NxStage Question

I have been wondering. Almost everyone who uses the NxStage has increased their Blood Pump Speed. Is the reason for increasing the Blood Pump Speed to get shorter dialysis treatments or is increasing the Blood Pump Speed suppose to make the treatment more efficient.
Is a 4hr treatment on a Fresenius at Blood Pump Speed 350
= to a 4hr treatment on NxStage at Blood Pump Speed 350?

I would say that they are equivalent, and I have been on both, if anything I think the NxStage gives a better treatment, but that is my personal bias. One reason I upped my speed was that my pressures were much lower on the NxStage so I could go faster and get the same treatment in a shorter time. My numbers are great, last month my pre bun was 44 and post 24, my creatinine was 7 something and 3 something post, my kt/v was 2.4.

My number were equivalent when I ran slower speeds so, at least for me, going slower or using more dialysate is unnecessary.

Cathy
home hemo 9/04
fresenius then Nxstage 3/05

I don’t think so. Qd is linked directly to Qb with NxStage so the faster your Qb the faster your Qd. The NxStage cartridges come with an insert that shows clearances using their artificial kidney increase as Qb/Qd increase. I think it has been pretty conclusively shown that Qd = Qb x 2 maximizes clearance per minute on the machine which is what is (or can be) set on a FMC machine whereas the System One cycler maximizes the clearance per unit of dialysate.

Cathy to compare how you feel on both machines you’d need to compare both machines keeping Qb constant for it to be an apples to apples comparison; I think you are running faster on the cycler than you ran on the Freni.

I run almost identical blood volume processed, generally 78-83, so I think they are comparable runs. I do run faster, 480 bfr vs. 350, but the amount of blood processed is approximately the same. Numbers aren’t that different, but I feel better on the Nxstage, maybe because I spend so much less time on it, so psycologically I feel better, running a higher lactose is what really made me feel better although for whatever reason I wish I could run even higher. As even with the 45, my co2 is still only 21 or 22, but better than the 16-18 on the freni and the 40 lactate on the Nxstage. (Yes, I ran the highest bicarb I could on the freni).