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August 13, 2008


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We have offered HHD with H machines for many years, and outcomes are excellent. We are also pleased with the flexibility of the system - one can do 3, 4, 5 or whatever number of treatments you want, and manipulate dialyzers, dialysate and blood flow rates, and dialysate solutions. It is, however, a bit intimidating for some people, and the support time in tech maintenance is high. So, we looked at NxStage as an easy option. It does appear easy, but it is inflexible with the limited flow, and it appears most people would require frequent treatments (5-6/wk) and dialysis times would likely be 2.5-3 hours for many. The clincher is the cost. We are limited to reimbursement for 3 treatments per week by our MCR FI and by our local commercial payers. We can't afford this therapy unless we are reimbursed for a greater number of treatments. It would be nice if we could get a more uniform protocol for MCR payment around the country - as is, it is not a level playing field.


Any update on increasing dialysate flow rates on the NxStage?

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