Baby K vs. NxStage

[Simon Dog]

I recently switched from PD to Hemo (insufficient KT/V from PD combined with an atypical loss of residual forced move to hemo - one of my docs tells me I am in the realm of cases that get up in medical journals).

Once I transition from vas cath to fistula, I am going into training for home hemo which my doc and the clinic tell me I am already approved for.  In fact, when I registered I the manager told me that she heard "I was that patient getting a home machine" (this Fresenius clinic has none at present).

I can get a BabyK Fresenius 2008 machine or a NxStage.  If I get BabyK, I will probably do conventional every other day (3x/weeks is a cost based sucky compromise in quality) or nocturnal, and if I get a NxStage it will be short daily 5 or 6 days a week or perhaps nocturnal for the same number of days.    I know every other day or 3x/wk is not an option for NxStage.   I am not interested in "home assist" where a tech comes out to set the machine up for you and stick the needles in - I'm kind of the ultimate do it yourselfer and that extends to dialysis.

I welcome opinions and thoughts on the BabyK vs. NxStage from the "Been there, done that" community, or anyone else who has researched the issue.   I have a few months (non-renal medical issue blocking fistula installation for a few weeks) to make the decision.

[M3Riddler]

I recently switched from PD to Hemo (insufficient KT/V from PD combined with an atypical loss of residual forced move to hemo - one of my docs tells me I am in the realm of cases that get up in medical journals).

Once I transition from vas cath to fistula, I am going into training for home hemo which my doc and the clinic tell me I am already approved for.  In fact, when I registered I the manager told me that she heard "I was that patient getting a home machine" (this Fresenius clinic has none at present).

I can get a BabyK Fresenius 2008 machine or a NxStage.  If I get BabyK, I will probably do conventional every other day (3x/weeks is a cost based sucky compromise in quality) or nocturnal, and if I get a NxStage it will be short daily 5 or 6 days a week or perhaps nocturnal for the same number of days.    I know every other day or 3x/wk is not an option for NxStage.   I am not interested in "home assist" where a tech comes out to set the machine up for you and stick the needles in - I'm kind of the ultimate do it yourselfer and that extends to dialysis.

I welcome opinions and thoughts on the BabyK vs. NxStage from the "Been there, done that" community, or anyone else who has researched the issue.   I have a few months (non-renal medical issue blocking fistula installation for a few weeks) to make the decision.

Simon,

I would suggest the NxStage... For the following reasons.
Travel
More dialysis = feel better
More likely to get off all blood pressure meds
Better Fluid control
More liberal diet
No ups and downs in labs
No washed out feeling at end of treatment.
You can always add time to the treatment which will produce even better results.
Comfort of your own home
You are in charege
On your own schedule
Do whatever time you wish.
Water System completely different...
Much smaller water hookup...
Can change to bags if problems with water system.
Take it in a car and travel without making plans, just load your car up.
Company will delver dialysate bags and other supplies prior to vacation
Very easy to learn.
I could go on and on...

Ultimately, this is your decision.  Feel free to ask any questions..

[Speedy1wrc]

I am now on the NxStage at home and was on the full sized Fresenius in center.

They are certainly different. M3 went through a pretty extensive list.

The NxStage System1 is pretty easy to set up. drop in a cartridge, hook up your dialysate supply, and off you go. For me, I like the portability and the easy water/dialysate supply. It does not have the control or technology of the BabyK but for my prescription it works well for me.

Anecdotally two NxStage treatments are equivalent to one in center treatment. So if you go the NxStage route you will definitey be dialyzing more often. It uses a lactate based dialysate which is significantly different than the sodium bicarb of the BabyK. Bicarb is more efficient but technically more difficult to use and handle. Thus the BabyK uses more water and the water system is more extensive.

For me, the short daily was the clincher. I have fluid issues and only having to remove minimal quantities helps me feel better. Being at home was my second priority taking a back seat to fluid control. In center I was on for 3.5 hours then there was travel and wait time. At home I am on for around 2:50 minutes but then there is still rinseback and getting off the machine, but now also setup and inventory and logistics. Timewise you won't save any time from in center to home.

The simplicity and modularity of the NxStage make it popular however it also dumbs the machine down. For example if yu inadvertently stop the dialysate drain process you could end up with a 50 or 60L bag of fluid that is stuck in the PureFlow SL machine. That leaves you to get creative in how to take care of getting rid of it. Don't get me wrong, it's a super machine however there are a few gaps in concept.

Is there anything specific you desire in one machine or the other?

[Simon Dog]

I picked the BabyK since my MD felt it was better for me, particularly since I don't put on a lot of water weight, and he's scheduling me for EOD rather than 3x/wk., with the goal of going nocturnal.    Having every other day off is a huge plus for me, though I know I will have to go in center when I travel.   (Ideal would to be issued a BabyK for home and an NxStage for travel, but I'm not important enough to get that).

[obsidianom]

That's interesting that your doctor picked the Baby K . You live near the Nxstage home in Massachusetts.  My wife also takes off very little water and often NONE . She does Better on Nxstage than Fresenius system. Her nephrologist also felt Nxstage was better with more frequent dialysis. It worked wonders for her. She feels  so much better than on the Fresenius . She is on treadmill singing as I write this. I am a physician also and researched this carefully and feel Nxstage has many advantages. I love the system and its simplicity. It is a part of our family now.

[Simon Dog]

Curiously, my doc has a mixture of NxStage and BabyK patients.   My doc seems to feel that every other day overnight is as good a short daily, and was convinced the BabyK was a slightly better choice for me.   The clinic I use has 2 NxStage patients and I am their only BabyK patient.   It's going to be an interesting ride.