Why is it that home hemo and nocturnal programs are not well advertized so patients can find them?

This is a good question. But I think the reason we don't here more about them is that there are so few. I would like to know why if patients are suppose to have the choice of home hemo the centers aren't mandated to provide the programs.

Another type of home dialysis is being promoted by a new, innovative company called Aksys. They have received FDA approval and are marketing the PHD (Personal Hemodialysis) System in the U.S. It has been designed for use in the home by the patient for short, daily dialysis. It is totally automated (takes 10-15 minutes to set up and 5 minutes to tear down), uses no chemicals, makes it's own saline and reprocesses the blood set and dialyzer on line. Thus, monthly supplies are very, very minimal. The best part is that papers show thatmore frequent dialysis is a better modality. It's the future of home hemo.

I've worked in the daily dialysis field for 4 years now. I hope I can clarify some things recently posted.

1. The reason daily programs are not advertised is because there are only a handful of them in the US. To date there are around 30 programs nationwide offering either in-center daily or home daily dialysis. This modality is not recognized by Medicare, so the facility offering this program must be willing to absorb the cost not covered by Medicare (around $150/week). If you are interested in finding a program, ask your nephrologist, social worker, or dietitian. They all have resources to track down the closest program.

2. Aksys machine. This machine has been in production for 4 years and recently received approval for short daily dialysis. Production and distribution of this machine is slated for this year. This machine is a revolutionary machine for perfoming dialysis, however it still requires intensive training and does have its drawbacks.
The machine is a self contained dialysis machine. It purifies the water and disinfects with little involvement from the patient. Additionally, blood lines need only be changed every few weeks, not each day. From reports, this machine is also portable!
The biggest drawback with this machine that I have heard (I have not had a chance to see and use the machine) is the length of time needed for disinfection. I believe the disinfection time is 15 hours. If there is a problem during this time, the machine will turn off and the disinfection needs to start from scratch. This could interfere with your dialysis for that day.
For more information on this product, visit the aksys website at www.aksys.com

FYI, there are other companies producing portable hemodialysis machines and machines geared towards daily dialysis.

Lots happening on this front. The best way to assure a daily program coming to a dialysis unit near you is by writing/calling/visiting your congressional representatives and making them aware of this modality. Each year a grassroots effort, led by Drs. Lockridge and Blagg, to get this modality recognized and covered by Medicare gets underway. Congressional leaders look towards their constituents. Let them know that this is a cause worth supporting.

Daily Dialysis Gal,
The Aksys is not portable, at least not any more portable then a regular machine. The Aksys can be disconected from the water source and/or drain during treatment because it makes all the dialysate it needs during that 17-18 hour period it needs between treatments to get ready. I would say that one of the current drawbacks is the 2 hour 50 minute maximum run length.

The maximum run length is an issue because it limits patient flexability. On a standard machine I could go to a four day/week longer run schedule, or run longer if I miss a treatment for any reason. The Aksys' short run length makes it harder to "make up" dialysis. This could change.

Next month I expect to start testing 8 hour over night treatments, every other day, on the Aksys. 8 hour treatnments will require the reuse of the dialysate, I will be doing a set of pre/post labs to compare the results to daily short treatments. I've been told that the company is working to reduce the machine's turnaround time to the point that nightly nocturnal home hemo could be done on the Aksys. If this was accomplished it would give patietns a full range of home hemo options.

One other note about training - if you are a home hemo patient (as I was) switching to the Aksys from a standard home hemo machine the training takes just a couple of weeks. If you were coming from incenter I think training on the Aksys would take no longer then training on a standard machine.

Hi:
I think we all agree that home dialysis is THE alternative for many patients. Remember that location, age, condition, support and other issues might interfere. This is a reasonable demand. Even they take time.

Best,
Mike

Does anyone know how much the Aksys or any of the other home HD machines cost?

Have you looked at http://www.nocturnaldialysis.org? It is a really helpful site

quote:

Originally posted by patient:

Why is it that home hemo and nocturnal programs are not well advertized so patients can find them?