The Use of B. Braun Hemodialysis Machine to Provide Home Hemodialysis.

Abstract

Background: Home hemodialysis (home HD) continues to be an underutilized dialysis modality despite its potential advantages when compared to peritoneal dialysis (PD) and in-center hemodialysis (HD).

Methods: We conducted a retrospective study to evaluate the feasibility of using the B. Braun Dialog+ HD machine to provide home HD with the necessary requirements and modifications at home to be able to provide such treatments. In this retrospective study, we compared data obtained from patients who received home HD using the B. Braun Dialog+ HD machine since we started utilizing it for home HD (n = 27 patients) to data obtained from eligible patients who received home HD using the NxStage System One machine around the same period (n = 36 patients).

Results: Our results showed that the B. Braun group had a better single treatment single-pool Kt/V (spKt/V) (1.48 ± 0.27 for B. Braun vs. 1.14 ± 0.32 for NxStage, p < 0.001), better standard weekly Kt/V (4.44 ± 0.82 for B. Braun vs. 2.65 ± 0.57 for NxStage, p < 0.001), and better urea reduction rate (URR) (71.4 ± 6.2 for B. Braun vs. 59.2 ± 9.1 for NxStage, p < 0.001). The duration for the HD treatments among the B. Braun group patients was significantly shorter than that of the NxStage group patients (3.48 ± 0.32 vs. 4.58 ± 1.52, p < 0.001) while the ultrafiltration rate for the B. Braun group patients was significantly larger than that of the NxStage group patients (1.83 ± 0.64 vs. 1.18 ± 0.66, p < 0.001). The average laboratory data for both groups showed that there was only a significant difference between the two groups in bicarbonate level, with B. Braun having a lower level (23.5 ± 2.0 for B. Braun vs. 24.9 ± 2.8 for NxStage, p = 0.021). There were no significant differences between the two groups in the average albumin, BUN, calcium, creatinine, hemoglobin, phosphorus, platelets, potassium, WBC, or PTH.

Conclusion: B. Braun HD machine is another HD device that can be considered to provide home HD. Our study has shown that B. Braun machine had higher spKt/V in addition to standard weekly Kt/V and URR when compared to the NxStage machine. Larger, well-designed, and well-powered studies are needed to confirm these results.