyzer & tubing for a month–and has many other benefits that folks who know the system in more detail have outlined in other posts.

The Allient Sorbent system is unique & somewhere in between, in that it doesn’t need plumbing changes–it uses tap water & treats it itself. I don’t know if it needs wiring changes, but I don’t think so. It’s not as transportable as the Nxstage, but like the BBraun & Fresenius machines, it’s very flexible in terms of treatment length–it can do short daily, conventional 3-5 hour treatments, or long nocturnal.

To paraphrase Pierre has said, and I agree with him, the technology is a means to an end. The point is to get longer and/or more frequent dialysis, and to be able to get the treatment YOU want that will best fit your life. Exactly which machine will work best for your needs will depend on your individual situation. Also, some people’s choices are constrained by what their home clinic will offer–I’d hate to have people not choose a home treatment because they can’t get a particular machine that they have their hearts set on.

15

Dori writes:
In all fairness, Nephnurse (who never identified her(?)self) wrote that message before the Allient Sorbent system was approved by the FDA.

Yes, absolutely. The Allient Sorbent is out now and I would like to know how it compares with the competitors.

Dori writes:
The point is to get longer and/or more frequent dialysis, and to be able to get the treatment YOU want that will best fit your life. Exactly which machine will work best for your needs will depend on your individual situation. Also, some people’s choices are constrained by what their home clinic will offer–I’d hate to have people not choose a home treatment because they can’t get a particular machine that they have their hearts set on.

Again, yes, absolutely. But this is not what I am discussing. I am saying, if there were no physical or financial constraints and patients could select the machine of their choice based upon a point by point comparison, which machine is technologically/clinically superior?

16

I live in a small medium rise apartment, and I personally have no problem with my Fresenius system in there. The Baxter guys who deliver the concentrate jugs every month love it, because they don’t have to climb any stairs. They just wheel the stuff on a handtruck into the elevator, and then right into my apartment :slight_smile:

One thing about nocturnal hemo is that, well, you’re sleeping. Nobody except the machine itself and a couple of leak detectors are watching over you during that 7 or 8 hour treatment. While new machines and new technology are always interesting, I’m not the one who is going to trust my life to it until it has been very well proven to be reliable through a few years of actual real-world use (not just the trials for FDA approval). Daytime treatments are different because you can keep an eye on things.

By the way, the sorbent system of dialysis works. It has been in regular use since the 1970’s (the Redy system). What’s new are the implementations of it.

Pierre

17

Pierre writes:
One thing about nocturnal hemo is that, well, you’re sleeping. Nobody except the machine itself and a couple of leak detectors are watching over you during that treatment 7 or 8 hour treatment. While new machines and new technology are always interesting, I’m not the one who is going to trust my life to it until it has been very well proven to be reliable through a few years of actual real-world use (not just the trials for FDA approval). Daytime treatments are different because you can keep an eye on things.

This is an interesting observation. How do others feel about this?

18

I think I would have no know more about the machine before I could decide if I would dare to trust it or not right off the bat.

19

Gus, Just curious you are a NxStage fan or at least that is the impression I get, what has you interested in the Allient Sorbent?

20

I don’t think there is any solid evidence for which machine is the best choice when it comes to nocturnal daily, because there are so many benefits of doing nocturnal versus doing either traditional 3 times a week or short daily. Just the fact that the choice to do nocturnal was made makes it high on top of the list as far as clinical concerns, regardless of which machine is used.

But when you are talking about short, daily I definitely feel that the Aksys PHD is clinically superior. That is assuming that the Allient Sorbent machine doesn’t trash the reason I am about to state (I still don’t know much about Allient’s machine so I can’t place it in any category yet.)

Here why I say the Aksys PHD is superior than other machines used for short, daily hemo: Everyone concurs that most of the blood cleansing is done in the first 2 hours of a tx, which is when most of the smaller molecules get taken out of the blood. The larger particles take longer to get cleared out of the blood, and they start to clear out during the last 2 hours of a 4 hour tx. So if you think about it, what that means for patients doing short daily hemo is that not as many of the larger molecules (phosphorous, for one) get cleaned in their 2 hour treatments. Fortunately, the Aksys PHD solves this problem and the larger molecules DO get cleaned out of the blood during a 2 hour tx.

This happens because during every tx, the Aksys PHD goes through several cycles called a “Backflush”. The backfulshes occur at predetermined intervals (10 min, 15 min, 20 min, … whatever your prescription is) and basically just move the dialysate back and forth through the kidney at a high pressure. The result of each backflush is that the kidney has any clots or debris cleared out of it and the larger molecules are able to pass over the kidney’s membrane as a direct result of the higher pressure. So, unlike other machines used for short daily hemo, the Aksys PHD can clear the blood of larger molecules (like phosphorous) in only a 2 hour tx.

I think that fact alone makes the Aksys PHD a much better technical option for short daily than other machines (remember, I’m not talking nocturnal here).