Is anyone familiar with the AKSYS heomdialysis machine intended for home dialysis use? Most patients dialyze 5 days a week on it for 2 hours a treatment. Any information would be appreciated. Thanks.

Would be happy to help you. What info are you looking for?

I have been using the PHD since August 2002, I like the system. I self-dialyze 6 days a week for three hours at a time. I'm not on the transplant list so I expect to be on hemodialysis for the duration - for my situation I think the PHD is a great choice. I hope more frequent dialysis will help with the long-term consequences of dialysis and I think the PHD has some important features that can minimize the body's inflammation response to dialysis.

What aspect of the PHD do you have questions about? http://www.homedialysis.org has some great information as well as an active bulliten board.

Thanks for the information. I understand that the dialysate is only tested every 6 months. This seems to be a long time span, considering the ultrapure quality which must be maintained for patient safety. I am curious about your thoughts regarding this.

Dialysate is checked monthly just like all machines as regular dialysate. The 6 months test is to verify that it continues to be ultra pure dialysate. Not all labs are able to test to ultra pure standards.

The dialysate is suppose to be ultrapure quality all the time. When they check the dialysate once a month, shouldn't they be checking for ultrapure standard? The ultrapure standard for the dialysate for this machine is critical for patient safety. Checking every 6 months just doesn't wash. If I used thid machine I would want to check the ultrapure quality of the dialysate every week.

I'm not sure where the break down here is (I'm sure it is me) and not really sure how to get it across but here goes. You have to understand how the machine works. The dialysate is not "hand" mixed outside of the machine and then attached to a line to be drawn up into the machine. It is mixed within the machine in a tank, sort of like a batch system. This machine does not pull in water all the time like most in center machines. There are 2 ultra filters in place that the dialysate must go through before it gets to the patient. So the dialysate is always ultra pure. The lab test cost more than a regular dialysate culture so it would be very expensive to test it every week. Of course it could be done if someone wanted to do it. I hope that I may have cleared myself up some here. Sorry for the confusion.

Thanks for your response. I guess if it has FDA approval for a medical device all is "kosher" as they say. I just thought that the ultrapure standard would need constant monitoring, but I guess 6 months is approved and satisfactory.

jd,

I tend to agree with you. If the ultrapure water is intended to be used in place of saline (thats what it sounds like in the literature) I personally would want assurances more frequently than every 6 months. Now if it is strictly for ultrapure dialysate it's probably not near as critical.

Chuck

What is the testing standard for centers that provide "ultra pure" dialysate incenter?

The dialysate on the AKSYS machine is the source of fluid replacement during the treatment. From what I understand their are no saline bags for this system. When the patient requires fluid, the ultrfiltrate pump reverses itself, and moves the appropriate amount of fluid into the blood compartment. This machine "manufactures" its own saline. I imagine pharmaceutical standards of care would be the standard required for this application. I would think that checking for this standard would have to be done more than twice a year.

Aksys recommends that the test be done every 6 months. Ultimately it is the responsibility of the dialysis center to determine the frequency of the testing.

The sample should meet a microbial limit of <0.1 CFU/ ml and <0.25 EU/ ml. There currently are no dialysis guidelines to test for injection quality of solutions used for infusion. There may be soon as more companies are becoming more interested in �ultra pure� dialysate. I am not sure if AMMI has put out a guideline yet.

Thanks for all your comments on this post.

Hope that it was helpful.
lb

They went out of business, so don't worry about it now.