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Stephanie M Toth-Manikowski, Surekha Mullangi, Seungyoung Hwang, Tariq Shafi
BACKGROUND: Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. CASE PRESENTATION: From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen...
July 5, 2017: BMC Nephrology
Chiara Ralli, Patrizio Imperiali, Ennio Duranti
The home extracorporeal hemodialysis, which aroused a great interest in the past, has not kept its promises due to the complexity and expectations for family involvement in treatment management. In the United States NxStage One portable system was proposed and designed for home use. In this work we describe, starting from the history of home hemodialysis, the method with NxStage system by comparing it with the conventional HD in 5 patients. The dialysis efficiency was similar between the two treatments, even if home hemodialysis showed a reduction in serum urea, creatinine and phosphorus...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Yasmin Brahmbhatt, Arinze Ikeme, Navjyot Bhogal, Vincenzo Berghella
Pregnancy in the setting of the uremic milieu of renal disease has a lower success rate than in the normal population and is a rare event. While intensified renal replacement therapy (RRT) during pregnancy can lead to improved outcomes, most studies have focused on nocturnal hemodialysis as the main RRT in pregnancy. Although thousands of patients use the home NxStage System One short daily hemodialysis (SDHD) machine in the United States, pregnancy outcomes with this therapy are unknown. The NxStage System One uses low-volume dialysate and hence small and middle molecule clearance may differ compared to conventional therapies and affect pregnancy outcomes...
2016: Case Reports in Nephrology
Steven M Brunelli, Steven M Wilson, Linda H Ficociello, Claudy Mullon, Jose A Diaz-Buxo
The prevalence of home hemodialysis (HHD) in the United States is growing, driven in part by improvements in dialysis machines for home use. We assessed clinical parameters and outcomes in HHD patients using either Fresenius 2008K@home or NxStage System One over 1 year. Patients were 18 years or older and received HHD for ≥30 days between January 1, 2009, and June 30, 2010. A propensity score match was used to control for differences in baseline characteristics, and 2008K@home patients were stratified by frequency of use...
March 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Mohamed Sekkarie, Michelle Waldron, Texas Reynolds
Thrombocytopenia in hemodialysis patients has recently been reported to be commonly caused by electron-beam sterilization of dialysis filters. We report the occurrence of thrombocytopenia in the first two patients of a newly established home hemodialysis program. The 2 patients switched from conventional hemodialysis using polysulfone electron-beam sterilized dialyzers to a NxStage system, which uses gamma sterilized polyehersulfone dialyzers incorporated into a drop-in cartridge. The thrombocytopenia resolved after return to conventional dialysis in both patients and recurred upon rechallenge in the patient who opted to retry NxStage...
January 2016: Clinical Nephrology
(no author information available yet)
No abstract text is available yet for this article.
August 2015: Nephrology News & Issues
Vittorio Scaravilli, Stefan Kreyer, Katharina Linden, Slava Belenkiy, Antonio Pesenti, Alberto Zanella, Leopoldo C Cancio, Andriy I Batchinsky
Acidification of blood entering a membrane lung (ML) with lactic acid enhances CO2 removal (VCO2ML). We compared the effects of infusion of acetic, citric, and lactic acids on VCO2ML. Three sheep were connected to a custom-made circuit, consisting of a Hemolung device (Alung Technologies, Pittsburgh, PA), a hemofilter (NxStage, NxStage Medical, Lawrence, MA), and a peristaltic pump recirculating ultrafiltrate before the ML. Blood flow was set at 250 ml/min, gas flow (GF) at 10 L/min, and recirculating ultrafiltrate flow at 100 ml/min...
September 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Christopher T Chan, Guo Hua Li, Alan Valaperti, Peter Liu
Cardiac injury triggers cellular responses involving both cardiomyocytes and nonmuscle cells to process cardiac structural remodeling. End-stage renal disease (ESRD), despite conventional dialysis, is associated with adverse cardiac remodeling and increased cardiovascular events. Intensification of hemodialysis with nocturnal home hemodialysis (NHD; five sessions per week; 6-8 hours per treatment) was associated with regression of left ventricular hypertrophy and downregulation of genes in apoptosis and fibrosis...
September 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Martina Ferraresi, Anna Pia, Gabriella Guzzo, Federica Neve Vigotti, Elena Mongilardi, Marta Nazha, Emiliano Aroasio, Cinzia Gonella, Paolo Avagnina, Giorgina Barbara Piccoli
Severe hyperparathyroidism is a challenge on hemodialysis. The definition of dialysate calcium (Ca) is a pending issue with renewed importance in cases of individualized dialysis schedules and of portable home dialysis machines with low-flow dialysate. Direct measurement of calcium mass transfer is complex and is imprecisely reflected by differences in start-to-end of dialysis Ca levels. The study was performed in a dialysis unit dedicated to home hemodialysis and to critical patients with wide use of daily and tailored schedules...
October 2015: Hemodialysis International
Leslie A Spry, John M Burkart, Christina Holcroft, Leigh Mortier, Joel D Glickman
Vascular access infections are of concern to hemodialysis patients and nurses. Best demonstrated practices (BDPs) have not been developed for home hemodialysis (HHD) access use, but there have been generally accepted practices (GAPs) endorsed by dialysis professionals. We developed a survey to gather information about training provided and actual practices of HHD patients using the NxStage System One HHD machine. We used GAP to assess training used by nurses to teach HHD access care and then assess actual practice (adherence) by HHD patients...
April 2015: Hemodialysis International
Eric D Weinhandl, Kimberly M Nieman, David T Gilbertson, Allan J Collins
BACKGROUND: Cardiovascular disease is a common cause of hospitalization in dialysis patients. Daily hemodialysis improves some parameters of cardiovascular function, but whether it associates with lower hospitalization risk is unclear. STUDY DESIGN: Observational cohort study using US Renal Data System data. SETTING & PARTICIPANTS: Medicare-enrolled daily (5 or 6 sessions weekly) home hemodialysis (HHD) patients initiating NxStage System One use from January 1, 2006, through December 31, 2009, and contemporary thrice-weekly in-center hemodialysis patients, matched 5 to 1...
January 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Vittorio Scaravilli, Stefan Kreyer, Katharina Linden, Slava Belenkiy, Bryan Jordan, Antonio Pesenti, Alberto Zanella, Kevin Chung, Jeremy Cannon, Leopoldo C Cancio, Andriy I Batchinsky
The combination of extracorporeal carbon dioxide removal (ECCO2R) and hemofiltration is a possible therapeutic strategy for patients needing both lung and renal support. We tested the effects of the recirculation of ultrafiltrate on membrane lung (ML) CO2 removal (VCO2ML). Three conscious, spontaneously breathing sheep were connected to a commercially produced ECCO2R device (Hemolung; Alung Technologies, Pittsburgh, PA) with a blood flow of 250 ml/min and a gas flow of 10 L/min. A hemofilter (NxStage, NxStage Medical, Lawrence, MA) was interposed in series after the ML...
May 2014: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Seyed Amirhossein Razavi, Mary D Still, Sharon J White, Timothy G Buchman, Michael J Connor
BACKGROUND: Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit (ICU) bedside nurse delivery model for CRRT while comparing circuit patency and circuit exchange rates in 2 Food and Drug Administration-approved CRRT devices. This article presents the data comparing circuit exchange rates for 2 different CRRT machines...
April 2014: Journal of Critical Care
Joshua Zaritsky, Anjay Rastogi, George Fischmann, Jieshi Yan, Kenneth Kleinman, Georgina Chow, Barbara Gales, Isidro B Salusky, Katherine Wesseling-Perry
BACKGROUND: The utilization of short-term daily hemodialysis has increased over the last few years, but little is known on its effects on the control of serum phosphate and fibroblast growth factor 23 (FGF23) levels. METHODS: We therefore performed a cross-sectional study to compare FGF23 levels as well as other biochemical variables between 24 patients undergoing short daily hemodialysis using the NxStage System® and 54 patients treated with conventional in-center hemodialysis...
February 2014: Nephrology, Dialysis, Transplantation
Kelly D Heegard, Molly A Tilley, Ian J Stewart, Harcourt P Edgecombe, Jonathan B Lundy, Evan M Renz, Kevin K Chung
Adverse reactions during hemodialysis are extremely common and include a wide range of clinical presentations from mild to life threatening. We present a case of a 34 year old woman in the Burn Intensive Care Unit, who developed acute kidney injury requiring renal replacement therapy. She was placed on continuous veno-venous hemofiltration with the NxStage machine which uses a synthetic PUREMA polyethersulfone filter sterilized by gamma radiation. Within two minutes of initiating hemofiltration, the patient complained of pruritus as well as dyspnea and became flushed and agitated...
May 17, 2013: International Journal of Artificial Organs
Susumu Takahashi
To improve the quality of life (QOL) of patients with renal failure who are on dialysis, we have been working to promote home hemodialysis (HHD), but it has not come into widespread use at present because of various problems, including limitations of the equipment, the large proportion of elderly patients, and difficulty performing self-care. With regard to problems with the equipment, dialysis equipment for home use has not yet been approved in Japan, so equipment designed for medical facilities has to be used for home dialysis...
2012: Contributions to Nephrology
Denny Treu
Denny Treu of NxStage Medical, Inc., who has led the development of six dialysis systems with various companies, reports here on a home hemodialysis system that his company successfully designed specifically for home use.
2010: Biomedical Instrumentation & Technology
Andrew Connor, Robert Lillywhite, Matthew W Cooke
Climate change presents a global health threat. However, the provision of healthcare, including dialysis, is associated with greenhouse gas emissions. The aim of this study was to determine the carbon footprints of the differing modalities and treatment regimes used to deliver maintenance hemodialysis (HD), in order to inform carbon reduction strategies at the level of both individual treatments and HD programs. This was a component analysis study adhering to PAS2050. Emissions factors were applied to data that were collected for building energy use, travel and procurement...
January 2011: Hemodialysis International
Orly F Kohn, Fredric L Coe, Todd S Ing
"NxStage System One()" is increasingly used for daily home hemodialysis. The ultrapure dialysate volumes are typically between 15 L and 30 L per dialysis, substantially smaller than the volumes used in conventional dialysis. In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights and volumes of distribution was evaluated. Serum measurements before and after dialysis and total dialysate collection were performed over 30 times in 5 functionally anephric patients undergoing short-daily home hemodialysis (6 d/wk) over the course of 8 to 16 months...
January 2010: Hemodialysis International
Deborah L Zimmerman
Patients treated for end-stage renal disease (ESRD) have a poorer quality of life and a higher mortality rate than patients in the general population. In addition, the cost to provide ESRD care is tremendous. Daily hemodialysis programs have been associated with improvements in the patient's quality of life, anemia management, blood pressure, nutrition, and left ventricular hypertrophy. In addition, especially when treated at home, cost savings are possible. Daily hemofiltration may offer additional benefits with enhanced middle-molecule clearance, improved cardiovascular stability, and perhaps a further reduction in cost...
April 1, 2004: Hemodialysis International
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