I confused, a totally normal state for me, but still confused.
Are you saying a lower dialysate flow is better than a higher dialysate flow? I have a pretty low BUN, I believe last month even after my day off it was 38 and post was 10. I do have a high creatinine (7+ pre after my day off). Would a lower dialysate flow increase the removal of other toxins? I currently run at bfr of 350, dfr of 500 or 600 and run for 4 hours daily. I am a large patient at 114kg.
Hi NephNurse. I just want to thank you for the very interesting posts. I had some initial suspicions because I’ve found a fair amount of specific dialysis machine boosterism in these forums, but I found both of your posts very interesting.
I don’t use either the NxStage or the Aksys for my daily nocturnal, and I’m happy with what I’m using now, but I know which one I would choose if I had to.
Pierre
I hope so to, it’s time for dialysis machine companies to “THINK SMALL”…
Say no more to refrigerator size monsters…say yes to compact dialysis machines…
With more smaller sized machines more patients can go home…if you ask why it’s because most of us here have a very spacious comfortable home while a large percentage of patients DO NOT…most of them are low-income and live in small apartments, so if more companies re-think design strategies then there will be a win win for most of us…
Also, I think computer models are not 100% foolproof…the best proof is the user…let alone real living users report their findings on how their labs, and health is doing.
Hi Gus.
I’m low-income, and I live in tiny apartment (really tiny!). The Fresenius machine itself is tall, but it doesn’t have a large footprint. I do agree with miniaturization though. If you ever see the panels off the back of one of those baby K Fresenius machines, it looks very much like a large desktop computer vs a little laptop. There’s lots of empty space in there, and I would think, plenty of opportunity for making things more compact - I’m guessing the same functionality in half the space would be possible. But on the other hand, I would guess more space means it’s easier to work on, and to remove and replace the modular units that make up the guts of the machine.
Pierre
Pierre, do you have some pictures of your setup at home? If not, show the world that it is possible having this machine this size in your tiny apartment…I would like to see it to…if you want, send a few pictures to my gallery on my site…I can make a section for Fresenius as well…
Still, I hope Fresenius is reading this so they can start designing a Tiny K… 8)
Can someone confirm, is the AKSYS PHD being used for SDD only or can it be used nocturnally?
So Nephnurse, what your saying is that by slowing down the dialysate your not getting good Nitrogen Clearance? So Nocturnal is not providing good Nitrogen clearances? Please elaborate
Gus or anyone-
Our Center is in the process of negotiations with Nxstage. We my hubby Ralph and I would like to be able to use it.We do nocturnal and I know that it is not yet ready to do the nocturnal but they are working on it.
I would like to know if there is anyone out there that is a large person like 120K who uses Nxstage and what are ther clearences? I know that it probably won’t take all the Phosphorus out but we could take Renegel.
Any thoughts?
Thanks,
Pat
Dr. Alan Hull made a post recently and talks about patient size and other factors… go here
http://www.homedialysis.org/phpBB2/search.php?search_author=Alan+Hull
At my clinic I myself have talked to a patient who is quite a BIG guy, over 200lbs… :oops:
As for using NxStage for Nocturnal it is useable for that am am kinda interested myself as well but I don’t think it’s fully ready for that. some additions are needed. I believe the dialysate addon module will make nocturnal the way to go, am not sure yet as I don’t have the full information or facts. These are just assumptions… :roll:
However, it was offered to me as Nocturnal but I declined that option as I believe my schedule didn’t fit that option. I really need to look into it more and gather the information. Once I do will post more about it…
Neph Nurse writes:
Preserving this coating, along with the injectable quality dialysate, result in this machine providing the world’s most biocompatible dialysis.
NephNurse,
I have read your posts over numerous times. You present an impressive argument as to why the AKSYS PHD seems to provide a superior tx to the other model machines that are available at this time for home use. Unless someone can refute your points, it looks like you have made your case. From what I have learned, however, the PHD is not available at this time for nocturnal length txs. So, how does the PHD then compare with models that can be used nocturnally? And, I have not yet gotten an answer to my question on whether new programs can be started with the PHD or if it is only available to patients who are in trials. Supposedly NxStage is economically feasible and can be started up anywhere, but what about the PHD?
NephNurse,
I have read your posts over numerous times. You present an impressive argument as to why the AKSYS PHD seems to provide a superior tx to the other model machines that are available at this time for home use. Unless someone can refute your points, it looks like you have made your case. From what I have learned, however, the PHD is not available at this time for nocturnal length txs. So, how does the PHD then compare with models that can be used nocturnally? And, I have not yet gotten an answer to my question on whether new programs can be started with the PHD or if it is only available to patients who are in trials. Supposedly NxStage is economically feasible and can be started up anywhere, but what about the PHD?
I don’t know about any of the plans for the PHD but I do know they had contracted with our home dialysis center then at the last minute backed out and told them they couldn’t provide service. Prior to this they had also let the sales rep go that was working with our center. This has nothing to do with the benefits of the PHD, I just don’t think it is quite as available as the others.
Am looking forward to the new portable PHD that’s currently in the design process… 
Hi
I thought we the ones who are on dialysis have to go with what the center has to use. In the center that i was trained the only machines open for home hemo were babyk’s and nxstage.
I as for me i went with nxstage, I’m 210lbs I hang 4 bags,(20liters) run around 2hrs and 48min. It takes me 30min to set the whole thing up that’s start kit and off kit also. I had my first trip back to the center and everyone was very happy with my #. I really don’t pay any mind to my #'s that up to doctor and center people. The bottom line for me is how do I feel. I feel great, I have to watch my food intake so that I don’t eat to much. As for next week or next year I’ll deal with them when they get here.
bobeleanor
hey gus
Yes I could run longer but I would start to clot. Right now I use 5cc of heprin, 1.5 cc of epo 3x and when I go back to the center they will give an iron shot. plus i watch my weight betwwen tx. i try and not go over 1kilo and sometimes i will be under that. Before all this happened i was very phyical guy. I"m even more so now. Hikeing into mts. running. all the outdoor stuff. I was into landscaping for a high end company in my area.
bobeleanor 
Hi
I’m still on a cath, have been since the start. I put 5cc in post after my blood reaches the blue post. Then at half way on days that I use epo I put in 1.5 cc in blue post. Right now I’m changeing doctors. I want a whole new team. The changes I’ve I’ve seen over the yrs. are both great and not so great. The medical break throughs have been and will continue to be great. The people who are in the medical world have change some not for the better. I’m some what upset that techs who work in dialysis center only have to a GED or high school diploma. But that is my problem and will not go any deeper.
I’m very happy with my life, I have a great wife, A house in the woods and the computer. I don’t want any thoughts on my choice of access. I’v heard all the facts more than once.
bobeleanor
Hey Gus
I live in PA , I have a house that sits on 1.5 acres and have a county park outside my door, both front and back door. i love the outdoors. We have no kids, just pets. my wife want to get goats, i’m not ready for that, dogs and cats and two talking birds is good for now.
Have a great day
bobeleanor