I have PKD and recent testing shows I have approximately 19% of my renal capacity remaining. In planning for the future, I am wondering about the setup for a Home Nocturnal Hemodialysis machine. Is "hard" plumbing required, or just a hose running to a bathroom sink? Are there any websites which show the equipment and the suggested setup?

Hi:
Some hard plumbing is required from a connecting bathroom. A filter is set up for water being directed to the machine, including for the high-temperature clean-up at the end. I had a partial ensuite (toilet and sink) and the connection was not an invonvenience at all.

Best,
Mike

I set aside a room for home dialysis. I installed what amounted to a washer/dryer hook-up. Hot and cold water spigots and a drain. Currently the hot water is never used but I thought it was a good idea to install a hot water source while the walls were open because you never know what will be needed in the future.
I also installed a deep basin sink which has come in very handy.

I'm looking into home hemo. I have an idividual well and septic. I was told I will need to install (my expense) DI tank(s). There will be an additional monthly fee involved, also my expense. I realize the fee is relative to the mineral content of my water, btw am wondering approx. how much it will cost me. People from the unit couldn't tell me because their other clients are on city water and sewer. Thanks, Ruth

Can anyone tell me from city water/sewer how much of an increase they experienced in their bill? Did it increase alot or not?
Thanks

In Geelong Australia, hospital engineering set up the system for me at no cost. Outside, beside the bedroom is the filtration system. It gets water from cold input feed for our hot water system. I have connectors in the bedroom for the filtered water and for waste. The waste goes into the storm water although I understand it should be sewer. I have directed the backflush of the filter system onto the grass.
Since starting home dialysis, our water bill has doubled. I can't say, yet, how much it's gone up again for nocturnal.
I have yet to make enquiries about a rebate from the water authority. Not confident.

I am now very comfortable with nocturnal.

Any ideas how much water is used in an 8hr cycle of the nocturnal home unit?

Dennis,

The answer to your question will depend on the type of water purification system used (Reverse Osmosis or Deionization) and the dialysate flow rate that the treatment is run at.

A typical RO machine will use aproximately 1 gallon per minute which is 480 gallons per 8 hours. Most of this water goes straight down the drain.

If a DI system is used, the only water used is what the dialysis machine itself uses. At a dialysate flow rate of 500 ml/min, the water used would be 63.4 gallons.

Each type of system has its pro's and con's..

RO Machine:
Pro
1. Low on-going cost - The membrane will last a number of years before needing to be replaced.

2. Relatively inexpensive to purchase.

3. High quality water without the need of post-treatment polishing.

Con
1. High water usage.

DI System:
Pro
1. No cash outlay, the system is rented.

2. Low water usage.

Con
1. Requires expensive post-system filtration to guard against bacteria an endotoxin.

2. High on-going cost. The system must be replaced at least every 3 months or when water quality degrades, which ever comes first.

I am glad to see a great discussion on this plumbing/water topic. Can you give us an idea as to the cost of the "expensive post-system filtration to guard against bacteria an endotoxin"? What one person may deem expensive, when compared to the cost of some city water systems, may not seem to expensive.

It has been a few years since I have priced them because we stopped using DI systems. At the time we were using them, the "ultrafilters" were around $75 each. We had out patients backflush them prior to each run and they were replaced monthly.

If I remember correctly, each DI system exchange was around $450.

I hope this helps!

Alan in Oz:

Getting off topic for a second, wonder if this is the same gentleman I corresponded with a while back. It was the first time I�d heard of Geelong.

Cheers,
Mike

FMC is requiring me to have installed at my expense DI tanks, and I will also have to pay the upkeep, in addition to what my insurance company is already paying. Do other patients (different companies) have to also pay extra or is it just FMC? If everyone has to pay extra I can certainly understand why home hemo patients are few and far between. FMC offers it as a choice, but only if you can afford the additional expense!

Our center is non-profit in our slow nocturnal program no one has to pay for the DI tanks or RO systems which ever they use depending on their water. For the RO patients our carbon filters replaced monthly are also paid for by the unit. Also our 5 micron filters are furnished by the unit they allow 1 a week. If your water requires the 5 micron filter to be changed more often you then need to buy our own. We buy them by the case at about $3.50 each.

See if you can get a NXstage machine.
From the user standpoint, it is easy to use and set up.Minimal water concerns

Lin,
First off, if you have a well, you will need to find out if it can handle the water output you will need for 4 hours. Then your septic tank should be able to handle it but I would have it drained before you start. Third, I would look around your area for other dialysis companies that will offer Home Hemo. . . . . The 3 companies I have worked for have always paid for the plumbing and ectrical work that is needed for Home Hemo and we have always supplied the water treatment systems and machines.

Good luck.

This message has been edited. Last edited by: Michael Williams,