Which is better NX Stage or Baby K

[emma67834]

Hubby wants to do home dialysis and I amjust wondering which is the better way to go? How many days a week do you run? How much better do you actually feel? How long does it take to set up and break down? What about interference with a normal life?

[greg10]

Hubby wants to do home dialysis and I amjust wondering which is the better way to go? How many days a week do you run? How much better do you actually feel? How long does it take to set up and break down? What about interference with a normal life?

from the other thread:

CDW, I do know how he is feeling. He wnats to do the baby K not the NX. He says its because on the babky k its only 3 days per week versus 6. I want him to do whatever will make him feel the best and maybe that will help with his grouchiness too. I have NO help from his family because he has me. His mom made that comment last night to me. My own family lives 3 states away so I cannot rely on them except for when I need to vent. I realize that this is about him and his health but the rest of us are in this battle too. I can't get a home health place to come in for respite care unless he is terminal, I have checked. I am glad that you are doing so well with it. Unfotunately with us I see him being codependent on me for everything as it has been in the whole 16 years of our marriage.

Welcome to the forum, Emma 
I understand you are a reluctant participant in your husband's desire to do home HD (HHD) from the other thread.  The whole idea about HHD is that the patient regains certain control over his life and dialysis treatments and hopefully improve his quality of life at the same time.  It is not a short cut to doing less dialysis and have a caretaker who services the patient at his time and leisure, which is the impression I get from reading the other thread.  If your husband is not willing to do his share, hopefully a great deal of his share in his own treatment, then HHD is probably a bad idea for your family given your circumstances.  I would suggest you look into nocturnal in-center dialysis as an alternative because he would get more treatment time and he should get better.

As to whether the babyK or the Nx, there are certain advantages to both.  The Nx is slightly smaller, requiring less power and more importantly, less water and there is an option for using premixed dialysate, which the babyK doesn't offer.  The babyK has more control over the dialysis such as ultrafiltration profiles and single needle dialysis, but contrary to what your husband thinks, the babyK doesn't allow you to do 3 days per week and get the same result as a 6 day treatment on the Nx.  Most HHD do 5 to 7 dialysis per week regardless of what machines they use.  You should familiarize yourself with this simple formula on the adequacy of HD, there is no miracle dialysis machine, other than a functioning kidney, that will shorten your dialysis time.

Scribner and Oreopoulos, 2004:
The Hemodialysis Product
Based on published evidence from many sources, we propose a new index of adequacy of hemodialysis, to be called the
Hemodialysis Product (HDP). This new index incorporates dialysis frequency, which is an important variable:

HDP = (hrs/dialysis session) x (sessions/wk)^2

[Zach]

Most HHD do 5 to 7 dialysis per week regardless of what machines they use.  You should familiarize yourself with this simple formula on the adequacy of HD, there is no miracle dialysis machine, other than a functioning kidney, that will shorten your dialysis time.

Most traditional (1980s-2005) home hemodialysis programs were 3 times per week with 4 to 5 hour durations.

Except for offering NxStage, perhaps emma67834's center is still on the traditional version of home hemodialysis when it comes to the larger machines such as the Baby K.

[carol1987]

Hubby wants to do home dialysis and I amjust wondering which is the better way to go? How many days a week do you run? How much better do you actually feel? How long does it take to set up and break down? What about interference with a normal life?

Everything about ESRD and dialysis interferes with a "normal" life... no matter which treatment you chose...  all have their positives and negatives

[boswife]

NxStage is protable and you can travel with it. ( Dont know about babyK though).  I know NxStage support staff is amazing.  And i know lots of people love nxStage............. as well as me and hubby 

[emma67834]

The home dialysis people are the ones taht told us that with the baby K that it will be 3 days a week. All the research I have done says that the NX is 6 days a week and that everyone feels so much better doing it 5-6 days a week. I haven't gotten much info on the baby K and how people feel though. I am a little reluctant to doing this at home as I said in my other post. Ultimately, I want to do what is best for my husband but also my family. I am still on the fence about us doing this at home, trying to work, raising 3 kids and having 2 dogs and a cat in my house. I could use all the info I could get. Thanks guys, this forum has been a godsend in my life since most people I know don't realize how stressfull this disease can be.

[Bill Peckham]

You use more water with the Baby K. You'd have a seperate water treatment system - a Reverse Osmosis water purifier - that "rejects" ~90% of the water coming in from the tap, using ~10% to make the dialysate you need and which means you can easily use a gallon of water a minute during dialysis.

Clinically the Baby K delivers more dialysis per minute than the NxStage cycler. Every other over night dialysis at a 400 or 500 dialysate flow rate would be very good dialysis ... a lot of the programs in Australia use a standard Fresenius machine for their home machine.

The NxStage requires less time to set up but the difference isn't that great. The big difference is that the NxStage water system - the PureFlow (or bagged dialysate) - take a lot less work than the RO that the Baby K requires. The NxStage requires no home modifications, while the Baby K needs a dedicated electrical circuit.

The Baby K is basically a shrunk down version of a standard incenter machine. Zach is right that until 2001 home hemodialysis meant a standard machine and often a conventional schedule. There are advantages to home dialysis even if the dose dialysis is going to be the same - for instance being able to control the environment , some schedule flexibility, less exposure to germs - but it is when you add treatment frequency that you see the clinical improvements that many of us talk about.

[M3Riddler]

Everything about ESRD and dialysis interferes with a "normal" life... no matter which treatment you chose...  all have their positives and negatives

Carol,

I have to respectfully disagree with you about not being able to live a "normal" life on dialysis. I was able to:
1. Graduate High School With High Honors
2. Graduate College with A BS Degree
3. Hold a Full Part Time Job while in High School and College
4. Find a Full time Job After College with a major Insurance Company
5. Live on my own being totally independant purchasing my own home
6. Travel around the country on an Amateur Paintball Team

All While On Dialysis and with 3 transplants between it all.  There are many people who do not accomplish half of this who have no health problems.  I believe I have made something of my life with my disease and being on Dialyssis. All it takes is a will to survive and dedication.

Yes, everyones circumstances are different, but you can life a fully functional life on dialysis. Too many people give dialysis a bad name. No its not fun and you must arrange your schedule differently, but with home dialysis, this is completely possible.  Yes, there are positives and negatives, but what is the alternative? 
I beleive you must make the best of what is given to you....
And what really is the definition of "normal"......

Again, this is my opinion and mean no disrespect to you...

///M3Riddler

[Desert Dancer]

Hubby wants to do home dialysis and I am just wondering which is the better way to go? How many days a week do you run? How much better do you actually feel? How long does it take to set up and break down? What about interference with a normal life?

There is no 'better' way to go; everyone's circumstances and expectations are different, and what's right for me could be disastrous for you. I can only tell you my experience with the Baby K.

The Pros
I dialyze every other night (though lately pain has had me averaging every third night). BUT - I dialyze for 8 hours every treatment, not 4 hours. For me, doing long slow dialysis has allowed me to keep my fluids under control, because even if I gain a lot (for me, a lot is 3 kilos) my ultrafiltration rate never goes above about 330 and is usually around 190: an easy, gentle rate. This was important to me.

The same can be said for my blood chemistry: I have been able to keep things like potassium and phosphorus within range without altering my diet by much (just practicing moderation). This was also important to me, as a renal diet basically decimates everything I live on and I wanted a way to preserve a somewhat normal diet without jeopardizing my health or having to take a lot of expensive binders (which I've been able to drop).

Doing a long, slow 8 hours allows me to have a much lower blood flow rate, which is easier on my access (a fistula). This matters to me because I want to do everything possible to safeguard and extend the life of my fistula. This might not be very important to someone with a catheter.

Doing nocturnal allows me to (theoretically) sleep while I dialyze which means (again, theoretically) that my days are my own.

I feel fantastic doing it this way - downright normal - and have achieved everything that was a priority for me. HOWEVER, there are also

The Cons

The Baby K uses a LOT of water. Your water bill will at least double, if not triple.

The supplies take up a LOT of room, even if you're ultra organized and stay on top of them when they come in, and manage your ordering well. Take away any one of those things and it's a mess.

The machine and RO system take up a lot of room. You're not taking this machine anywhere.

They do need both a dedicated electrical circuit and a dedicated tap.

Not only is there a dialysis machine to clean and maintain, there is also an RO system that must be fed and cared for. There is ALWAYS something that must be done to one, the other or both, be it a daily, weekly, monthly or quarterly task. This means that you're pretty much dealing with some aspect of it on a daily basis, even on days no dialysis takes place. This can be mentally and emotionally wearying.

I think a more important question is whether home hemo is right for you at all, if you'll pardon my blunt opinion. I understand from your other posts that you've been more or less corralled into this. My husband is a willing partner who went into this whole thing fully informed and fully supportive - and I do everything I'm supposed to for my health - and it's hard even on him sometimes. It's a grave responsibility with no shortcuts. The added stresses you speak of won't be mitigated by your choice of machine.

[emma67834]

Thank you Desert. My water bill is already $80.00 amonth and now to think of it being around $240.00 a month really has me against this. I appreciate the honesty from your post along with everyone else's. I think he is starting to think seriously about the NX now. I am still not sold on the home option for this. Financially, I don't think we can afford any higher bills and can definitely not afford the 244 mile drive round trip for 6 weeks to train. I just wish that he would see what I see financially from my viewpoint. I am at my wits end with everything this weekend and having to help make this decision when I think that In Center is doing what we need it to right now. I know I should be more enthusiastic about some of this but I am already drained from the past two years and the effects this has had on our family so far.

What can I expect with the NX if we decide on that system that would be different from the baby K?

[lmunchkin]

I really do not know how to advise you on your husbands decision to do home dialysis. But please be informed that anyway he chooses it is going to take both of you to make this WORK. He has to know your feelings on this too! If you dont work together and remedy this together, your marraige of 16 years could very well go SOUTH! Just sayin!!!

You still have the center, so there is no rush to do this right away, right?  Without his History, I take it this is new to you both? Just take your time, sit down and discuss the pro's & con's of doing it at home. First, I will tell you that the more dialysis (fluid removal & cleaning toxins) the better!  That is a fact!  He has no kidneys so dialysis is a must whether incenter or at home. 

I do Nxstage on my husband. He is dependent on me solely, but I do it willingly.  Now he does help me some with it, but I do the bulk of things. We sat down along time ago and discussed this alot before we did it.  We did not rush in to it. Plus, I needed to educate myself before I FELT that I could do this.  Had I decided not to, he would not have liked it, but would have understood completely! That being said, I am so glad that we choose Home dialysis. Now I believe you asked about the time of set up and all.  I go to work at 7:30am and get off at 3:30, go home and set machine up in about 30 to 45min (sometimes less), get him hooked up, then when things seem okey doaky, I start dinner and we eat in dialysis room, watch TV and just really spend quality time 2gether. I have lenghtened his time to about 4hrs. Sometimes longer, yet slower to get a good slow cleansing and fluid removal.  His neph has okayed 3on 1off and so on.

It seems absolutely overwhelming at first, but It Will Get Better. But if it is not for you and you don't think you can do it due to all the other responsibliities you have, then he has to know that this is hard for you too. After all, you are going through this with him.  He has this horrible disease and we as garegivers have to understand that and support them as much as possible, but he wants to do it at home and if you dont want that, you need to let him know how much you love him and support him but he needs to know that this is too much to handle right now.  Who knows, maybe later down the road, you might give it a try. Just talk to him about it in a nice way and speak whats on your heart!  He truly may not know of your concerns because you have not expressed them to him.  It's like my husband told me once, "I can't read your mind, Woman".  It was true!  They are not mind readers!

Just relax and get familar with it all!  If he needs to stay incenter for awhile to give you some absortion time, then I believe he will!  He needs you more than ever and I believe he will do his part to make you Happy!

Don't know if this helped, but know that we are all here for you! Update us if you will!

  lmunchkin                                                                                                                                                 
p.s. I know that this is very hard for you, but we do alot more for them now than ever before because of this ugly disease.  He knows that and Im sure wishes this had never happened to yall. Probably feeling very much like he is a burden, but really, they aren't, and as loving wive's, we should absolutely let them know that!

[Bill Peckham]

On the water issue - NxStage uses either bags of dialysate so there is no additional water usage (but a lot to store) or it uses a separate device the PureFlow to turn tap water into dialysate. The PureFlow uses a different type of water purification process DeIonization. Unlike an RO, a DI doesn't have to reject water in the process of purifying it, so the PureFlow uses 60 liters of water to make 60 liters of dialysate.

The bottom line NxStage using PureFlow use up to about 7-8 gallons of water per treatment vs. the Baby K which would use hundereds of gallons of water per treatment.

If you did end up using the Baby K it is worth checking with the water department to see if they would discount water used for medical reasons.

[cookie2008]

I do nxstage and I use the bags, Im doing my treatment right now sitting on my couch watching NCIS,  its the best decision I ever made and I would highly recommend it.  I have a small 2 bedroom house and I store my supplies in my bedroom closet and the bulk of bags in my basement.

[tyefly]

I too do nxstage at home....  I know they said  6 weeks of training..... but I and most in my clinic have done the training in 3 weeks....and they we go home....its a good life doing it at home..... I would not go back to a clinic... NO WAY.... I like to do dialysis when I want to and I like to do what I want to do while on Dialysis....  at the clinic I just have to sit there...and watch TV....  So much nicer at home....