New dialysis technology designed to be more user-friendly for patients, staff

[okarol]

New dialysis technology designed to be more user-friendly for patients, staff
Dialysis technology currently in development shares a common theme: simplicity for users and connectivity for staff

MARK E. NEUMANN — JANUARY 6, 2016

Dialysis technology currently in development shares a common theme: simplicity for users and connectivity for staff.

Among the thousands of posters and multiple meeting rooms with interesting presentations at the American Society of Nephrology’s annual Kidney Week, there was something the industry has not seen in some time: an invigorated push for new dialysis machine technology.

The exhibit hall this year, as always, was a colossal cavern of companies, patient and professional nephrology organizations, data collecting and analysis groups (USRDS, DOPPS, PEER to offer a few acronyms), publishers—everything you need to know about nephrology.

What was intriguing this year was the machine technology on display shared one theme: simplicity for users and connectivity for staff.

Outset Medical debuted the Tablo. It has been some time since the U.S. market has seen a new dialysis machine built from scratch for in-center use, and the company’s unique exhibit at Kidney Week—the machine was housed in a larger-than-life wooden shipping crate—drew lots of attention. The company says the Tablo “is a system designed for simplicity.” Company CEO Leslie Trigg has told NN&I that the machine should be ready for sale this spring, and it hopes to see its best work initially in dialysis clinics with self-care programs before looking at a home dialysis application.

NxStage Medical offered attendees a glimpse into their future, with a detailed slide show and discussion at a nearby hotel on their plans for a new, bagless cycler for peritoneal dialysis, along with plans to improve on its groundbreaking System One home hemodialysis machine. CEO Jeffrey Burbank has called the new products “truly game-changing.” The new home hemodialysis system should be out in the fourth quarter and will produce on-demand carbonate buffered dialysate from tap water, at “significantly higher flow rates than offered today,” Burbank said during an investor call last fall. “The new PD cycler under development eliminates the need for bags of fluid. We are planning to reinvent peritoneal dialysis the same way we reinvented hemodialysis.” The system is expected to be ready in 2017.

Baxter Health Care was taking orders on its new Amia PD cycler. Like other dialysis machines manufacturers, Baxter wanted the Amia to be simpler to use, lightweight, and offer technology that connected patient and caregiver. Its new ShareSource system is like a GPS that helps staff monitor patients while on the cycler.

“A doctor and nurse can come into the clinic in the morning and see what happened to their patients overnight—how much fluid was taken off, did they do a treatment or not do a treatment, did any alarms go off. We can gather all that information now with ShareSource,” said Bruce Culleton, MD, vice president and renal therapeutic lead at Baxter. He said it was “a natural progression” for companies to make dialysis machines simpler; that can lead to attracting more patients to PD and also increase technique survival. “The goal here is to make patients feel more comfortable and more confident with this therapy,” said Culleton. By removing steps, we not only make it easier but we also remove opportunities for patient error.”

Baxter’s new home hemodialysis machine, VIVIA, is now undergoing U.S. trials. The system is designed to be patient friendly and will also use the ShareSource connectivity system; a touch screen and user interface displays large, easy-to-comprehend graphics and animations that help guide patients through setup, treatment and cleanup, the company said. The hemodialysis machine was approved for sale in Europe in 2013.

Fresenius Medical Care, which has talked in general terms about using the sorbent technology it bought years ago to develop a new home hemodialysis machine, is now working with Swiss engineering firm Debiotech SA to develop a portfolio of state-of-the-art peritoneal dialysis technologies to replace FMC’s aging Liberty cycler. The new product platform will offer dialysis machines that are lightweight and compact, making it more practical to dialyze at home.

“We are dedicated to continuing to produce home dialysis machines that are as easy and convenient as possible for our customers to operate, because this is what they demand and deserve,” said Mark Costanzo, President, Fresenius Medical Care Renal Therapies Group. The Fresenius Medical Care and Debiotech partnership is exclusive globally, with the exception of Japan, the companies said.

Costanzo said Fresenius liked what Debiotech CEO Frédéric Neftel showed them a few years ago in a new prototype for a PD cycler. Neftel had never designed a dialysis machine before. “What led me to the company is the simplicity of their technology. We saw it in its earlier stages and like it,” said Costanzo, who worked with FMC Home Therapies Director Rob Kossman, MD, and the late FMC PD expert Jose Diaz-Buzo, MD on designing the machine. Costanzo said the machine is about 75-80% complete but will take around two years to go through the FDA approval process. The final version should weigh around 10 pounds and be the size of a laptop, making it easy for travel, said Costanzo.

Fresenius is investing the money into the new PD cycler because the company sees the home dialysis market expanding, particularly among its own 2,300 dialysis clinics. “We are getting more requests to start patients on both forms of home dialysis—PD and home hemodialysis,” said Costanzo. “Increasing treatment options education is making a difference.”

You can get a view of the new Fresenius cycler while in development, called Dialease, at http://www.debiotech.com.

Conclusion

With this new focus on technology and on patient-caregiver connectivity, it may finally be time for nephrologists—perhaps fearful in the past that patients were incapable of handling the rigors of the home dialysis experience—to read these new “easy-to-use” instructions.

http://www.nephrologynews.com/new-dialysis-technology-designed-to-be-more-user-friendly-for-patients-staff/

[kickingandscreaming]

Here's hoping they all succeed and get approval.

[Vt Big Rig]

I agree.... hoping for the success so there are more alternatives.

But I wish someone was working on an access safer than a perma-cath and less painful than needles every day.

I have not seen much on that .......

[kickingandscreaming]

But I wish someone was working on an access safer than a perma-cath and less painful than needles every day.

That's what I am waiting for.  This whole needle business is a real turn off (hence my eventual choice of PD once I can get trained).  I would happily (well, maybe not happily) choose home hemo if it didn't involve needles.  My dialysis center does NOT use buttonholes, and I keep waiting to see someone balk or say "ouch" or some sign of life when they are poked every other day with knitting needle sized needles. Maybe everyone has become totally passive and resigned, but not a peep out of anyone.  Blows my mind every time I'm there.  I have a chest cath for the interim and that, fortunately, is painless.

[Vt Big Rig]

I keep waiting to see someone balk or say "ouch" or some sign of life when they are poked every other day with knitting needle sized needles. Maybe everyone has become totally passive and resigned, but not a peep out of anyone. 

We do not use buttonholes and my blessed bride cannulates me each treatment. I show a sign a life but try my best to not "ouch" so to not make her apprehensive.

 Maybe it is resignation, maybe it is getting used to it. But the days it seems she needs a hammer to get through the developing scar tissues is definitely an event.

[Simon Dog]

My dialysis center does NOT use buttonholes, and I keep waiting to see someone balk or say "ouch" or some sign of life when they are poked every other day with knitting needle sized needles.

Does your center offer home hemo?    Even centers that offer home hemo typically use sharps in the clinic and buttonholes for home users.   Clinic patients using buttonholes are highly atypical, unless they were previously home patients.

I have seen a patient cry when the needles go in, but that is the exception.   If you use Emla cream, it's painless.    Buttonholes are pretty much painless even without the cream.

If you find yourself in need of a home hemo program with buttonholes, there is an excellent one two towns west of you.

[kickingandscreaming]

Does your center offer home hemo?    Even centers that offer home hemo typically use sharps in the clinic and buttonholes for home users.   Clinic patients using buttonholes are highly atypical, unless they were previously home patients.

I have seen a patient cry when the needles go in, but that is the exception.   If you use Emla cream, it's painless.    Buttonholes are pretty much painless even without the cream.

If you find yourself in need of a home hemo program with buttonholes, there is an excellent one two towns west of you.

My clinic does offer home hemo, but I have little information about it.  But when I brought up the subject of buttonholes with my PD nurse, she said they don't use them.

Is it REALLY true that Emla cream makes canulation painless?  Why doesn't everyone use it? I asked my Hemo nurse today why more people don't squawk in pain and she said that quite a few use some (unnamed) cream an hour before coming.  But she also said that it really doesn't work.  I have no idea from zero experience.








Edited: Fixed quote tag error- kitkatz-Admin

[cassandra]

Emla cream, and Xylocain spray are both local anesthetics that work. At some point I used both cream and spray for a 'luxury' day when not feeling much at all.
So they both numb, you'll still feel it, but less

Why not everybody? After all these years I still don't know.

Love, Cas

[kitkatz]

After awhile i think the patient gets used to being stuck with the needles.  I did use EMLA cream for awhile while my arm healed form surgery and was tender.  Then it was just easier to go cold turkey.

[Simon Dog]

My clinic does offer home hemo, but I have little information about it.  But when I brought up the subject of buttonholes with my PD nurse, she said they don't use them.

Is it REALLY true that Emla cream makes canulation painless?  Why doesn't everyone use it? I asked my Hemo nurse today why more people don't squawk in pain and she said that quite a few use some (unnamed) cream an hour before coming.  But she also said that it really doesn't work.  I have no idea from zero experience.

Emla cream helps considerably.  Keep in mind that blood donation drives use a needle at least the size of a dialysis needle and people still show up.

If you  really want buttonholes, consider transferring to the clinic in Framingham.  The MD and RN at that clinic are excellent.