NxStage Device to Prepare High Purity Dialysate at Home

Discussions for Patients, Family, and Friends HD For Patients
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beachy I hope all goes well for you and you get the go a head from your Dr.

The average wait time for me would be 5 years also because of my blood type. Unless like you said, you happen to be a perfect match for the next kidney that comes up. Here they call it the one in a million match. It has happened at my center twice in the last few years so you never know. I’m not on the list at this time as I just recently recoered from the last one.

I don’t mind waiting a little bit if it will give me a chance at a good run the next time I get one.

I went to the National Institutes of Health a few years back to take part in a study for fsgs. Go figure acording to them I’m at low risk for recurance. I have a very low protien A factor. According to them that seems to be the culprit in fsgs. Not only that but I guess recurent fsgs usually comes back with in hours after transplantation and mine didn’t come back until 3 years the first time and 1 year the second time. Seems to have been faster the second time.

My Dr.was pleased that even after the 3rd one 4months out there was still no sign of the fsgs. That’s a good thing.

Sorry for the long post some times I get going and have a hard time stopping :oops:

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Keep those long posts coming. I love talking to other FSGS ers! 8)

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Lets revive this thread…

Anyway, here’s some early first pictures of “Pureflow SL” NxStage’s addon module that makes dialysate in your own home without needing dialysate bags…as you can see, it can be used as a stand for the machine itself…

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[quote=“Marty”]Pierre, No ours doesn’t have one of those filters. When our program first started those filters were left off all the machines. However some patients kept getting bad machine cultures … quote]
Well there’s a surprise !!! :o :roll:
Thanx for reviving this thread Gus, as I must’ve missed it first go round. I was horrified to read the above…and immediately thought “Ah yes, Yankie ‘gung-ho!’, shoot-from-the-hip attitudes again!” :?
We not only automatically have Diasafe filters on the Frezzies & supplied regularly, we also have a strict regime for their change. We were doing 12 week stints…but since our dams have been so low & bacterial action is up, we’ve been up’d to 6 week stints. Each time you fit one on, you date it, so you know when to change it.
Does the lack of a Diasafe filter mean you do not do a ‘TEST’ before going on the machine??? Or is the Diasafe check part somehow configured out of the TEST??

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Hi guys, back again for another update on the PureFlow SL…right here I present you some information that was gathered by one of our members at “Nxstage Users Group” who participated at a meeting whom NxStage representatives made a presentation on the addon module for NxStage System One…Pureflow Sl …this is just part of the information and another part will follow…

Hey everyone,
Two NxStage Reps. came to our meeting today as you know (Leigh and a
woman who does local sales–forget her name at moment). They gave an
excellent presentation about PureFlow SL. All slides. They went kind
of fast so I took what notes I could. Here is what is on the website
and part of what was presented today:

PureFlow SL Highlights

Simple, compact “all in one” design – about the size of an end-table,
this compact unit eliminates the need for a large water purification
system, as well as the need to receive, store, hang, and dispose of
bagged dialysate fluids in the home.

No special plumbing or electrical modifications. Just a simple faucet
or under-sink connection and standard electrical outlet helps avoid
the often costly home modifications required by traditional systems.
Purity at home. Innovative technology prepares ultra-pure water and
high purity dialysate that meets or exceeds industry purity
standards.

Fast, easy batch preparation. In a few simple steps, PureFlow SL
produces a batch of dialysate that is good for up to three daily
treatments—all while the patient goes about their normal daily
activities.

No complicated water testing.1 The integrated, replaceable water
Purification Pack includes built-in purity sensors and lets you know
when it’s time to change it.

Reliable support. 24/7 clinical and technical support availability
and 24-hour service swap program for all key system modules helps
simplify use and maintenance and minimize missed treatments.
Increased treatment flexibility. Large batch capability increases the
ability to treat larger patients and provides greater therapy
flexibility.

Continued travel freedom. The ability to take the System One cycler
off the top of the PureFlow SL unit and use bagged dialysate fluids
(Express package) on the road maintains travel freedom.

I took 2 pages of notes and will try to type them up and share but if
anyone has specific questions right now, I will answer them before I
type complete notes. The questions I turned in were answered as far
as I could tell. If I missed a question, it isn’t hard to reach
Leigh.
Take care,
Erik

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Okay all, here’s Part 2 of the above post regarding information about “PureFlow SL”…BIG thanks goes to Erik who gathered this information from a recent meeting at his clinic.

OK, here is the info from the meeting:
PureFlow SL:
Exclusion: Can’t use currently with well water.
2 sacks per box for home made dialysate. Each sack holds 60 liters. Add sterile dialysate concentrate. This ultrapure dialysate is more sterile than current dialysate bags. There is also a Purification Pack. Most people will make 2 batches/week approx.
Flexibility; Portable; Less supplies (approx. 2 boxes vs. what you currently receive); Control Panel similiar to current NxStage machine design. Door opens in front of PF SL machine and a drawer slides out for dialystate bag/controls.
Set up: It will take 2.5 hours to prime unit & 7 hours to fill 60L dialysate bag. Most people do it overnight or while away at work. Supposed to be quiet according to Reps. who have seen this new unit in use at another clinic. No need to worry about water shutting off or overfilling if you are asleep or away during the 7 hours process.
The dialysate lasts 4-6 weeks without going bad. There is a warning and machine will not allow you to do dialysis until a new batch is made. Test for chlorine; Use city water. The Reps. are checking on what to do if your city has high amounts of Radon in your water (like Batavia, IL).
You can use this new unit with a water softener. There will be plumbing parts that you can install under the sink for use with water softeners. If you travel or prefer to use a hose faucet, then there is an attachment for that too. Last, there is an attachment that goes on the faucet (remember the old dishwashers??) The drain line for the new unit will be attached underneath sink to your existing plumbing (beyond my experience to explain this part). Again, 3 plumbing options and two sizes (diverter for under sink/softener–40 ft. tubing (can be cut very str8 to shorten if needed); Hose line attachment; faucet hook up attachment.
No More Plastic Drain Lines!! Waste from dialysis machine will go out same drain line as dialysate drains out of. Over 20 liters/Tx then you probably will be making new dialysate every other day and extra will drain out. If you do not have enough pre-made dialysate then machine will let you know that you need to make more dialysate before you can begin Tx (so either you end up waiting 7 hours OR hang bags and do Tx–can make dialysate while using bags/Tx). Be sure to plan ahead and be aware of how much you use per treatment so that you don’t get caught off guard with no dialysate.
You may need a plumber (approx. 30 minutes) to attach drain line to current plumbing.
If not using dialysate bags, then your pole will be new and shorter to accommodate just a saline bag or two.
When you are done training (2 day training in center), you will receive at home: a water kit (all the parts); cabinet and purification packets (2).
It is easy to hook up everything at home because like a computer certain lines only fit certain holes. First day home it will take 10 hours for entire prime and make new dialysate (they suggest doing this on your day off dialysis or use dialysate bags)
Filter in back of machine is changed one time a year. Air filter on back of unit is cleaned every 3 months.
Currently, NxStage is losing hundreds of dollars a day, every month they add a new patient. Using PureFlow will begin to change this and please their investors in the long run.

Well, that is all I have for notes. NxStage Reps who came to our meeting said they will be coming back in the future to present more info for us. I thought it was great of them to do this without an invite. The current PureFlow SL is in its second design (Unit B) since it was 1st used on select units. Bugs worked out for most part and NxStage feels confident they are ready to mass produce and begin training people. If you are interested in receiving this new unit, let your Home Dialysis RN/Coord. know and have him/her contact NxStage about setting up training dates. Also, you may want to try to get your local Rep. to come to your unit and do a presentation like they did for us. It is all on a slide show so should not be hard to present in other cities/states, especially if you have at least a handful of patients using their machine in the home.
Best of luck!
Erik

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Add sterile dialysate concentrate. This ultrapure dialysate is more sterile than current dialysate bags.

The highest water quality today is called sterile and must meet certain standards to be called that. NxStage’s dialysate bags are described as sterile now. I wouldn’t be surprised to hear that the dialysate produced with this new device is ultrapure (dialysate must meet certain standards to be called this too) if this person’s description of how it is made is accurate. Ultrapure is still much, much, much better than conventional dialysate, but not quite as pure as sterile dialysate.

I talked with one of the nurses at one of the clinics in my area. They are going to be starting patients on the NxStage soon using this device and I asked if I could drop by and see it. I’m anxious to see it.

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There could be a Discrepancy in that line, that’s what I thought myself as well but didn’t want to argue about it. That’s what Erik gathered and am not sure whether its a fact or not, but based on other readings around the net they state its UltraPure quality so most lilkely it not sterile as claimed there but will investigate further as mis-informed patients can get the wrong impression…

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Another update, NxStage website updates with a new flash video describing how PureFlow SL addon module works…

WATCH VIDEO NOW!

50

I’ve been on the NxStage Purification system about 2 weeks now. It takes a little over 7 hours to prepare a batch. It will make 60L and will last up to 72 hours. The dialysate is made in a sterile bag held in a tub. The tub keeps the water warm. There is a heater control that goes from 0-20.

You have a drain line and a water line going to and from a water source and drain. The NxStage Cycler works the same but you don’t have the warmer or the dialysate bags hanging. The therapy fluid lines attach to this bag. Right now I have my water lines taped across the floor but when I decide on a permanent dialysizing spot I will run the lines underneath the house.

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Hi PMB, can you tell us more about this device? How noisy is it? Does it have wheels so you can move it to re-organize room or do room cleaning? What can you tell us about setup, what you need to do for each treatment…before using this device? In other words, do you need to test for clorine in the water? What about maintenance? How often do you need to change the filters and/or parts to keep it functioning? Finally, where do you use this device, in your own home or rented apartment/condo?

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Hi Gus,

I will try to answer your questions.

First, there are no wheels on the chasse but you can purchase them for about $300 from NxStage. The whole thing weighs about 90 pounds without the water. We put felt pads underneath because mine sits on hard wood floors and this allows us to scoot it as needed. I own my own home so running the water lines and drain lines under the house will not be a problem.

The control unit is suppose to last about one year. The purification pak will last up to about 12 weeks depending on the water. The incoming water goes through a filter and a UV light before it reaches the dialysate sak. It takes arouond 7 hours to make 60L and it starts heating as it is filling. The control unit prompts you to test the dialysate for chloramines after each new batch. Green for yes and go on, or Red to stop and trouble shoot or start over. Each batch will lwe good for 72 hours. After the 72 hour time limit, the control panel will not let you go any further. You must immediately shut off that source of dialysate and either continue your treatment with bags or disconnect. The 72 hour limit starts at the beginning of making your batch. If it takes 7 hours to make the batch, then you have remaining time of 65 hours.

You will use the same cartridge in the NxStage cycler. However, the therapy fluid line (green) will connect to the therapy fluid line (green) come from your bag of dialysate. Your waste line will plus into the control unit (yellow and yellow.)

Instead of me going through 18 boxes a week of dialysate, use 3 boxes a week. Two bags a box. I use 30L each treatment so one bag lasts 2 treatments then its time to make a new batch.

The machine hums just like a computer or the NxStage cycler. It must be kept on though at all times one reason so the temperatur of your fluids stays warm.

Hope this answers your questions. If not, please ask.

PMB

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Hi PMBm
Do you find the new system more or less complicated/ time consuming then the bags? It would be more costly for the patient if the machine has to run all night and if the patient pays for water/elec.

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Only one cord is going to the electrical outlet. The rest plugs in to the other equip. I’m not going to be able to tell you the difference in my water and elec bill because nothing is equal from month to month. 60L is not a lot of water.

No I don’t find it time consuming. I’m at home doing dialysis at my convenience. I guess it all depends on how long it takes you to hang your bags of fluid. Making a batch takes 7 hours, but i do that at night. Then all you do is hook up one line to your therapy fluids.

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I no nothing about electricity but I think it says 150 PSI. Does that make sense?

So far I’ve passed the chlorimine tests. The water detector did go off. pparently the connections weren’t tight as it leaked in the bottom of the tub.

Also, I was making a batch without the water turned on and it told me to check water source. The control unit walks you through most of the steps.

I use 30 L a treatment so I get two days out of each batch. But, I’m saving storage space too.

There is no need for the heater on the side of the cycler but it will fit on there if you go from the water system to the bags. You will have to get a cord to attach to the electricity because there is no outlet on the control unit for the heater to plug in. A computer cord will work great.

Another option instead of the wheels is those furniture movers (for those who have carpet). Those should really slide on carpet. We’ve moved heavy furniture using those and they work great. Just place underneath before you install the control unit and the purification pak.

57

PSI is the amount of pressure of the water inlet…anyway, you know how light bulbs have their wattages printed on them? The same goes with electrical devices, especially large ones…its okay though, don’t stress out finding the reading, we’ll get it later…

Thanks alot for the additional information on this! :slight_smile:

58

Hey, Gus…

When all else fails, read your manual. Here’s the info you requested.

Input voltage: 100-120 VAC
Frequency 50/60 Hz
Input power: 400 VA

59

PMB,
How many hours are you on the Nxstage? We will be starting to learn and switch for noctural. Our nurse thinks we will be able to get 2 nights on one batch. Hubby weighs about 120K longer and slower is better. We just saw it working today at the center. The lady will be going home today and start on nocturnal tomorrow night. We are anixous to see how she does.
Pat

60

Hi Pat,

I’m running 2.5 hours during the day using 30 Liters of dialysate each treatment. I run at a dialysate flow rate of 12.0 Liters per hour and a blood flow rate of 550. I only take off 2 kilos max each treatment. I’m not a very big person either.

I make a new batch every other night which seems to work for me.

Good Luck with your new experience and let us know how it goes.