By Bill Peckham
Today RenalWEB linked to a press release from Xcorporeal:
New Machine Makes Home-Based Dialysis a Reality for Millions of Patients Worldwide
LOS ANGELES--(BUSINESS WIRE)--Xcorporeal, Inc. (AMEX:XCR) announced today the XCR-6 Dialysis Platform
for self-directed kidney hemodialysis. The XCR-6 will be the smallest,
lightest, and easiest to use dialysis machine ever conceived, using
Xcorporeal’s proprietary closed loop,
regenerated dialysate technology platform. The Company is currently
preparing for unattended/home use clinical trials of the XCR-6 in
anticipation of commercialization in the near future.
The XCR-6 was developed through extensive research and represents a significant improvement compared with equipment currently utilized by patients suffering from chronic renal failure. The technology will, for the first time, allow dialysis providers to "bring the therapy to the patient" because the XCR-6 uses an extremely small amount of tap water; requires no special plumbing or water processing plants; runs on standard household electricity; is the size and weight of a small household appliance; is easy to learn and use as all tubing is integrated into a single proprietary cassette that snaps into place with one hand and retains all fluids within the disposable cassette, facilitating clean up. The Company estimates that the home hemodialysis market represents a multi-billion dollar revenue opportunity.
We are extremely excited to announce the XCR-6, said Kelly McCrann, Chairman and Chief Executive Officer of Xcorporeal. The XCR-6 represents the culmination of years of research and development activities in an attempt to change the lives of patients living with kidney dialysis on a daily basis. With its compact size, allowing it to fit into an airline carry-on compartment, the days of patients requiring Center visits for dialysis are numbered. Our ability to deliver a simple, robust, portable, cost-effective solution will finally remove the barriers to home-based hemodialysis services.
Unlike conventional, single pass dialysis machines that require 50 liters or more of dialysate generated by a large water purification plant, Xcorporeal’s unique approach requires only 6 liters of dialysate, generated from readily available tap water, and then recirculated in a closed loop to attain the same toxin clearance rates as conventional single pass machines.
It is a public relations communication so I undestand (those already in the field should remember their own company's claims when they were first entering the home hemodialysis device market). I wish Xcorporeal well and hope that the market for their device is in fact as large as their headline suggests. Making "home based dialysis a reality for millions of patients worldwide" implies just about everyone on hemodialysis. I hope that the claim is true.
More likely the potential market is smaller (though larger then the numbers of people dialyzing at home today). To the extent that logistics represents a barrier to home hemodialysis, this machine may help. The size of the machine is a nice feature (hard to judge scale from the drawing but being able to fit in the airline carry-on compartment implies a small, light machine). However, I am not sure logistics is the main barrier to wider use of home hemodialysis and of course home hemodialysis has been around for over 40 years.
We are facinated by your machine , is this peritonial dialysis ? how often and many days they have to do it ? we have 19 dialysis centre and are interested to know more about your product. Thank you
Posted by: Tommy Ooi | November 13, 2008 at 02:47 AM
It is indicative of my basic personality that I was all OHHHHH, SHINY when I saw the picture. I am such a tech whore.
Posted by: Tracy Lynn | November 13, 2008 at 08:02 AM
My son has been on home hemo for 22yrs. He is 25 now and doing great. Iam very interested in newer machines available for home use. We have the Baxter Tina now. Can't get parts anymore. Please educate me on your machine. I use D.I tanks and dialyze him every other day. No interested in next-stage, daily dialysis. Can you help?
Posted by: Deborah A Clay | December 29, 2010 at 05:40 PM
Does this machine still exist? I've never heard of it, and the original post is dated 2008, so did anything ever come of this?
Posted by: MooseMom | January 04, 2011 at 04:30 PM
There are two machines expected for commercial release either in late 2011 or early 2012.
(1) the Fresenius + RSI + 'Xcorporeal' machine (I wont give its likely name here) ... which is a sorbent-based desktop portable designed initially by Xcorporeal. Xcorporeal was then bought out by Fresenius who have subsequently modified the system and have incorporated RSI's sorbent technology for dialysate regeneration (as I am on the Medical Advisory Board of this development, I can assure it is a very nice machine). It is designed with home nocturnal 8 hr treatments as its specific target but will clearly allow shorter therapy times too. It has a wide range of dialysate flows to an easy 500ml/min flow rate using regeneratable dialysate via a sorbent cartridge. It requires no fixed water source, no R/O, no dialysate other than that which is prepared from ~6L of tap water and is all that is required for each full 8-9hr treatment, and clearly also needs no drain. All it needs is 6L tap water and a power source.
I published a primer paper on sorbent dialysis for the Asia Pacific readership in Nephrology in mid-2010: Agar JWM. Understanding Sorbent Dialysis Systems. Nephrology (Carlton). 15(4): 406-411. June 2010 for those wishing a simplified explanation of how sorbent systems work.
The second machine to be available shortly (I believe also planned for commercial release later in 2011 or early in 2012) is the Baxter portable system - based on the very nice but now defunct Aksys hot water sterilization system developed for the old Aksys PHD (Bill will well remember this machine in the late 90's through till 2006). This, too, is a desktop model, small, portable and well capable of the full range of dialytic modalities, sessional lengths and frequencies.
Both are desigend for the home market. Both have simple user interfacing and use a similar cassette line and dialyser system to the NxStage machine. While the NxStage is best suited to short hour dialysis, these will both cater more easily with longer hour programs, as I understand (and know).
The UK has a machine (the Quanta) ... you can Google it ... which seems nice while there is also a South Korean portable, capable of HDF (a specific bonus for the Australian market which is very HDF-alert) and which is also coming fast.
Hope that is a brief answer to your question.
Keep your ear to the ground. There is much coming!
Posted by: John Agar | January 04, 2011 at 07:43 PM
I don't think my kidneys will hold out quite that long; if I don't have to start dialysis sometime this year, it will be a miracle. I want to do home hemo with the NxStage machine; my clinic offers training and my neph likes the clinical results a patient can get. I don't know how this works...if I were to start NxStage and then a more marvellous machine comes on to the market next year, as a general rule, is it easy to switch machines? Do nephs just hate that, or do they not really mind such switching?
Posted by: MooseMom | January 05, 2011 at 08:55 AM
Thanks John for the update. It is very difficult to find any information on any of these new machines that we all know are coming down the system. I look forward to seeing the specs on all of these systems to see if it is going to be a step above the NxStage. I am sure NxStage is not just sitting back as well. It will be an interesting time in the next couple of years and with all of this competition, we may actually begin to see a sizable number of patients taking dialysis home.
Posted by: Peter Laird, MD | January 05, 2011 at 12:16 PM
Switching shouldn't be an issue if that is what you decide to do. There would be an inevitable period of familiarization and retraining and, clearly, you and your team would have to (a) be convinced of any benefit/risks of any change and (b) appraised of any costs (short/long-term) that may accrue to either you or the service that cares for you.
Make no mistake, the NxStage is a good machine. It is, however, within its greatest comfort zone for frequent, short-hour dialysis. As I prefer (and believe in) frequent, long-hour dialysis, I still think that the NxStage has some short-comings in that area.
No single machine (yet) is all things to all men ... or all things to each situation. I doubt that will ever be the case. All equipment has is own short-comings and strengths. This is one of the reasons why I am so against machine-centricity. In my view, it is the global dialysis milieu, the total hours per week, the outcomes in survival (first) and in the sub-outcomes like rehabilitation, symptom relief, return to work, return to 'life' (second) that matter ... and not the technology by which one gets there. All dialysis technology is good (though clearly from what I have just typed, all dialysis technology has its faults and all could be improved.
The advent of the new machines and the new and certain focus of the big manufacturers and equipment designers on home, simplicity and miniaturization that gives me hope that more and better is really on its way.
'On its way' means 'coming' ... and coming means 'not yet' ... and not yet means some will miss the new wave of 'stuff in the pipeline'. For the individual, this is frustrating, worrying and in the end, sad. For the future patient, however, it is bright, hope-giving news and will be worth the watching.
Posted by: John Agar | January 05, 2011 at 12:24 PM
I look forward to the competition....I like the idea of a lighter machine.... more portable.... I use Nxstage now and go alot of places... and it is somewhat bulky but still possible... I still love home dialysis and I have encouraged many people to give it a try....
Posted by: kathy heffner | January 05, 2011 at 06:44 PM
I understand what you are saying, Dr Agar...I am not so much interested in the specific machine as I am in the fact that any machine at least gives the patient the opportunity for self-care at home. We are awaiting the FDAs approval for the use of NxStage in nocturnal dialysis. Using it for frequent, longer hour dialysis is already a reality. The head nurse at the clinic I will be using has already told me she could train me on how to use it for extended hour dialysis.
Posted by: MooseMom | January 06, 2011 at 02:13 PM