NxStage warning 24 is arterial pressure that’s too high, its reset by simply pressing the yellow alarm reset button. Error 25 is a hard machine stop for arterial pressure that’s too high and forces you to Stop and Restart the unit. In addition to halting the NxStage unit, high arterial pressure is dangerous for your fistula. Both of these errors require that you correct the problem that’s causing them, or reducing your run speed.

I’m lucky, I have a great button-hole fistula, and normally run at 500 speed with my NxStage dialyzer. I start at 350, advance to 470 with the first couple of minutes and most of the time I am running at 500 within the first 15 minutes.

Why run at the fastest speed? The faster the run speed, the higher the dialysate rate. These two factors determine how long you will be on the machine. If you’re like me, the last 30 minutes of dialysis seem like hours. Anything that reduces this time is GREAT.

Every now and then I have trouble getting much over 470, but why? The obvious issues are needle placement in your fistula. Sometime simply adjusting the arterial needle will allow faster speeds.

When I first started at home, I frequently had to “prop” my arterial needle. I used three 3”X3” cotton swabs rolled up to form a one inch round pad that I placed under the tabs of the needle to allow a faster run speed. Luckily I only needed this for a few weeks.

About a week ago I again had trouble getting to my usual 500 run speed. After reviewing both the arterial and venus lines, I discovered that if these lines were crossed one or more times, it slowed my run speed. Also I use two pieces of tape on the bicep of my fistula arm to hold the needles and lines in place, if these pieces of tape are too tight, it can reduce blood flow, and run speed.

I also check to make sure there aren’t any unusual kinks in the lines, anywhere between my arm, and their entry back into the NxState unit. I only takes a very slight kink or sharp turn to reduce blood flow, and run speed.

Lastly I carefully inspect my needle sets. If I find one that has unusual curves in the tubing portion of the line, I only use them on the venus line, and save the perfectly straight lines for use in my arterial side.

As I mentioned in one of my earlier posts Have Your Fistula Checked if trying these steps still won’t allow you to get to your normal run speed, it might be time to have your fistula checked by an Arterial Surgeon.  Clotting or narrowing of your fistula can also cause loser run speeds.

Over time, you will learn what minor issues can reduce run speed, and become very adept at correcting them and completing your dialysis run as fast as possible.