Home Dialysis News

NxStage Medical Inc.’s next generation System One hemodialysis system has received the CE mark in Europe. The system consists of new features and capabilities, including a new touchscreen user interface and integrated blood pressure monitor designed to enhance ease of use for patients performing home hemodialysis.

Dialysis product manufacturer NxStage Medical Inc. has named Allan Collins, MD, FACP chief medical officer.

Home dialysis therapies—both peritoneal dialysis (PD) and home hemodialysis (HHD)—are important treatment options for patients with stage 5 chronic kidney disease. These modalities generally offer meaningful clinical advantages and significant quality of life benefits. These home therapies, however, specifically PD, have traditionally not been utilized to their expected potential.

Baxter International Inc. presented data at the American Society of Nephrology’s 2016 Kidney Week that indicates its Sharesource telehealth platform is helping physicians recognize adverse issues early, enabling faster treatment (Abstract #PO023), and the Amia automated peritoneal dialysis system, is helping a clinic reduce training times by more than one day, per patient (Abstract #PO1047).

Updated products introduced to the renal community in 2016 that will be on display during Kidney Week.

Baxter International Inc. has started a Phase 3 clinical trial evaluating an investigational drug that combines a citrate anticoagulant and renal replacement solution to determine if it lengthens the extracorporeal circuit life in acute kidney injury patients treated with continuous renal replacement therapy (CRRT). Currently, there is no citrate anticoagulant approved for use in CRRT in the United States.

Modalities of renal replacement therapy are categorized into in-center hemodialysis and home therapies. A subset of hemodialysis patients referred to as in-center self-care hemodialysis (ICSCHD) receive patient training as if they were going home but instead perform their dialysis in-center with minimal staff support. Preliminary data suggests ICSCHD is associated with better outcomes than traditional in-center hemodialysis. We looked at ICSCHD patients initiating maintenance dialysis from April 1, 2011 to March 30, 2014 and compared them at a 1:2 ratio to propensity-score matched controls from surrounding facilities within the same catchment area. The median follow-up was 14 months. Patients on ICSCHD had lower mortality rate (0.02 vs 0.07 per patient year; p <0.05), fewer hospitalization events (0.82 vs. 1.70 per patient year; p = 0.008) and fewer missed treatments (1.1% vs 3.8% of all treatments; p = 0.005) than matched controls. We concluded that patients on ICSCHD had lower mortality rates and fewer hospital days than well-matched controls and spent more time on dialysis and missed fewer treatments. Establishing a facility-wide culture of care promoting patient engagement in ICSCHD may have contributed to these findings.

Satellite Healthcare has signed a three-year agreement with NxStage Medical Inc. that includes NxStage's Nx2me Connected Health platform for their patients performing home hemodialysis with the NxStage System One.

Conventional in-center hemodialysis is the modality used by approximately 90% of patients receiving dialysis in the U.S.1  For patients and providers, there are clear disadvantages to conventional in-center HD therapy. The current alternative is to use a home-based self-care modality, either home hemodialysis or peritoneal dialysis. These home-based self-care modalities have been shown to have a number of advantages, but are not widely adopted for a variety of reasons.2 Another option would be to offer in-center self-care HD, which could provide many of the advantages of home-based dialysis, and remove many of the barriers that prevent patients from choosing to do dialysis at home.

More frequent dialysis, typically performed five to six times per week at home, has been associated with a number of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous quality improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD). This initiative demonstrated that every other day (EOD) nocturnal HD is a feasible alternative option to daily HHD and should be considered to individualize home dialysis therapy.