I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis - NxStage Users => Topic started by: vcarmody on August 13, 2010, 07:15:14 PM
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I am still new to all this dialysis stuff. My husband only started dialysis last Sept 2009, shortly there after we started training on NxStage. We have been home since Feb 2010. I read a lot on here which is a great, because without all of you I would be totally lost. When we trained on NxStage I was never clued in as to what the goals were for adequate dialysis for my husband. I read on line that KT/V of 1.2 is considered adequate, but I am not sure if this is right because my husbands KT/V has been 1.87, 1.61, 1.68, 2.34, 1.97 and 2.04 but he was told by his nurse his clearance is not good. Can any of you tell me what you clinic considers good KT/V clearance? :thx;
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I was told 2 was good.
Anyone else??
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We were told that 2 was fine, but she always is in the high 2's or low 3's......
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I am at a Davita in center and they say 1.4 or higher is fine. My last 3 were 1.28, 1.49 & 1.47. My neph says that mine are fine.
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How often does your husband dialyze and for how many hours per treatment?
That is an important part of the issue.
Here's an IHD thread on the topic:
Taking NxStage System One to the Max
By Peter Laird, MD
http://ihatedialysis.com/forum/index.php?topic=17790.msg309899#msg309899
8)
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He dialyzes 6 days a week, we were doing just short of 3 hours each treatment at FF 35, But we recently changed our FF to 30 so that we could get better clearance now his treatments are about three hours and ten minutes. He really wants to only do 5 treatments a week, he feels all his blood work is good (Albumin, Potassium, Calcium, and Phosphorus are always great and he don't even take binders) but he is being told he can not do 5 treatments a week because he signed a contract saying he would do 6 treatments a week and if it is to much for us to do 6 treatments a week then he would have to go back in center. They keep telling him his blood work or his clearance is not good and I just don't get why they are coming up with that if all his values are good and his KT/V is above 1.4 what other things can they be considering to say he is not dialyzing enough? Mind you his kidneys still work last time they checked they were at 10%.
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Oh, I should tell you we run at blood flow of 470 to 490.
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Our center bills the insurance $500 PER treatment, that would be a loss off $2.000 a month in income for them if we went to 5 days.....
It's your Neph who writes the prescription for the number of treatments per week, the center has no choice but to follow his orders....
Also, if the Neph is hesitant to have him taking 2 days off in a row, suggest 3 on, 1 off type of schedule
Tom
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I am still new to all this dialysis stuff. My husband only started dialysis last Sept 2009, shortly there after we started training on NxStage. We have been home since Feb 2010. I read a lot on here which is a great, because without all of you I would be totally lost. When we trained on NxStage I was never clued in as to what the goals were for adequate dialysis for my husband. I read on line that KT/V of 1.2 is considered adequate, but I am not sure if this is right because my husbands KT/V has been 1.87, 1.61, 1.68, 2.34, 1.97 and 2.04 but he was told by his nurse his clearance is not good. Can any of you tell me what you clinic considers good KT/V clearance? :thx;
VCarmody,
KT/V is a difficult equation. In fact there are over 8 ways to calculate KT/V and many of the formulas will yield a different result. First I would find out which formula your center is using. Are they using the calculator that NxStage includes in their packet of information? This makes a big difference.
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... but he is being told he can not do 5 treatments a week because he signed a contract saying he would do 6 treatments a week and if it is to much for us to do 6 treatments a week then he would have to go back in center...
Well, a contract is a contract.
:cuddle;