Staying HOME: Transitioning from Peritoneal Dialysis to Home Hemodialysis

Users should weigh the risks and benefits of performing home hemodialysis with NxStage systems.

• Medical staff will not be present to respond to health emergencies that might happen during home treatments, including, among other things, dizziness, nausea, low blood
  pressure, and fluid or blood leaks.
• Users may not experience the reported benefits of home, more frequent, or nocturnal hemodialysis with the NxStage systems.
• The NxStage systems require a prescription for use.

Users will be responsible for all aspects of their hemodialysis treatment from start to finish.

• Medical staff will not be present to perform home treatments. Users will be responsible for, among other things, equipment setup, needle insertions, responding to and resolving
  system alarms, system tear-down after treatment, monitoring blood pressure, ensuring proper aseptic technique is followed, and following all the training material and instructions that
  nurses provide.

Users will need additional resources to perform home hemodialysis.

• Users will need a trained care partner to be present during your treatment at home (unless their doctor prescribes “solo/independent” home hemodialysis, described below).
• Users must have a clean and safe environment for their home treatments.
• Users will need space in their home for boxes of supplies necessary to perform home hemodialysis with NxStage systems.

Certain forms of home hemodialysis have additional risks.

• If a doctor prescribes home hemodialysis more than 3 times a week, vascular access is exposed to more frequent use which may lead to access related complications, including
  infection of the site. Doctors should evaluate the medical necessity of more frequent treatments and discuss the risks and benefits of more frequent therapy with users.
• If a doctor prescribes “solo/independent” home hemodialysis without a care partner during waking hours, risks of significant injury or death increase because no one is present to help
  users respond to health emergencies. If users experience needles coming out, blood loss, or very low blood pressure during solo/independent home hemodialysis, they may lose
  consciousness or become physically unable to correct the health emergency. Users will need additional ancillary devices and training to perform solo/independent home hemodialysis.
• If a doctor prescribes “nocturnal” home hemodialysis at night while the user and a care partner are sleeping, risks increase due to the length of treatment time and because therapy is
  performed while the user and a care partner are sleeping. These risks include, among other things, blood access disconnects and blood loss during sleep, blood clotting due to slower
  blood flow or increased treatment time or both, and delayed response to alarms when waking from sleep. A doctor may need to adjust users’ medications for nocturnal home
  hemodialysis, including, among other things, iron, Erythropoiesis-Stimulating Agents (ESA), insulin/oral hypoglycemics, anticoagulants, and phosphate binders