Fresenius Medical Care Sees US Plans for Kidney Disease as Positive
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The 2008K@home™ hemodialysis machine is powerful enough for in-center treatment but simplified for use in a patient's home. Built on in-center technology, it provides patients with a reliable and robust dialysis experience where they're most comfortable — at home.
When dialysis professionals seek the most trusted hemodialysis (HD) technology, they look to us, Fresenius Medical Care Renal Technologies, a division of Fresenius Medical Care North America. For over 30 years, we have provided nephrologists with the tools necessary to meet the clinical needs of hemodialysis patients and caregivers alike.
Nephrologists, clinicians and patients rely on Fresenius Renal Technologies to deliver the ideal combination of innovation and practical application. Our research and development teams work collaboratively with physicians and clinicians to provide powerful tools designed to not only maximize treatment success but also provide a variety of treatment options ranging from in-center hemodialysis, peritoneal dialysis and home hemodialysis. We believe these options allow for a more customized approach to therapy designed to best fit the needs of patients.
Nephrologists and patients have been working together to offer home dialysis since the 1970s. Today, home hemodialysis (HHD) is one of the fastest-growing renal treatments available for chronic dialysis patients.1 And with the ever-evolving healthcare environment, HHD is becoming a popular option among physicians and patients to treat end stage renal disease.
Only patients, together with their doctor, can decide if home hemodialysis and the 2008K@home machine is right for them. On the 2008K@home machine, patients have the flexibility, based on their physician's prescriptions, to perform a variety of therapy options.
The 2008K@home machine offers greater treatment flexibility, which gives patients the freedom to dialyze on their schedule. With a committed care partner, patients can dialyze at home and achieve results that stand to improve their lifestyle.
Chronic kidney disease (CKD) and acute renal failure cause the kidneys to lose their ability to filter and remove waste and extra fluid from the body. Hemodialysis uses a machine to pump blood through a filter (called a dialyzer) that takes out water and waste products.
Hemodialysis is often done in a dialysis center; however, there are many patients who do dialysis at home. In the dialysis center, nurses and technicians usually perform the patient’s hemodialysis treatment multiple times a week, but when done at home, the patient and their selected care partner will set up and perform the treatments using equipment like the 2008K@home machine.
Patients, along with their physician, can determine the therapy options and treatment schedule that best fits their lifestyle. With conventional home hemodialysis, patients may be able to achieve adequate dialysis in as few as three treatments per week.3 Flexibility in treatment days each week may allow for more freedom and independence.
Home hemodialysis, or HHD, is currently one of the fastest growing renal therapy treatments available.5 With HHD, the patient and their care partner perform dialysis at home after completing a few weeks of HHD training in the dialysis home training center.
To find out if HHD is right for you, talk with your physician.
Who is eligible for home hemodialysis?
Many patients may believe that hemodialysis at home is not an option or may not even know the option exists. Often, patients find out that they are eligible for at-home treatment. You must consult with your dialysis medical team to determine if home hemodialysis is the right treatment option for you.
You may be the right fit for home hemodialysis if you want:
You may prefer in-clinic treatment if you:
Nephrologists and dialysis staff identify and assess patients who may be candidates for home therapies. Ask your doctor if home hemodialysis will work for you.
2. Decision to transition — In addition to approval from the medical team, you should review the benefits and risks of home hemodialysis carefully, talk with your family about their desire to transition and ultimately decide if home hemodialysis is the right choice for you and for them.
3. Access Site — There are three types of blood access used in hemodialysis:
Any of these access types could be used to perform hemodialysis at home. During the instruction period, the home training nurse will teach you and your care partner how to access your blood.
4. Home assessment and setup — In preparation for equipment setup, a qualified person from the home hemodialysis team performs a home assessment that includes water quality testing and volume, space requirements and electrical supply. During the inspection, the team member will review:
The clinic staff will help you complete the assessment and set-up; however, there may be some additional costs including any direct changes to the home, like plumbing or wiring.
5. Training — You and your chosen care partner will undergo several weeks of training in a dialysis center on the 2008K@home machine. A home hemodialysis training nurse will instruct you and your care partner on the following:
The dedicated home training nurse will help you and your care partner feel comfortable handling all aspects listed above to perform home hemodialysis successfully. The nurse may visit your home to observe the first few home treatments and to answer any questions. Once the nurse and home care team determine you are ready, you and your care partner can begin treatments on your own.
6. Monthly visits — You will typically be expected to return to the clinic monthly to meet with physicians, the home training nurse, and any other members of the healthcare team. In order to maintain the best level of health, it is vital to follow your medical team's advice, attend clinic visits as scheduled, share concerns or issues openly, and manage your diet based on team input and lab values.
7. Home care assistance — The home training nurse is available to assist you and your care partner by phone between clinic visits. If you or your care partner ever have questions or concerns, the nurse is available by phone. In the case of an emergency, you should follow the instructions provided during training. Find out if HHD is right for you – speak with your medical team to learn more.
Home hemodialysis requires commitment from you and your designated care partner. This includes setting up for, performing, and completing the dialysis treatment, learning how to insert needles into the blood access site, testing the machine and water system, responding to any machine alarms or emergencies that may occur, ordering supplies, and communicating on a regular basis with the home dialysis team.
You will need to follow all instructions that are given by the home dialysis team, such as using aseptic technique, monitoring blood pressure, documenting treatments, and following up with the home training staff on a regular basis and as needed.
Machine — The dialysis clinic will provide a 2008K@home hemodialysis machine for use in the home. Many patients who commit to home hemodialysis find that they quickly become familiar with the procedures and the machine since many patients have been treated in the clinic on a similar 2008® series machine. You or your care partner will need to monitor the following:
The 2008K@home machine is a powerful dialysis machine that has been created specifically for use in the home. The device, simplified for caregivers and patients, delivers hemodialysis treatments to the patient on a flexible schedule that comfortably fits into their lives.
The 2008K@home machine performs hemodialysis treatment by pumping the patient's blood from their access through bloodlines and a dialyzer membrane. The dialyzer membrane comprises many fibers and is surrounded by a solution called dialysate. When used in combination with the 2008K@home machine, the system can remove excess fluid and waste products from the patient's blood, which would normally be done by healthy kidneys. Additionally, there is a separate device used together with the 2008K@home machine that purifies the water used for treatment called the Reverse Osmosis (RO) system.
With the 2008K@home machine, you gain flexibility in treatment schedule and have more available prescription options. What you can expect from the 2008K@home machine:
*Based on an average 2008K@home patient's 3 1/2 day/week treatment plan (versus competitor's average 5 day/week plan). Number of treatment days may vary according to your physician's prescription.
By choosing the 2008K@home machine for dialysis, patients, caregivers and healthcare providers alike partner with a trusted and reliable resource in Fresenius Medical Care. When deciding to start HHD, a training nurse at the clinic will train the patient and their care partner on all steps required to perform dialysis at home. The process continues until they are comfortable and confident with their HHD treatment plan.
Performing hemodialysis at home, as opposed to in a dialysis center, provides flexibility in the scheduling of treatments. The appropriate treatment schedule will be determined by your physician in consultation with you in order to determine what will meet your medical needs, while also considering your lifestyle needs. Below are a few of the available treatment options:
There are risks to hemodialysis, whether performed in-center or at home. Here are some things to consider:
Hemodialysis treatment sometimes causes loss of blood, high or low blood pressure, increased amount of fluid, fever, headaches or itching. It may make you feel sick to your stomach, cause cramping or other aches and pains, confusion, nervousness, or may make you feel hot or cold. Convulsions, seizures or other problems associated with the brain are also potential risks.
Other more serious problems such as too much bleeding, air in your veins, or damaged red blood cells can cause serious injury or death. Venous needle dislodgement (VND) is also a risk and this should be assessed before beginning treatment. The most important precaution you can take against VND is to monitor the access site, keeping it visible at all times during dialysis. Follow your doctor’s prescription and instructions to reduce the risk of these problems.
If you choose to perform HHD, you will not have a nurse present in the home to assist with emergencies, so adequate and appropriate training must be provided to ensure you and your care partner can respond to emergencies or call 911.
For a more comprehensive list of safety and warnings: Indications, Safety and Warnings
1. U.S. Renal Data System, USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2013. The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.
2. Sands J. Stano M., Li Z., Bryant R., Ofsthun N., Updyke D., Lazarus J. “DIASAFE Decreases Endotoxin Levels 16 Fold Below New AAMI Standard.” 2004 (Abstract submitted for ASN)
3. Sands, J.J., Lacson, Jr. E., et al. Home hemodialysis: A comparison of in-center and home hemodialysis therapy in a cohort of successful home hemodialysis patients. ASAIO J 2009;55(4):361-8.
4. U.S. Renal Data System, USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2013.
5. The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.
Caution: Federal (US) law restricts these devices to sale by or on the order of a physician.
Note: Read the Instructions for Use for safe and proper use of these devices. For a complete description of hazards, contraindications, side effects and precautions, see full package labeling.
© 2015, 2018-2019, Fresenius Medical Care. All Rights Reserved. Fresenius Medical Care, the triangle logo, Fresenius Renal Technologies, 2008, 2008K@home, success@home, the @home logo, DIASAFE, Dialysis without Boundaries, WetAlert, Optiflux, CombiSet, TruBlu Logistics, Fresenius Polysulfone, and bibag are trademarks of Fresenius Medical Care Holdings, Inc. or its affiliated companies. All other trademarks are the property of their respective owners. P/N 102337-01 Rev D 06/2019