20/08/2026
HOME DIALYSIS?
(PHYSIDIA S3)
How it works?
The basic principle is the same as conventional hemodialysis in a dialysis center:
Patient → arterial bloodline → blood pump → dialyzer → venous bloodline → patient
Inside the dialyzer, the patient's blood flows on one side of a semipermeable membrane while dialysate flows on the other side.
Urea and other waste products move from blood into dialysate.
Excess electrolytes can be controlled through the prescribed dialysate.
Excess fluid is removed by ultrafiltration.
The cleaned blood returns to the patient.
Physidia describes the S³ as using an extracorporeal blood circuit and a hemodialyzer, just like conventional HD.
What are all those bags?
This is one of the biggest differences from a typical Fresenius 5008/5006 setup.
The S³ can use pre-prepared dialysate bags, rather than requiring a large RO/water-treatment system in the home. The bag rack in your picture holds the bicarbonate dialysate bags, and the system detects the proper mixing of the two compartments in the bags.
So conceptually:
Dialysate bags → S³ monitor → dialysate cassette → dialyzer → waste
The S³'s dialysate flow is limited to 200 mL/min, and the machine uses Physidia's SeCoHD® push-pull technology to provide a convective component.
What does the patient actually do?
After proper training, the patient/caregiver follows the machine's guided procedure. The system uses an interactive tablet with step-by-step instructions and displays treatment parameters.
The preparation includes things such as:
1. Set up the S³.
2. Install the dialyzer.
3. Install the bloodline.
4. Install the dialysate cassette.
5. Connect the dialysate bags.
6. Prime the extracorporeal circuit.
7. Connect the patient's vascular access.
8. Start treatment.
9. Monitor pressures, alarms and treatment parameters.
10. Return blood and terminate treatment.
Physidia provides dedicated training material covering preparation, bloodline installation, dialyzer installation, priming, starting/ending dialysis and alarm management.
How often?
This particular system is designed for frequent home HD. Physidia describes a typical approach as 4–6 treatments per week, about 2–3 hours per session, although the actual prescription is determined by the nephrologist.
That's different from the common in-center schedule of approximately 3 × 4 hours/week.
Important point for you as an HD nurse
The S³ isn't simply a "smaller Fresenius." The dialysate delivery system is fundamentally different:
Conventional center HD Physidia S³ HHD
Central/RO water system Dialysate supplied in bags
Large dialysis machine Compact monitor
Usually ~500 mL/min dialysate flow Up to 200 mL/min
3 sessions/week commonly Often 4–6 sessions/week
Staff-operated in center Patient/caregiver trained
Conventional HD Frequent/short HHD
Standard extracorporeal circuit Dedicated S³ bloodline/cassette system
The S³ still requires vascular access, anticoagulation as prescribed, dialyzer, blood circuit, monitoring and safety alarms—so physiologically it is still hemodialysis.
Requires Doctor's order.
(I posted actual photos of what we are using in my department , for reference)
You can check the comment section.
-FocusSym
