Go ahead and visit them…
Good site Gus…very good
Richard C/O Jessie
The site is over selling the System One (which appears to be the machine they are offering). This has been a problem generally and is I think part of the reason more than 1/3 of the people trained on the System One return to center.
In their information for nurses they say:
Short Daily Hemodialysis (SDH), is performed at home by the patient five or six times a week. The treatment is performed while patient is awake. Duration of dialysis is 2.0 - 2.5 hours.
This creates an unrealistic expectation among people selecting the System One better to be up front that the treatment length can vary with dose (amount of dialysate and blood pump speed) from 2 to 4 hours (not to mention set up/take down/misc).
They also write about nocturnal:
Nocturnal Hemodialysis, By far the most efficient form of dialysis, it is performed by patients (five to six nights a week) while the patient is sleeping. The duration of the treatment is dependent on the patient’s sleeping habits which could be anywhere from 6 to 10 hours. This is a slower form of dialysis with reduced blood flow [300-350ml/min] (pump speed) and lower dialysate flow rate [300- 500 ml/min]. The dose of dialysis delivered (Kt/V) is at least 2.5 times higher than conventional dialysis. Middle molecule clearance as typified by B2 microglobulin removal is increased four fold. Phosphate removal is twice as effective as conventional therapy, with many patients actually requiring the additional of phosphate into the dialysate.
Not if they’re using the System One. The nocturnal setting for Qb and Qd would be a Qb of 200 to 250 and a Qd of about 4 liters an hour (depending on FF and amount of dialysate) that’s a QD around 70ml/min. A System One can not under any circumstances have a Qd of 300- 500 ml/min. Those clearance impacts are from studies that reported the results of dialysis at Qd of 300 to 500 they do not directly translate to Qd < 70.
Weird too that the information provided to patients is a bit different. Of course they wouldn’t want to confuse patients with any actual treatment parameters (just as well if they’d be off) but the times they give are different for SDHD it’s now 1.5 to 3 hours and for NHD it’s 8.
People should just hire Dori to edit their sites.