NxStage Training

We would like to know anything NxStage users can tell us about the training. How difficult is it to learn to set up the machine, to familiarize yourselves with the alarms, how to handle air in the lines etc. ?

Check out ihatedialysis.com – the moderator is currently training on the NxStage and logging in every day to describe his training.


Thanks Lorelle, read it already. Epoman was helpful to journal his training sessions. Wondering what others thought of the training, too. We will journal our training when the time comes.

Epoman wrote:

But back to the “goal” I explained to the “chief” that every Monday when I came in, I would always remove 4.0kilos as a minimum at in-center, and we only had removed 1.5kilos on Monday. I explained to him that I felt fluid overload, in fact my BP was high yet again today and it has been great for months. So later when my doctor came, she agreed with me that I need a higher limit of fluid removal per hour. which is now 1.5kilos per hour, which means I can only remove a maximum or 3.0kilos per treatment, since with NxStage they calculate in whole hours so the last half hour doesn’t count. Basically that means they will remove all the fluid in the first 2 hours then after that, the machine is just cleaning my blood. I know it’s strange. But oh well, that’s just the way it is.

Why do they stop removing fluid the last half hour? We heard they can also remove fluid until the end if they set it to. But don’t know the reason they would want to finish pulling the fluid 1/2 hour from the end.

Epoman wrote:

She (dietitian) asked me the usual about my diet and my meds and was shocked that I was not on a vitamin. I had told her that when I did take a vitamin I did not notice a difference in my lab results. But she really wanted me to start taking a vitamin again so I agreed to try taking a vitamin again. So I’ll see if it makes a difference, she explained that since I will be dialyzing twice as much, I will lose more of the “good” stuff through the NxStage.

If there is vitamin/mineral loss from dialyzing twice as much how is it made up?

This is true, daily-short and nocturnal you will lose more of the good stuff…you will need to keep up by eating well and taking supplements such as protein drinks, and folic acid…read more about it here…

Would anyone care to comment on what you thought was the most difficult part of the NxStage training? Everyone seems to say the training was easy, but what were the hardest parts to master? Could a patient who knows nothing at all about dialysis terminology and how machines operate, become confident enough to run his own tx?

Definately when it comes to dealing with your access, needles… :stuck_out_tongue:

Cannulating is probably the hardest. Of course people who know nothing to start out with can learn home dialysis. I learned when I was all of 18 and knew nothing as dialysis was very new when my father started in 1972. The machines were much more complicated in those days.

home hemo 9/04

How about getting air out of the lines, knowing which line to connect to what- did you find this easy? Did you have any concerns that when you did it by yourself the first time at home that you could forget something and panic?

And how about alarms- did you thoroughly understand what each one was and what to do about it?

There’s one step priming the lines getting air out…that’s not a hassle…its straightforward and there’s nothing to mess with, in other words there’s nothing to connect in a row…all you do is spike the saline bag and start the process and from there you can start getting tape and needles ready for treatment… :stuck_out_tongue:

Now if you meant air in the lines during treatment that hasn’t happened yet but the training to get it out is simple…it all depends how much air you got in and the circumstances. On the contrary probably most patients woould panic… but again this is a very rare case getting air in the lines during treatment…beeing on dialysis myself at home since late 2004 that is something hasn’t happened unless something on the lines failed…before treatment the machine goes through some tests to check that the lines are working correctly, but if it ever happened I know what I would do…

Literally it all memorized…just like we know our birthdays and our personal information NxStage becomes part of us, we tend to know it by heart…

I’m not on NxStage, but…

I had a rare HIGH CONDUCTIVITY alarm the other night. Like most of these rarer occurences, when it happens for real, the only thing to do is to reach for the manual (or whatever you have that is equivalent). First the alarm wakes me up. Then the blood pump stops. I’ve got to do something before my blood is too old to rinse back. So I quickly scan through the instructions on High Conductivity. Everything looked good. I can’t see or hear my R/O in the other room, so I asked my wife to check to see if it was still on. It was. By this time, the conductivity has returned to normal, and so I simply press RESET, and carry on with the treatment. No more problems that night. My best guess is that there was a short interruption in the water supply in my apartment building.

My point is that even though we do go through all the possible alarms in training, some situations are rare enough that by the time it happens at home, you’ve probably forgotten the exact procedure anyway, so, keep the manual handy.


In your training with NxStage did they give you the manual to read ahead of time or did they just give it to you when the training began? Did you feel like reading it when you got home after training? Were you given any other written material you could refer to to help you understand the machine set up and the procedures for connecting the lines to the neddles, giving IV meds etc?