Recent clinical data supports a much broader adoption of more frequent home haemodialysis with the NxStage System One.
Length of life
Clinical studies have shown that patients performing more frequent haemodialysis with the NxStage System One may live longer, when compared to patients performing traditional in-centre haemodialysis.1
- Weinhandl ED, et al. Survival in daily home haemodialysis and matched thrice-weekly in-centre haemodialysis patients. J Am Soc Nephrol. 2012;23(5):895-904.
Practice changes decrease buttonhole infection rates in home haemodialysis patients1
Buttonhole cannulation (BHC) is associated with greater rates of infection compared to standard cannulation of arteriovenous fistula. The authors report infection rates of buttonhole cannulation of AVF in home haemodialysis patients over 9 years, before and after changes in practice aimed to reduce infection rates.
A total of 43 buttonhole infection episodes (systemic – 22 episodes, local – 21 episodes) were identified, giving an infection incidence of 1 episode per 10.4 patient years. The comparison of infection rates in the three different stages was: 1 episode per 7.9 patient years with 35 infection episodes (systemic 18, local 17) in pre-new butthole cannulation technique procedures (BHTP); 1 episode per 9.7 patient years with 7 infection episodes (systemic 4, local 3) in post-new BHTP; 1 episode per 100.9 patient years with 1 local buttonhole infection episode in post new BHTP with topical mupirocin prophylaxis (TMP).
Infection rates in BHC can be decreased with strict hygiene procedures and TMP.
- Snelling P. Presentation given at 50th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology. August 2014, Melbourne, Australia.
Trials and Studies
A prospective study of patients who convert to home haemodialysis (HHD) with NxStage System One showed the following results:
- Improved time to recovery1
- Fewer symptoms of depression1
- Improved sleep quality2
- Improvement in symptoms of restless legs syndrome2
- Improved mental and physical health3
- Fewer antihypertensive medications4
- Increased satisfaction with physical intimacy5
- Improvement in quality-of-life scores5
- Jaber BL, Lee Y, Collins AJ, et al. Effect of daily haemodialysis on depressive symptoms and postdialysis recovery time: interim report from the FREEDOM (Following Rehabilitation, Economics and Everyday- Dialysis Outcome Measurements) Study. Am J Kidney Dis. 2010;56(3):531-539.
- Jaber BL, Schiller B, Burkart JM, et al. Impact of short daily haemodialysis on restless legs symptoms and sleep disturbances. Clin J Am Soc Nephrol. 2011;6(5):1049-1056.
- Finkelstein FO, Schiller B, Daoui R, et al. At-home short daily haemodialysis improves the long-term health-related quality of life. Kidney Int. 2012;82(5):561-569.
- Jaber BL, Collins AJ, Finkelstein FO, et al. Daily haemodialysis (DHD) reduces the need for antihyperten¬sive medications. Abstract presented at American Society of Nephrology Conference, October 29, 2009.
- Kraus M, Finkelstein FO, Daoui R, et al. Short Daily Haemodialysis (SDHD) improves overall Quality of Life (QOL) and physical intimacy: interim results from the FREEDOM study. Abstract presented at the American Society of Nephrology Conference, 2011.
Reduction in left ventricular mass
Several studies, including the Frequent Haemodialysis Network (FHN) daily trial, have shown that patients who perform more frequent haemodialysis may experience significant reductions in left ventricular mass when compared to patients who do conventional 3-times weekly in-centre haemodialysis.1
- FHN Trial Group. In-centre haemodialysis six times per week versus three times per week. N Engl J Med. 2010;363(24):2287-2300.
Likelihood of transplant
Studies carried out by the Chronic Disease Research Group (CDRG) have shown that patients receiving daily or more frequent home haemodialysis with the NxStage System One are more likely to receive a kidney transplant when compared with conventional 3-times weekly dialysis, particularly in patients not on the transplant waiting list at initiation of daily home haemodialysis.1
- Weinhandl E, Collins A. Incidence of kidney transplant in dialy home hemodialysis, peritoneal dialysis, and in-center hemodialysis patients. National Kidney Foundation. Poster 279. 2015. (Abstract)
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