Injectable medications with home Hemo

[Lastname_Redacted]

I'm new here, and my doctor has recommended that I use the nxstage for home Hemo when I restart dialysis. If you use a machine like the nxstage, how do you take injectable meds like iron or aranesp? Are there ports in the tubing or do you have to stick yourself separately?

[obsidianom]

You do a seperate injection . I give my wife a sub Q injection of EPO weekly. It works BETTER subQ than IV.

[Simon Dog]

EPO is about 1/3 more effective sub-Q than IV (sources vary on the 1/3 figure; some will quote other values).   When I was in clinic, there was a time when I maxed out the EPO dose, so the next step was for my doc to change the orders from "via machine" to "subq".

The FMC clinic I use has a policy that no injectables other than heparin may be self-administered in a home hemo setting except via sub-Q.

The clinic also has a policy that iron IVs must be administered in-clinic.  Even the RN who handles my case is not authorized to give an iron IV in a patient's house.

There is a NxStage line set with a heparin port you can connect a separate heparin pump to, however, these don't seem to be in common use.

[cdwbrooklyn]

Okay, I'm slow today.  What is subQ?

[Simon Dog]

Okay, I'm slow today.  What is subQ?

Subcutaneous injection, as in injected into the subcutaneous tissue.  Other options are intra muscular (I don't think this is an option for EPO); IV (intravenous) push and IV drip.

[Speedy1wrc]

Administration of iron can have adverse side effects, thus the stricter policy.

[cattlekid]

When I was using NxStage for home hemo in 2012/2013, I gave myself weekly EPO injections subcutaneously (aka, "grab the flab and jab").  I still had to get iron infusions on occasion at the center when I went in for my monthly clinic visits.  I would not want to do iron infusions myself, as others said, too much risk.

I'm new here, and my doctor has recommended that I use the nxstage for home Hemo when I restart dialysis. If you use a machine like the nxstage, how do you take injectable meds like iron or aranesp? Are there ports in the tubing or do you have to stick yourself separately?