HDF @ Home

[Matt Waite]

Does anyone have home patients running HDF treatments? Do you take any additional precautions? Are you sampling any more frequently? If so what and how often? Are there any pitfalls to be mindful of?

We run HDF in-unit with no problems, but historically only HD at home. That may be about to change...

[Chris Bates]

Hi Matt,
We only started home dialysis 11 years ago and have always done HDF on Fresenius 5008S.

Before starting, I spoke to a German Fresenius development engineer who also dialyses at home on HDF; he saw no need to be concerned.
No additional precautions were deemed necessary.

Hardness sampled by the patient regularly, shedloads of carbon filtration and 6 monthly RO water ubio and chem samples.

Initially four of our most dependable patients took HDF fluid samples monthly for us. We only had about 4 results >1 cfu, all were under 5. Each of those >1 the patient had been unsure that they had done the sampling properly.

As a result, and as there are 2 levels of ultrafiltration, we don't do any HDF or dialysis fluid samples. We also stopped doing these samples in our units too.

Chris

[Ian Wilde]

I concur with everything that Chis says Matt

[Garry]

Only had a brief period of experience with home HDF as patient received transplant.  No additional issues noted in that time.  We had a hardness level of 7.56 degrees Clark and ran a Purite/Suez RO1500+ UF without water softener.  Typically 800ml/hour dialysate flow used here.  We maintained our usual home microbiology sample frequency of every 3 months while it in use of the RO.

[Roger Moore]

A topic for ART Virtual Conference 2021?

We could look at the uptake of HDF @ Home, how it is managed by technical teams and what the companies recommend in terms of additional testing, etc.?