NxStage - Running Out of Dialysate Before End of Treatment


#1

I know this topic has been brought up before, but would like to bring it up again…Has anyone been experiencing the Dialysate running out before the end of your treatment both on PureFlow and Bagged Dialysate… This has been happening to me over the last several months and it seems as if its not a big deal when discussed. The treatment will sometmes end withmore than 10 minutes left and the bags will be dry. We will sometimes get an alarm, and sometimes just get the 000’s.
The answer I seem to receive is that as log as I get all of my dialysate, I am getting my treatment in.
My only issue with this is that each time this happens, There ae at least 2 Liters of blood that could have went through if the treatment went the full length. In a week, that is approx 12 liters, and in a month can be approx 48 liters blood that could have been cleane. Also, that is approx 60 minute of treatment time per week missed.
NxStage is aware of this and suposidly looking into it.

What are everyone else’s findings…

///MM


#2

Brian, as you know I offerred a theory to the cause of the issue with NxStage Product Management this morning. They will begin a test tomorrow to see if I am right. More later…


#3

Lets hope you are correct so that this issue can be solved after several months. Not that it is a big issue, but would be nice to be resolved…

//MM


#4

[QUOTE=MiracleMan;18381]I know this topic has been brought up before, but would like to bring it up again…Has anyone been experiencing the Dialysate running out before the end of your treatment both on PureFlow and Bagged Dialysate… This has been happening to me over the last several months and it seems as if its not a big deal when discussed. The treatment will sometmes end withmore than 10 minutes left and the bags will be dry. We will sometimes get an alarm, and sometimes just get the 000’s.
The answer I seem to receive is that as log as I get all of my dialysate, I am getting my treatment in.
My only issue with this is that each time this happens, There ae at least 2 Liters of blood that could have went through if the treatment went the full length. In a week, that is approx 12 liters, and in a month can be approx 48 liters blood that could have been cleane. Also, that is approx 60 minute of treatment time per week missed.
NxStage is aware of this and suposidly looking into it.

What are everyone else’s findings…

///MM[/QUOTE]

This situation is not new. It has been going on for a number of years. I got the same answer when I reported it to NxStage and was told to lower my dialysate volume to .2 less then it should be, because there is overfill in the bags and I would still get all the dialysate. On another occasion, a head tech told me I should not have been advised to do this as it is a doctor’s prescription. I would like to know what the correct answer is here. Are we losing valuable dialysis therapy or is there no reason for concern?


#5

Jane,

I too have received the same answers. It seems different people have a different answer. I have brought the issue up with just about everyone I can think of that can b involve including my nephrologist, the nurses, NxStage Technical Support, NxStage Nurses and NxStage Trainers. All have a different answer but yet all say as long as Im using al of the dialysate, im getting my treatment in.
Its not a major issue because my lebs have not been affected, but it is one of those little things that you would like crossed off the list.

///MM


#6

I spoke to a NxStage Traner and ask about this topic. She stated that they are aware of the issue. (which most likely everyone already knew). Then she stated what everyone else is saying that if you are using all of your dialysate, then you are receiving your full treatment…
She added that if anyone is experiencing this to please continue to report it to NxStage even though you may think it is not a big deal.

///MM


#7

I run 40 liters a night and for many months would routinely run out at 38.8 to 39.4 liters.

On Monday my machine was swapped out because I had a yellow 71 alarm indicating that it was time - I had achieved 4,000 hours of use.

I ran on my new machine Monday night (took last night off so this is based on an n=1) and it used exactly 40 liters - just what it was suppose to do. The bags were of the same vintage as before when it “ran out” at 39; the only thing that changed was the machine.


#8

Sounds like a calibration issue to me. This was one of the items which I thought could be causing the problem. Bill, please let us know if this happens anytime in the near future with your replacement machine.

///Brian


#9

However, I was running short on my last treatment of my PF batch consistently, but hit the mark exactly doing my own experiment at home. I’m waiting for NxStage to repro this week. Waiting with bated breath.


#10

Do you mean baited or is this something new?


#11

[QUOTE=Bill Peckham;18415]I run 40 liters a night and for many months would routinely run out at 38.8 to 39.4 liters.

On Monday my machine was swapped out because I had a yellow 71 alarm indicating that it was time - I had achieved 4,000 hours of use.

I ran on my new machine Monday night (took last night off so this is based on an n=1) and it used exactly 40 liters - just what it was suppose to do. The bags were of the same vintage as before when it “ran out” at 39; the only thing that changed was the machine.[/QUOTE]

I love it when I finally solve a tx issue by ruling things out as you have. So, let’s see if it was a fluke or if you continue to get your full 40L. Don’t forget to come back soon and let us know.


#12

I know I’m currently lousy in Word Twister, but I did mean bated.


#13

I don’t usually use bags, but due to the expiration date being pretty close, I decided to use them instead of letting them expire. My treatment calls for 30L. I hung the 6 bags and got 31L out of each treatment. So I agree, could be a calibration thing.


#14

I’ve had one treatment come in .2 under but the rest have been spot on since swapping out my machine.


#15

Thanks for letting us know this Bill. Wonder what the variable is that made the one tx come out .2 under? It was also observed that with the PureFlow, the final dialysate volume #s of the last tx in the batch were coming out at various different #s less than what the volume had been set for. Not known at the time, the control unit in the PureFlow was going out. When the control unit was replaced, the same thing happened as with the bags- no more txs ending early and the final voume #s were on the dot per what they had been set for. Boy, I sure miss the good old days of Renal Web when you could find a biotech to explain what all this means.


#16

I have been experiencing the same thing of running out of dialysate around 5 minutes left. I have a new control unit and will be looking back to see if it happened on the old one. I know they say that we are getting all of our treatments is the dialysate is running out, but… what if the machine is not filling the bag up like it is programmed. I use 25L per treatment. My machine is suppose to put 60L of water in the sak for 2 treatments. Is it really putting in the whole 60L? Just thought I would see if anyone else thought of this.


#17

I’d strongly suggest that you contact NxStage tech support. They can tell you whether the amount you have left in the bag (SAK) is acceptable. Also reporting the problem lets NxStage know that there may be a problem.


#18

I’m my Mom’s care partner 24/7. My Mom switched from PD (which I did for her) to Hemo in July 2017. In October 2017, we started on Home Hemo, which I also do for her. We ran out of dialysate before the UF goal was met, a couple times. I spent forever trying to figure out how I could UF 2.0 out of a 20.0 liter treatment without running out of dialysate. Turned out the problem and the answer, both, was in the FF rate. If the FF rate is dropped, in our case, from 35 down to no greater than 31, I can get her UF of 2.0 out of only 20.0 liters. If I keep her FF at 35, I can only UF 1.6 before running out of dialysate. I don’t know if this is of value to anyone.


#19

If you’re running out of solution during a treatment, call technical support. If it happens again, call every time this happens. It’s important for NxStage to hear about problems so they can investigate why it’s happening.