Doc Skipping Out on NxStage

Hi All - I am not on dialysis yet, but my GFR is down to 13% and I hope to do home hemo dialysis with NxStage - getting my fistula next week. My question is this - I have a nephrologist I like, but he seems to skip out on events with the NxStage representative - should I be looking for another nephrologist? I know this because I personally know the NxStage representative.

I have told him that I will be looking at home hemodialysis and he’s cool with that, but was informed by this representative that he is skipping the dinners and open houses. I question whether he’s up to speed on the NxStage dialysis machines and wonder whether he knows exactly how to perform a correct dialysis prescription. He didn’t understand that I didn’t want to do PD, but he wanted me to think about it. Well, to tell you the truth, I don’t want all that fluid in my gut and would prefer doing the home hemo as I don’t have issues with needles or any of that.

Again, should I be looking at another nephrologist?

Thanks for all your time and support.


Ask your doctor some questions:

  1. Where do you refer patients for dialysis?
  2. What home dialysis training and support is offered at that clinic?
  3. Do patients at that clinic have the option to use the NxStage machine for home hemodialysis?*
  4. Who is the home training nurse?
  5. Can you alert the nurse that I’ll be calling to set up an appointment to talk with him/her about home dialysis?
  6. Are you following any patients that do home hemodialysis that I could speak with?

If the doctor doesn’t refer patients to a clinic that offers NxStage and that’s the machine that you want and if your doctor is not willing to support you on that machine, you may need to change doctors. It would be important to let your doctor know that the NxStage machine is that important to you. Recognize that doctors have very little, if any, experience with home dialysis (PD or HD) in the medical school education, residency, or fellowship. Those with limited experience with a particular kind of treatment may be fearful of following patients on that treatment or that machine. If doctors are open minded and start to gain experience with a particular type of treatment (or type of machine) and they find that patients do well, they become more comfortable with it. Keep in mind that you may be the first patient who has pushed this with your doctor – a trailblazer for future patients.