Abstract: SA-PO921
European Experience of Nocturnal Home HD Using NxStage System One
Session Information
- Dialysis: Home Hemodialysis
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Hemodialysis
Authors
- Borman, Natalie L., Wessex Kidney centre, Portsmouth, United Kingdom
- Gangaram, Venkat, Wessex Kidney Centre, Waterlooville, Bath, United Kingdom
- Goffin, Eric, Cliniques universitaires St Luc, Brussels, Belgium
- Kubisiak, Kristine, NxStage, Medical, Minneapolis, Minnesota, United States
- Vilpakka, Mari K., Paijat-Hame Central Hospital, LAHTI, Finland
- Weinhandl, Eric D., NxStage Medical, Inc., Victoria, Minnesota, United States
Background
More frequent HD is associated with increased survival, improved physical health, and reduced LVH . Studies have shown benefits with long, slow dialysis, with reduction in blood pressure, improved solute removal, anaemia, and quality of life.
This study documents for the first time the outcome of a cohort treated with nocturnal home HD (NHHD) with low-volume dialysate in Europe.
Methods
A retrospective analysis of 20 patients at 4 European centres who received ≥12 months NHHD with the NxStage System One, a device that uses ≤60 L/session of lactate-buffered dialysate. Single-bolus low-molecular weight heparin was administered at the start of therapy. Fistulas were cannulated with double needle and button hole technique; needle strapping and moisture sensors were used. Data analysis included demographics, prescriptions, biochemical data, training and safety measures. Descriptive analysis was used to assess patient characteristics and prescriptions. Mean, standard deviation, and range of biochemical data at baseline, 6 and 12 months were calculated.
Results
Mean age was 44.4 years (range, 26-66). Most patients received 3.5 sessions per week, with 60 L/session of dialysate and ≥24.5 cumulative treatment hours. The table summarises biochemical outcomes, which met European standards. Reduced pill burden was also noted.
Conclusion
Data from this cohort supports the use of NHHD with low-volume dialysate, providing biochemical outcomes that meet European standards and reduced pill burden. Therapy was safe and effective, and extends a viable option for more patients to receive NHHD and its associated benefits.
Biochemical data
| Biochemical parameter | Baseline Mean (SD) | 6 Months Mean(SD) | 12 Months Mean(SD) |
| Standardised Kt/V | 2.1 (0.6) | 2.4 (0.3) | 2.5 (0.4) |
| Pre Phosphate mmol/L | 1.7 (0.5) | 1.6 (0.4) | 1.6 (0.6) |
| Pre Calcium mmol/L | 2.4 (0.1) | 2.4 (0.2) | 2.4 (0.2) |
| Pre Potassium mmol/L | 5.0 (0.7) | 4.6 (0.7) | 5.0 (0.7) |
| Pre Bicarbonate mmol/L | 24.6 (2.8) | 25.9 (3.4) | 25.7 (3.0) |
| Pre Hemoglobin g/dL | 11.5 (1.6) | 12.0 (2.1) | 12.1 (1.5) |
| Pre Albumin g/L | 35.6 (6.5) | 37.7 (6.3) | 37.5 (7.3) |
| No. phosphate binders | 4.3 (5.0) | 1.9 (2.8) | 1.5 (2.3) |
| No. of BP meds | 1.2 (1.3) | 1.0 (1.1) | 1.1 (1.2) |