April 2006' Neph. News & Issues Article

NxStage was compared to Aksys. As far as disadvantages of NxStage some of the following were listed:

> Computer display is not user- friendly, open to operator interpretation

> Some tx. adjustments during tx. are difficult and leaves operator uncertain about accuracy

> Preparation for tx. is complicated (almost 100 steps)

> Errors are very difficult to correct once tx has started


I have never heard anyone mention these points, previously, especially the one one about almost 100 steps for tx preparation??? ( is this a typo?). Any thoughts?

Absurd, sham, fake…

Hi Jane,

Where did you get this info? I doubt its accuracy as one of the best features of NxStage machine is that it is so easy to use and substantially easier than any other machine on the market.

Lorelle

p. 40, Nephrology News & Issues, April 2006’ issue.

Frankly, they posted the most incorrect information I ever read about NxStage…

Absurd, sham, fake…[/quote]

Gus I’m not sure what part of that you think is inaccurate but it looks about right to me - at least from what I have seen.

“Computer display is not user- friendly, open to operator interpretation”
Doesn’t the NxStage display error messages along the lines of “E3” and you either happen to know what “E3” means or you have to look it up in a book? To me the NxStage display is clearly not as easy to understand or as unambiguous as the PHDs conversational display.

" Some tx. adjustments during tx. are difficult and leaves operator uncertain about accuracy"
Is this a reference to changing the target fluid removal? Changing the target fluid removal on the PHD is very clear and literal.

" Preparation for tx. is complicated (almost 100 steps)"
Stringing the machine is always going to be more involved than changing the transducer and pushing a button. How one would count the number of steps involved could be open to debate. How detailed is each step? But the PHD sets a high bar.

"Errors are very difficult to correct once tx has started "
I would have to know which type of errors this refers to but in general changing the treatment length or fluid to remove is very simple, routine on the PHD.

What is your beef Gus? The article or at least Jane’s post didn’t even mention the clinical advantages/disadvantages. These convenience issues/ ease of use issues are less important. Biocompatibility is the key IMO
.

As someone who is slated to start training with the Nxstage machine I’ve tried to find out as much as I can both here, the Yahoo site, from a friend who used the machine prior to getting her txp., and too from the Nxstage site. The only negative thing I’ve heard so far is that one needs a fair amount of storage space for dialysite. I would like to hear from those who’ve actually used the machine, as to it’s ease of operation, or lack thereof Lin.

:lol: Ha ha was told by nurse that a Freni has (only) 79 steps! That mustn’t include the steps I walk up and down carting supplies!
All I can say is at least we live in countries with some choices. Some of our brothers and sisters have none. :frowning:

I found the article online but it requires paid subscription to gain access. :x It does say that the assessment was done by a “provider”.

I have 2 questions:

Why would a provider lie about the NxStage machine? :?

Why would they ask a provider and not a patient? :?

I hope someone presents a rebuttal in a subsequent issue.

Hey, Gus, think they’d print a “letter to the editor”?

Lorelle

The article is a a ploy…its innacurrate, a sham, a fake…

wait till you see my video blog coming sometime… 8)

P.S. 18 minute setup on NxStage doesn’t fit their statements…

You haven’t said what you think is inaccurate - what’s got you so upset??

18 minute set-up is still more than the PHD - the PHD takes about 1 minute of the user’s time and then 10 minutes later - after pushing a single button - it is all set to go.

You haven’t said what you think is inaccurate - what’s got you so upset??[/quote]
Don’t worry Bill, I have a wonderful video blog coming that will show the real deal about NxStage… :smiley:

A video is worth ummm, alot more…

That’s fine Gus but you still haven’t said what you think is incorrect about the article. Is your video going to compare the NxStage with the PHD side by side??

I read the entire article and if I still had that months NN&I I’d print it. The article compared both the PHD and the NxStage Advantages and disadvantages. Actually, I didn’t think the article was worth much as it didn’t make any statements in the clinical advantages of either machine. I didn’t think the article was false but I did think the statements made against the NxStage and PHD would be hard for someone who has never done a treatment to fully comprehend or get a feel for. It sounds like a lot 100 steps for the NxStage but it also sounded like a lot when they mentioned the PHD disinfecting for so long. Probably all the NxStage users don’t even think 100 steps anymore than the PHD users think about the disinfecting process being so long. When I got through with the article I thought ah…give me a machine with the set up of the PHD and the disinfect of the NxStage and the versatility of the Fresenius.

Hey there,

this is Gus, am on diaysis using laptop again… :stuck_out_tongue:

> Computer display is not user- friendly, open to operator interpretation

False, in the eyes of the patient the computer display on NxStage is friendly…simple with no added complexity :slight_smile:

> Some tx. adjustments during tx. are difficult and leaves operator uncertain about accuracy

False, in the eyes od the patient adjustments during treatment is so easy… :slight_smile: this is self-care, remember? …

> Preparation for tx. is complicated (almost 100 steps)

False, less than 40 steps…18min

> Errors are very difficult to correct once tx has started

False, all common errors…pinched line, low pressures, high pressures, are all easily solved without ending treatment. Rarest occasion is when you have to terminate treatment. In the past year, only terminated twice…not because of errors but for other technical reasons…

P.S. The article is without value and it does give the wrong impressions about NxStage. You go out there and talk to real people using it. :slight_smile: On the other hand I do think the new portable machine by Aksys will and should surpass NxStage System One

On HomeHemo Now,
Gus

Not very persuasive.

Forty four steps is still forty three more than the PHD.

If you want to change you target fluid removal or treatment duration is that easy?

“in the eyes of the patient the computer display on NxStage is friendly” … based on what? Isn’t the NxStage display a letter and a number?is it an LED? How is that friendly?

It seems that I’ve upset a number of you with the article. To start, we have been providing home dialysis for over 30 years. We have patients that have been at home for 29 years and 30 years. We offer all modalities of home choices, from AKSYS, NxStage and conventional hemodialysis machines (specifically the K @ Home and 2008H Fresenius). We also offer both Fresenius and Baxter PD systems. The article was written as an objective comparison between the AKSYS and the NxStage as was asked of me from NN & I. It was written with the input from our home patients (one of whom actually have experience with the AKSYS and the NxStage). A number of the specific issues such as 100 steps, etc. was the practical experience of our patients. No system is all positive and no system is all negative. Any objective comparison must included both positive and negatives. As far as my personal experience with dialysis and modalities, I’ve been a dialysis professional for 31 years with experience in clinical, technical, education and research.
D. Concepcion

DC, I think maybe you should try setting up the nxstage yourself. I literally was doing it myself, following the set by step instructions the second day, after about 10 days I never even looked at the instructions. Many instructions are simply verify this or that. Set up takes approximately 17 minutes, much of that time sitting around waiting for prime to finish. I have plenty of time to pull tapes, get needles, pull heparin, weigh, wash etc., before doing the final hookups (maybe 2-3 minutes) and inserting needles. From start to finish no more than 30 minutes.

I’ve never used the Aksys, but do know that it takes something like 12 hours to prepare for treatment and if you don’t happen to be there when there is an error message you can miss your treatment.

I’ve gotten only a couple of error messages on my NxStage, I keep the laminiated copies of the messages and easily fix any problem. I can adjust fluid removal, either up or down very easily, as well as blood flow rate, not sure what other adjustments need to be made.

I think a good article would be to use someone who has used different machines and get their take. I’ve used the Fresenius and the NxStage, the NxStage is much easier and quicker. Needs about 25% more space for supplies but will need nearly none if I start making my own dialysate.

I’m not saying there was any hidden agenda, but I will say I have heard from many unhappy Aksys users, but not a single NxStage. It is truly a machine developed with the consumer in mind, allowing us freedom and ease of use.

Cathy
home hemo 9/04

Absolutely Cathy,

The true setup of Aksys PHD, the real information is that you have to wait over 10 hours for it to setup itself and if it fails you also miss a treatment…

Overall that article gave the wrong impression about NxStage…for someone who doesn’t know anything about these machines its absolutely making them believe something that is not true, stirring them away from deciding what to choose.

The article was badly written and we patients looking for a machine don’t honor it.

You should think carefully before making articles like these…

Do you think it may have something to do with the reaction a poster gets if they post against NxStage marketing orthodoxy? When you switch to the NxStage do you have drink some Kool-aid?(’:roll:’)