Correct Dosing on NxStage

For those who dont know, Nxstage has an online calculator for correct settings and dialysate dose and speed and flow fraction etc. If you havent had your nephrology team check yours, DO IT. You may find you can improve what you are doing. WE DID!!
I assumed my wifes settings were ok as she felt better on NxStage than in center. Well when I checked the calculator it showed we were on too little dialysate and low flow fraction. Her kt/v had been running 2.5 so the neprrologist figured she was ok.
I put in the numbers for a kt/v of 2.75 and then 3.0.
At 2.75 it told us to increase the dialysate by 5 liters more. We did that and she felt a lot better in 2 days. After 2 weeks we went to the 3.0 kt/v settings which required another 5 liters added. AMAZING DIFFERANCE!!
The last few days on the additional 10 liters have changed her back into the woman she was before dialysis. Its an amazing transformation. She is walking all over the house doing things and has energy to burn now. I hadntrealized how low energy she was until I see the differance now. She tells me she feels so much different . She only wishes we did it sooner.

So my advice to you all is check with your team to run your numbers. See if you need to adjust the settings. WE only added 15 minutes of additional time to get this to work as we raised the flow fraction way up,to speed up the dialysate. We dialyze now for 3 hours, 5 times per week. Based on the calculator we should see a kt/v of 3.0. When she was at 2.5 she just didnt feel much energy. So its worth talking to your team about this.

I hope this helps some of you . We got complacent and just assumed our original numbers were good enough. Our nephrology team at least listened to our argument for more and went with it. We learned from this that it is worth rechecking the settings and treatment parameters every once in awhile and trying for more dialysis if possible. My only regret is not doing it sooner!!