Daily hemo with a Fresenius

[Adam_W]

Does anyone do, or know anyone who does short-daily hemo with a Fresenius (or any other non-NxStage) machine? I'm considering looking into the Fresenius home clinic here in Indianapolis, that way I can get on home hemo sooner and get my health more stabilized (three days a week in-centre just isn't doing it for me). My idea is that I could try Fresenius for a year or two, and if I don't like it, then I could switch to NxStage (The dialysis provider doesn't hold a gun to my head and force me to stay with them). The problem is that I would prefer to do short daily, rather than conventional home hemo. I don't see why it couldn't physically be done with a Fresenius machine, but is the number of treatments usually something the nephrologist decides, or does the patient usually have some say-so (in a "conventional" home hemo program)? Take care.

Adam

[Hawkeye]

Does anyone do, or know anyone who does short-daily hemo with a Fresenius (or any other non-NxStage) machine? I'm considering looking into the Fresenius home clinic here in Indianapolis, that way I can get on home hemo sooner and get my health more stabilized (three days a week in-centre just isn't doing it for me). My idea is that I could try Fresenius for a year or two, and if I don't like it, then I could switch to NxStage (The dialysis provider doesn't hold a gun to my head and force me to stay with them). The problem is that I would prefer to do short daily, rather than conventional home hemo. I don't see why it couldn't physically be done with a Fresenius machine, but is the number of treatments usually something the nephrologist decides, or does the patient usually have some say-so (in a "conventional" home hemo program)? Take care.

I may be able to help with this one.  I work as an equipment technician at a Fresenius clinic that has a home hemo program, and in my oppinion you would be better with a NxStage just from a start up standpoint.  Just to get the Fresenius training you have to go through a process where you home gets visited by a biomed person to determine if your home could have the necessary upgrades made to it for the home machine.  If your home passes then you have to get 1000's of dolloars worth of work done to support the plumbing and electrical requirements of the 2 machines needed for treatment.  Fresenius helps foot some of the bill, but not all of it.  Anything left beyond what they pay is out of your pocket.  The 2 machines you would then have in your house are very bulky and not very easy to move around even though they are on wheels.  The Dialysis machine itself is exactly the same size as a 2008K machine with the exception of the fact that it is about 4 inches shorter.  Then you have another cart thats about 5ft by 3 ft that houses the R.O. unit, 2 carbon tanks, and various pre and post R.O. filters.  In my opinion it is just to big, bulky and not a very user friendly setup.  From everything I have heard about the NxStage system good and bad you are better off with it.

[Zach]

But are NxStage dialysis filters as good as Fresenius?
What is the clearance of Vitamin B12 molecules on NxStage filters?  Is the membrane bio-compatable as is the Fresenius filters?

Is Lactate as good as Bicarbonate?

NxStage's web site provides no information on this.  Why do you suppose that is?

[Hawkeye]

But are NxStage dialysis filters as good as Fresenius?  Is Lactate as good as Bicarbonate?

That I can't completely answer because I don't know.  I do know that Fresenius dializers are some of the best in the world and that a lot of our competition even uses them.  I'm just going from a machine and start up standpoint.  Plus the NxStage offers the freedom of travel that could never be seen with the Fresenius machine.  I have my doubts now that DUH-vita has bought into NxStage as much as they have, but so far from everything I have read here and elsewhere it seems like a better system.

[del]

Hi

We do nocturnal on a fresenius machine.  Very little cost to get set up at home.  We had to put in one plug in on its own breaker and a drain and hot and cold water line to the bedroom.  We used the same setup that you use for water hookup and drain for a washer.  It is just a plastic thing that goes in the wall.  Hubby did the work himself. Cost us less than $40.

[Hawkeye]

We do nocturnal on a fresenius machine.  Very little cost to get set up at home.  We had to put in one plug in on its own breaker and a drain and hot and cold water line to the bedroom.  We used the same setup that you use for water hookup and drain for a washer.  It is just a plastic thing that goes in the wall.  Hubby did the work himself. Cost us less than $40.

If you have the ability to do the setup yourself that is great.  Most people don't and hiring a professional is not cheap.  The parts cost next to nothing, it's the labor that kills you.

[jellybean]

I'm looking into Home Hemo same as Adam. I'm wondering the same things as he is. But in addition I wanted to know what exactly they have to do to ur home. For both set ups. I don't know where in Florida I would get NxStage though. It sounds great though and thats what my partner and I want for home. But we don't know where to get it. any help there?

[Adam_W]

I'm looking into Home Hemo same as Adam. I'm wondering the same things as he is. But in addition I wanted to know what exactly they have to do to ur home. For both set ups. I don't know where in Florida I would get NxStage though. It sounds great though and thats what my partner and I want for home. But we don't know where to get it. any help there?

Hi, jellybean. Since I posted this, I have since started NxStage, and except for a few minor problems here and there with the machine, it has been the best thing that's happened to me since I started dialysis. There are some features that I like more about the Fresenius machines, but over all I'm glad I was able to get the NxStage after all. There isn't anything that needs to be done to your home to run NxStage. All you need is a water faucet or under-sink connection (if you use Pureflow), and a place to drain the waste, which can just be the sink, toilet or shower drain. It also takes up a lot less space than a Fresenius machine and RO unit, and it requires less supplies. As for getting the NxStage, I'm in Indiana, so I don't really know specifically about the NxStage in Florida. You can go to homedialysis.org and search for home hemo in Florida, and call and ask those centres if they offer the NxStage. I hope you are able to do home hemo. It is so much better than in-centre.

Adam

[jellybean]

  i'm glad ur doing well!!!

[Hawkeye]

I'm looking into Home Hemo same as Adam. I'm wondering the same things as he is. But in addition I wanted to know what exactly they have to do to ur home. For both set ups. I don't know where in Florida I would get NxStage though. It sounds great though and thats what my partner and I want for home. But we don't know where to get it. any help there?

Like Adam I cant speak about the availability of NxStage in Florida, but his lead should point you in the right direction for finding out more.  Also like he said the home requirements to use a NxStage machine is basically an outlet and a drain.  If you look at my first post from this thread you can see basically what a 2008K fresenius machine will require.  You have to have special plumbing w/backflow preventer and temperature blending valve installed, and preferably 2 GFI outlets installed on separate and isolated circuit breakers.

[ktpuppers]

Although I wi not be doing daily hemo, I have prepared my home for a Fresenius system, I actually had to construct a room in my basement because of our 2 dogs and 2 cats (don't need a dog asking for pets while putting in a needle).  In all, I spent about $1000 ($300 for the 15" HDTV).  We moved the Aquaboss RO and 2008K machines in last week and will have our first treatment at home be Dec. 14.  If not for the room construction, we probably could have done everything for $100-$150.  A big help for me was that I have already received self-care training so the training period for home hemo was able to be abbreviated.  I will try to post some pictures later this week.

[kruep]

Let me chime in here,
As a former Duh-Vita home hemo nurse (I helped write their P&P manuals and trainer manuals and easy guides and such), you can do daily dialysis on Fresenius.  In fact until they bought stock in NxStage we were told to push Fresenius.  Now they want everyone on NxStage.  The dialyzer on the NxStage is equiv. to a F-80.  If you normally do 12hrs a week in center you can do 2 hours a day 6 days a week on Fresenius.  It will take you longer to train on the Fresenius.  It takes longer for set up and break down and the cleaning time becomes a pain, then there are the pesky water leaks that can happen.
With DaVita they will (should) send a nurse and a bio-med to your home prior to your start to see if the home is suitable (aka..not a third floor appartment with a floor about to fall in).  DaVita does cover most or all of the expenses of home modifications.  If you have a private insurance some of them will pick up the cost because it is associated with medical care.  For Fresenius you will have to have a water hook up like for a water hose, and a blending valve, possible water softner, drain, and a hospital grade outlet.
Your training on Fresenius will go faster if you train 5 days a week and not the normal 3.  Even when I had patients that were going to do 3 days a week we trained 5 days a week just to get the repition (did I spell that right?) that made training go faster.
Hope this helps...
Feel free to leave questions for me I'll tell you all that I know, and if I don't know it I will find it for you.  Did I mention I was doing the training classes on this for DaVita for the staff all over the country.  I feel like this stuff has been tatooed on my brain.
kruep (Kristi)

[BigSky]

But are NxStage dialysis filters as good as Fresenius?
What is the clearance of Vitamin B12 molecules on NxStage filters?  Is the membrane bio-compatable as is the Fresenius filters?

Is Lactate as good as Bicarbonate?

NxStage's web site provides no information on this.  Why do you suppose that is?

Just to bump this up.

Has anyone heard anything to the questions Zach posed?   I emailed them several months ago and all I got was double talk out of them.  Does anyone know the stats on their filters and the lactate to bicarbonate question?

[Zach]

The dialyzer on the NxStage is equiv. to a F-80.

If this is so, where are the NxStage [edited] filter clearance stats on the site.

Transparency builds confidence.
 

[kruep]

Zach,
What info I was able to get came from one of the NxStage nurses that did our training in the clinic.  You should be able to contact NxStage and ask to speak to one of their clinical people and they should be able to get you info.  I'll look and see if I have anything on paper or disc at home.
kruep

[Hawkeye]

The dialyzer on the NxStage is equiv. to a F-80.

If this is so, where are the filter clearance stats on the site.

Not sure.  Fresenius clinics haven't used F-80 dials for many years now and I can't seem to find that info.  We use F160NR, F180NR and F200NR dials.