I have been dialyzing with the Aksys PHD for 13 months. I just learned about the NxStage System One. I would like to correspond with anyone who is currently using NxStage for home hemo. Thanks.
Hey Debby,
I am the caregiver for my Mom. We started the Nxstage system back in May and have been home since mid July.
Its great. Yes like everything else there are a few kinks to be ironed out, but its nice to be able to comtrol when you do dialysis.
As I understand it, the NxStage System One is FDA-cleared and available commercially as a prescription device. Like most other dialysis machines, it is not indicated for any particular environment, and physicians can prescribe how and where it is used to suit the needs of their patients. It is currently being used for both chronic and acute (ICU) patients. They do not yet have a specific home indication for the device, but they are seeking that through an ongoing FDA IDE trial. You can likely get more information through the company’s web site (www.nxstage.com).
I just started my first day training today and am quite excited…the control panel of the machine is SOoo easy to understand. You’ll pick it up right away on first day…
The machine is Quiet and not noisy to hurt your ears! 
It has volumetric control which quite nice to have on such a small machine…meaning that it can take out only the ammount of fluid you want taken out…then it will dialyze you removing wastes and not anymore fluid…
Though only my first day alot was learned…along the way I might get some pics to show here…
Anmyway, don’t let the looks of that small machine decieve you…it’s quite powerful!!..Feels like dialyzing with a conventional High Flux machine but without the drag feeling after each treatment… 8)
I have a question for those of you training on the Nxstage machines…
Can you control the blood flow rate and the dialysate flow? I was told that you could only set the dialysate flow as high as 200 mL/min.
I use the Aksys machine and can set my blood flow up to 500 and the dialysate flow at 800.
The Nxstage machine seems wonderful for those who want to travel. I’ll be curious too hear how everyone likes it once they are home and dialyzing on it for a while.
Keep healthy everyove!
Deena
You sure can!.. 8) …Pump speed at max 600…and dialysate flow at 12liters per hour…for traveling it’s a dream come true!..another precious feature is the no-reuse of the gamma sterilized dialyzer! 8) …Alot of punch in such a small machine ain’t it?
Would ppl say that NxStage offers the most ease as far as backup when the machine is down? Other companies have to send a technician out, so that’s time lost from tx unless one has a good back up unit. Also, that’s time spent dealing with the technicians, when with the NxStage a new cartridge is sent overnite mail. Can anyone who has had a machine breakdown, describe how good the back up service was? I understand in some areas, technicians have to fly in. It sure seems like NxStage has the corner on backup. Would like to hear actual experiences.
I am another Nxstage user (since June) and I think it is great. We took it with us to Vegas over Thanksgiving and it traveled great by car. There are a lot of supplies, though, so be prepared. I think if you were going somewhere for longer than a few days, it might be better to “drop ship” some supplies from the manufacturer and have them waiting for you. It is very versatile and I am able to control my UF rate and volume depending on each day’s circumstance. My blood pressure stays very stable during treatment and I feel BETTER after finishing dialysis. On traditional hemo in the unit, I always felt tired and drained after my treatment. Now, I am ready to hit the ground running when I come off the machine! It is a great solution for people who want some independence and flexibility in their treatment.
I am another Nxstage user (since June) and I think it is great. We took it with us to Vegas over Thanksgiving and it traveled great by car. There are a lot of supplies, though, so be prepared. I think if you were going somewhere for longer than a few days, it might be better to “drop ship” some supplies from the manufacturer and have them waiting for you. It is very versatile and I am able to control my UF rate and volume depending on each day’s circumstance. My blood pressure stays very stable during treatment and I feel BETTER after finishing dialysis. On traditional hemo in the unit, I always felt tired and drained after my treatment. Now, I am ready to hit the ground running when I come off the machine! It is a great solution for people who want some independence and flexibility in their treatment.
pattie - if you don’t mind me asking - how much do you weigh? What is your KT/V since starting on the NxStage?
Hello “Guest”:
I weigh 90 kg. (I am sorry to admit!) I average 1-2 kg uf volume removed daily, run at a BFR of 500 and DFR of about 8.0 liters/hour and UFR of 1.0 liters/hour. I have a very robust leg graft as my access. On traditional in unit hemo, my kt/v was around 1.75. According to our unit manager, there is no clear equivalence between the KT/V on in-unit hemo and the values they are looking for on the daily Nx/Stage machine. The closest equivalence would be the clearances that they calculate for PD. Based on that baseline, my clearances are 2.1 PD. Regardless of the numbers, I know that I FEEL BETTER than I did before!
Hope this helps.
what is the average run time with the NXstage
ive been on dialysis for twenty years and anything to make me not wiped out after treatment would bve great dont know bout doing this every
day tho?
Hi Guest, and welcome. If you become a member of this site, you can get email updates when someone answers you, so you don’t have to check back. Doing HD every other day IS better than doing it 3x/week. A study by Bleyer found that the risk of sudden cardiac death was almost 50% higher on the day after the 2-day no-treatment weekend (what Dr. Carl Kjellstrand calls the “killer gap”).
That said, more dialysis is better. I know it sounds strange to think that you’d want to do something 5-6 days a week when you could get away with 4 (not sure the NxStage machine is approved for 4, BTW). But your best chance of NOT being wiped out after every treatment (and 20 years is a LONG time to put up with that!) is to remove fluid as often as possible. Nocturnal HD is the best dialysis–Cadillac dialysis–because fluid removal is longer AND may be more frequent.
Dr. Agar does a great job of explaining why this is, so you might want to visit our home page (http://www.homedialysis.org and scroll down to Webinars. You can view recordings of Dr. Agar’s talks. Or, if you prefer to read, he’s also written a couple of articles about this, that you can find here:
– Fluid and solute removal, how and why - Part 1 http://www.homedialysis.org/resources/tom/200711/
– Fluid and solute removal, how and why - Part 2 http://www.homedialysis.org/resources/tom/200712/
Hi Beth,
I believe NxStage is the only system cleared for home use by the FDA. It received that indication in 2005.
Applications
[i][b]"The NxStage System One is indicated for the treatment of acute and chronic renal failure or fluid overload using hemofiltration, hemodialysis, and/or ultrafiltration, in an acute or chronic care facility. The system is also indicated for hemodialysis with or without ultrafiltration in the home.
All treatments must be administered under a physician’s prescription, and must be observed by a trained and qualified person, considered to be competent in the use of this device by the prescribing physician.
A patient should not dialyze alone, regardless of whether they are “trained and qualified.”"[/b][/i]
NxStage has given me the opportunity to live my life, I do my treatments when and literally where I want.
I know this is an old post so I hope everyone’s questions got answered. What I like about NxStage is the simplicity, low maintenance, and the portability.
Harvey Wells
Nxstage since 03/2007
In-Center 01/2006 - 03/2007
Living donor transplant (wife) 06/1998 - 01/2006
Peritoneal dialysis 01/1998 - 06/1998
[QUOTE=Harvey_Wells;19258]Hi Beth,
I believe NxStage is the only system cleared for home use by the FDA. It received that indication in 2005.
Harvey Wells
Nxstage since 03/2007
In-Center 01/2006 - 03/2007
Living donor transplant (wife) 06/1998 - 01/2006
Peritoneal dialysis 01/1998 - 06/1998[/QUOTE]
Yes, NxStage has been given FDA Approval for home use…
NxStage Medical Receives FDA Clearance for Home Hemodialysis System
First Truly Portable Hemodialysis System Cleared for Home Use; Gives Patients the Freedom to Receive Treatment at Home or “On the Road”; Increases Access to Daily Hemodialysis That Research Suggests Is Healthier for Patients
Lawrence MA, - (June 29, 2005) - NxStage Medical, Inc. today announced that it has received expanded Section 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market its System One™ portable daily hemodialysis device for home use. This clearance was based on a formal clinical study comparing center-based and home-based daily hemodialysis with NxStage System One representing over 2,200 patient treatments. The study showed that hemodialysis with the NxStage System One is equivalent on a per treatment basis in-center and at home.
Read more at http://www.nxstage.com/our_company/FDA_Clearance.cfm
//MM
Hi Harvey,
The thread you re-posted was from late 2004 and both you and Mark are right that the NxStage was long ago approved by the FDA for home use. Several changes to the NxStage have been made over the years, the most obvious of which is the option to hang multiple bags or to use the PureFlow system that makes dialysate for up to 3 days.
Most patients who do daily or nocturnal hemodialysis with the NxStage or its competitors feel much better than they did when they did in-center HD 3 times a week. I’m thrilled that this option is available to people with kidney failure and that you and others have said that it gives you and them back your lives.
[QUOTE=Beth Witten MSW ACSW;19261]Hi Harvey,
The thread you re-posted was from late 2004 and both you and Mark are right that the NxStage was long ago approved by the FDA for home use.[/QUOTE]
Well I guess that’s what those numbers are after the month and year! That’s what happens when you spend too much time on the road, you forget how to post in these forums.
Oh, that January!
Always glad to see you here whatever you have to say, Harvey!
[QUOTE=Unregistered;19250]what is the average run time with the NXstage
ive been on dialysis for twenty years and anything to make me not wiped out after treatment would bve great dont know bout doing this every
day tho?[/QUOTE]
Hello guest. I used to get wiped out after every treatment while do in-center too. There may be an average run time, but you’ll find a very large disparity. Some dialyze as low as 2 1/4 hours and some as much as about 9-10. The more dialysis the better in my opinion. I started doing SDD for about 1 1/3 year and have been doing nocturnal for 2 2/3 years. I think that tells you what I prefer. I’ve also been averaging 5 day per week lately instead of 6. But I syll stand by my slogan that “one has to hate 3xWeek in order to love 6xWeek”.
If you come over to the NxStageUsers Website, you’ll be able to get more info directly from the people that use the therapy. We have a public forum specifically for those not already using NxStage. We also have a feature where you can get a personal mentor or ask a specific type of helper a question. We’ve already helped numerous people thinking thrrough their personal journey.