NxSTAGE TO BABY K ?????

[lmunchkin]

Clinic where J goes has been training Baby K for awhile.  Now that Iam on time restraints due to work, they are really pushing me to do Baby K. Have any of you done Nxstage then switched to Baby K or viseversa?  Can you shed some light on the differences.  I understand that NxStage is almost everyday, but Baby K is not as many days.  I want my husband to get good dialysis not like incenter.

Iam seriously considering it, but want an opinion of those who are doing it whether the patient or caregiver!!!!

Thanks in advance,
lmunchkin

[Bill Peckham]

I think it something to try, at least it is something that could reduce the treatment burden. I was thinking about this reading about Amanda's (and other's) feeling of pending burnout.

The NxStage gets the most dialysis impact (it is more than clearance of urea, there isn't really a way to measure it or a name of it) per unit of dialysate. The Baby K will get more impact per unit of time. I think we all value our time more than the dialysate.

So I would expect that one advantage of using the Baby K is that it would provide more dialysis per each minute on the machine, due to the K using more dialysate per each minute. The downside is that the K's way of making dialysate requires a lot of water. You'd go from using about 15 gallons of water per two 30 Liter NxStage treatments (using PureFlow) to using 100 gallons of water or more for every hour on the Baby K.

Another advantage of the K will be that the treatment lengths are predictable. No more spending another 30 minutes on the machine because you couldn't get to your normal blood pump speed. With the K you set the time and whatever blood pump speed you use the treatment length and dialysate flow stay the same.

One question will be the setup time of the K vs NxStage. I think day to day the set up time will be very similar. The one thing the K will require is the disinfection and maintenance of the water system - the RO (reverse osmosis unit). When I used one - over 10 years ago - it was a weekly process using formaldehyde which I would rather not have to do but maybe there has been an advance in ROs in the last decade (one can hope) or since it is just once a week it would not be too bad.

If you can't give extended a try then I would definitely try the K if the alternative is going back to conventional. Back in 2008 I would have gone back to the B Braun if I couldn't have tried extended with NxStage (which I found worked great for me, after believing it wouldn't since I am so squirmy during 3 hour runs while awake).

[cattlekid]

Right there is the reason that I would never use the Baby K.  In our area, we have to pay a corporation for our water (it's a utility, but has shareholders that want profit!).  So right now, for average use of 3000 gallons of water, I pay $80 per month (this includes sewer as well). 

So if the Baby K uses 100 gallons of water an hour, and let's say you run for 12 hours a week times 4 weeks per month, that's an extra 4800 gallons of water, effectively doubling my water bill on a monthly basis. 

Add on to the fact that you are killing the environment with all of that water usage?  I'll stick with NxStage, thank you.

So I would expect that one advantage of using the Baby K is that it would provide more dialysis per each minute on the machine, due to the K using more dialysate per each minute. The downside is that the K's way of making dialysate requires a lot of water. You'd go from using about 15 gallons of water per two 30 Liter NxStage treatments (using PureFlow) to using 100 gallons of water or more for every hour on the Baby K.

[lmunchkin]

Thanks for the differences Bill.  First off, they (clinic) has been pushing Baby K, but since putting more hours in where I work, they think it would be an advantage for me.

On the other hand, John wants to remain on NxStage. He has felt better on it than any other modality.  Like Cattlekid, the water is an issue and the fermaldahyde, gee whiz, Im not crazy about that either.

For learning purposes, I think the Baby K is more like what they have in-centers and that would be interesting to learn, but for the minor differences, I think I will stick with NxStage.  John is very disciplined in what he eats & drinks so that does make it alot easyier.

After I get through training new employees, my hours should drop back some thus allowing more time with his needs!  Thanks so much for your replys. I just wondered about it and was considering the change, but if it isnt broke, then don't fix it right?

Again thanks,
lmunchkin

[Bill Peckham]

Thanks for the differences Bill.  First off, they (clinic) has been pushing Baby K, but since putting more hours in where I work, they think it would be an advantage for me.

On the other hand, John wants to remain on NxStage. He has felt better on it than any other modality.  Like Cattlekid, the water is an issue and the fermaldahyde, gee whiz, Im not crazy about that either.

For learning purposes, I think the Baby K is more like what they have in-centers and that would be interesting to learn, but for the minor differences, I think I will stick with NxStage.  John is very disciplined in what he eats & drinks so that does make it alot easyier.

After I get through training new employees, my hours should drop back some thus allowing more time with his needs!  Thanks so much for your replys. I just wondered about it and was considering the change, but if it isnt broke, then don't fix it right?

Again thanks,
lmunchkin

I would be real interested if you can confirm with your center the water issue and the maintenance requirements for the RO that goes with the Baby K. My experience with an RO is 10 years old now and I am wondering if things have changed significantly.

[lmunchkin]

He has an appt next monday, and I intend to ask those questions.  I wouldnt mind learning it cause it can't be that much different, but John does not wish to change.  So I don't know, but will inquire Monday!

Again, Bill, thanks for your insite.  I know you have done just about everything "Kidney" and could contribute alot of knowledge in this area.

God Bless,
lmunchkin

[Desert Dancer]

lmunchkin, I've never done anything but the Baby K and its RO system. If you search on 'Baby K' with me as the author you'll come up with tons and tons of 'pro and con' posts about it. I dialyze a minimum of 30 hours and a maximum of 48 hours per week. I have fantastic phosphorus control - no more binders - and I can eat and drink pretty much whatever I want.  Even if I have to take off something like 5 liters (which is rare, and something I could never do in-center) I can, because my UF rate will still only be 500, the most I can handle.

There are many things about the Baby K that prompted me to choose it over the NXstage. It's certainly worth looking into.

As to the water: yeah, that's bad. What Andy and I intend to do is divert the wastewater from the RO and tie it into an irrigation system for the entire yard; excess will be diverted to a holding tank, since it's still usable water. If the house we end up with has a pool, excess could be diverted there. He's a pipefitter so it should be a breeze for him to put it together once we do all the math involved. (We have to have the house first, too.)

[Bill Peckham]

Right there is the reason that I would never use the Baby K.  In our area, we have to pay a corporation for our water (it's a utility, but has shareholders that want profit!).  So right now, for average use of 3000 gallons of water, I pay $80 per month (this includes sewer as well). 

So if the Baby K uses 100 gallons of water an hour, and let's say you run for 12 hours a week times 4 weeks per month, that's an extra 4800 gallons of water, effectively doubling my water bill on a monthly basis. 

Add on to the fact that you are killing the environment with all of that water usage?  I'll stick with NxStage, thank you.

Being sick isn't ever green aside from possibly looking green. But I think most environmentalists I know would say that they are water conscientious so that it is available to people who actually need it. And DD's plan to divert it for irrigation is brilliant.

One thing about the water's cost is that the water agencies may be open to making an accommodation if they are made aware of the situation. It is actually one area of advocacy that dialyzors have had success. In Seattle, we have a long history of HHD so I don't know who got the policy put in place but over the years I've heard reports of others successfully advocating for a HHD accommodation from their water district or whoever it is that runs the water system. And if you get one established then it will be there for the next dialyzor.

[Bunhyung]

If you are concerned about water usage, ask your Home Dialysis facility if they can get a DI system. Completely silent and uses way less water. Also not as large as the Aquaboss RO. system which needs to be run 24/7