page_title: Home hemodialysis
section_title: Equipment
hierarchical_section_title: Home hemodialysis / Equipment
caption_attribution_description: This photo shows a hemodialysis treatment in progress using a NxStage System One cycler. The treatment was done aboard a boat. This made possible because of the machine's use of bags of dialysate. This particular treatment used 25 litters of dialysate over the course of a 195 minute treatment.BillpSea 16:26, 27 September 2007 (UTC)
context_page_description: Home hemodialysis, is the provision of hemodialysis to purify the blood of a person whose kidneys are not working normally, in their own home.
  People on home hemodialysis are followed by a nephrologist who writes the dialysis prescription and they rely on the support of a dialysis unit for back-up treatments and case management. Studies show that HHD improves patients' sense of well-being; the more they know about and control their own treatment the better they are likely to do on dialysis.
context_section_description: Currently, three hemodialysis machines are used for home hemodialysis in the United States. They are made by B. Braun Melsungen, Fresenius and NxStage, a division of Fresenius Medical Care. The systems take different approaches to the process of dialysis. The B Braun is a standard hemodialysis machine is used incenter and at home. The Fresenius "Baby K" home machine is close to a standard hemodialysis machines, but somewhat more user friendly and smaller. Both the B Braun and the Fresenius Baby K requires a separate reverse osmosis water treatment system which allow dialysate flow rates generally from 300 to 800 ml/minute.
  The NxStage System One cycler uses far less dialysate per treatment with a maximum dialysate flow rate of 200 ml/minute but generally runs at rates less than 150 ml/minute. The NxStage System One can be used with bags of ultrapure dialysate - from 15 to 60 liters per treatment (see photo showing treatment in process). This allows the System One to be transportable; as of 2008 the company supports travel within the continental US and will assist travel to Alaska and Hawaii (travel to AK & HI will result in the patient having additional out of pocket costs). Generally, the supplies including the dialysate are delivered as they are scheduled to be used, either bimonthly or monthly but the amount of supplies can become a concern. The System One can also use a separate dialysate production device manufactured by NxStage - the PureFlow. The PureFlow uses a deionization process to create a 60, 50 or 40 liter batch of dialysate depending on the SAK (bag of dialysate concentrate) specified by the MD. A batch has a 96-hour shelf life and is usually used for two or three treatments, although some patients are using the entire 60, 50 or 40 liter batch for a single extended treatment.
caption: NxStage System One cycler, being used for hemodialysis with bags of dialysate.
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