NxStage and dialysis meds

[MooseMom]

I haven't started dialysis yet, but I'm hoping to use NxStage eventually.  I know that in clinic, they add your dialysis meds like Zemplar, heparin, etc into your bag or whatever...how does this work on NxStage?  Where do you get the meds?  Do you pick them up at the clinic?  this confuses me..

[jbeany]

On home D, you have to go to the clinic once a month to see the doc, nurse, dietian, etc.  That's when you pick up supplies of heparin and things that Nxstage doesn't ship to you, like syringes, alcohol preps, etc.  Some centers may also have some things delivered directly to your house, but my center found it was cheaper to have the patients pick it up, rather than pay the delivery fees.  Some meds get more complicated on home hemo.  Nxstage doesn't have the same sort of port access the regular D machines do, so getting some of the IV meds becomes more complicated.  What you have to do about them depends on your center's policy.  Mine let me dose Hectorol thru the Nxstage, but I've talked to others on here with centers with different policies that don't allow for that.

[rocker]

For my hubby, Hep is delivered as a bolus at the beginning of treatment.  Hecterol is swallowed as pills.  Epogen is self-injected under the skin.

[tyefly]

  Yes   I did too get everything in center thru my lines and now that I am at home  I get nothing....  I am still having waiting to get EPO .... Now that I am at a new center  because of Nxstage training  it seems like they dont want to give me any of that.....they just keep telling me...lets just wait next month for your labs.... heck it been a month since I have had any thing...it probably cost too much money......

[M3Riddler]

I haven't started dialysis yet, but I'm hoping to use NxStage eventually.  I know that in clinic, they add your dialysis meds like Zemplar, heparin, etc into your bag or whatever...how does this work on NxStage?  Where do you get the meds?  Do you pick them up at the clinic?  this confuses me..

Hi MooseMom,
Not to worry. There is a way even on Nxstage to get everything you need including the IV Meds...Centers have different policies, but it shoudl not be an issue. 
You would probably be required to pick up your supplies monthly. NxStage will send you a shipment of supplies monthly also...

///M3Riddler

[MooseMom]

I'm sure there's a way it will all get done; I'm sure there will be plenty of people telling me what to do!

[Malibu]

We take pills, EPO at the beginning of treatment just before heparin in the V access, and iron at the clinic when necessary.

[rocker]

  Yes   I did too get everything in center thru my lines and now that I am at home  I get nothing....  I am still having waiting to get EPO .... Now that I am at a new center  because of Nxstage training  it seems like they dont want to give me any of that.....they just keep telling me...lets just wait next month for your labs.... heck it been a month since I have had any thing...it probably cost too much money......

They told us the same thing.  We were afraid....he took such a large dose of Epo when it was given through the lines in-center, and his hemo used to drop so fast when he didn't get it.  But they were right...he went almost a month without Epo and his hemo dropped only slightly.  The explanation they gave us was that toxin buildup causes a faster die-off of red cells, so they need to be replenished at a slower rate with better dialysis.  He went from between 11,000 and 28,000 IV three times a week in-center, to about 10,000 per week (subcutaneous injection) at home.

[Wallyz]

Just to nit pick- the issue isn't with quicker die off, the issue is that uremic toxicity shuts down red blood cell production.  Same result.

[Malibu]

I do not understand the difference in this:  some nurses say they cannot give meds through the filter port, other nurses give meds through it.  Both happened to us during training!  One day when our nurse was out another nurse attached the iron to the filter. 

[Wallyz]

Nx Stage used to recommend giving meds through the filter port, now they do not.  The issue is the clots that can form at the top of the filter.