What about AAMI water standards? I heard that Nextstage cannot assure this. Again, enlighten me!

Reviewed the Nxstage website. Very interesting! However I did a search for AAMI, R/O, carbon and couldn't find any specifications except that you couldn't use a well water source. There are no studies regarding kt/v. Most of the articles are abstracts and not really studies. But the technology is pretty new, April 2006. The pureflow looks efficient and user friendly, as does the set up of the nextstage machine. I didn't realize it was for daily short hemo treatments only. Learn something new every day. So I suppose unless you are willing to do dialysis every day, the BabyK is the better choice as well as for nocturnal too. The quality of the water concerns me, but I suppose if you have a filter from incoming water and UV, it must be safe from bacteria. However, with dialyzing daily I would think you would like to know the levels of certain minerals like aluminum, magnesium, etc because you are subjecting your blood to possible high or low levels of these substances almost daily. I would also have thought phophate removal would be better but after reading one of the articles patients still had to take the regular doses of binders. Only a decrease of BP meds was apparent, and that is a big plus. What type of dialyzer does a NxStage use, and what is its KOA?

I am interested in this thread even though my country does not have NxStage. Hope someone answers all questions soon.

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

The NxStage machine does pass AAMI standards for RO quality water. State agencies are now requiring the NxStage machine with the Pure Flow option be tested at the PAK(the water purification component of the system), and the SAK(which is the mixed dialysate in a large bag) every month. A cold water tap sample has to be collected as well for AAMI analysis. The Pure Flow system has no sample ports, but NxStage is distributing a guide that outlines the culture and LAL drawing techniques. We do for our patients, and let me tell you, it's a pain in the butt!

First off let me say that DI although it does produce good water quality suitable for dialysis, it does have some extreme draw backs. DI does not remove bacteria and endotoxins this is why they have a UV light and an Ultrafilter. However the UV light remove nothing all it is capable of doing is mutating the bacteria that either kills it or keeps it from reproducing. (A bacteria is a living organism and the endotoxin is the dead bacteria) the endotoxin is what is most harmful to the patient. So the UV light does nothing but produces the more harmful endotoxin. The Ultra filter is a sub micron filter thats pore size is small enough to block bacteria and endotoxins from passing "to an extent". I say to an extent because the Ultra filters can only handle up to about 5EU (endotoxin units). If you have a city water system that is already close to the 5EU plus the UV light creating more EU. Then the endotoxins level reaching the patient could be very harmful.

Also, DI does not last forever. All of the ions that are listed in the AAMI standard for dialysis water quality are removed by DI by ionic exchange. When it exhausts it releases harmful ions that combine to make acids.

I hope this helps everyone understand the process a little better and some of the hazards.

The original question may be a moot point. Has anyone tried to order a new k@home(baby k)? the FDA has put a hold on them until the software is approved for home use. The plot thickens! -2short

Interesting stuff on their site. Like this:

"No special plumbing or electrical modifications. Just a simple faucet or under-sink connection and standard electrical outlet helps avoid the often costly home modifications required by traditional systems."

...Does anyone know how they've gotten around the requirements for backflow prevention?

Acute programs and home dialysis are different animals all together. I am not too familiar with the Nexstage but all it takes is to have an airgap somewhere before any process begins to not need a BFP.

Acute and home programs are no different as far as backflow prevention is concerned. Don't believe me? Tell a local water purveyor that there's a home hemodialysis patient running in his/her district without a backflow preventer in between the equipment and his/her potable water supply and see what happens.

"Air gap" is an approved backflow assembly that provides a higher level of protection than an RPBA, which is what is required. I know of no piece of dialysis equipment where the requirements for a legal air gap have been satisfied, which is why I asked if NxStage had.

Is there still difficulty getting the Baby K's or has this been resolved? I have a new pt that is interested in Home Hemo. Also, is it true that NxStage uses only 1 K baths?