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Comment by nharada | Hacker News Reader

If this was effective on humans I think most people would accept having treatments 2x a year

One must live a very privileged life to mind a 2x a year inconvenience in exchange for a working brain.

I wouldn't mind 10x a day injections if it keeps Alzheimer's at bay. Actually, I wouldn't mind a continuous IV drip.

I usually consider dialysis to be the point where treatments start to become very limiting. Twice a week, most people feel tied to their dialysis clinic and cannot go far from it.

Dialysis specifically requires several hours and a specific location and its debilitating. Going to a random pharmacy to take an injection 2x a week would be much simpler.

And plenty of people living with diabetes manage to self-medicate with injections multiple times a day.

Being forced to sit in a chair for several hours every few days isn't what makes dialysis so debilitating. It's the loss of kidney function that dialysis doesn't replace, tied with the cardiovascular stress of emptying all the waste from the body at once.

Did anyone say that?

I have an acquaintance who has lived most of his life without kidneys(40 years). Looking in from the outside, his life seems normal; go to the gym and have a beer or two like anyone would, except for the dialysis trips.

I then have a relative into their late 60's that was very laxed about diabetics within recent years.This has lead to kidney issues. They are refusing dialysis because of I guess the stigma attached to it. Now they are experiencing a cognitive decline due to poorly functioning kidneys.

I guess when you want to live you would do whatever it takes.

Why has nobody made a backpack dialysis machine so you can keep going about your day?

A combination of not quite feasible, not quite usable if created, not quite safe.

There are portable ones you can self administer overnight.

If you've ever been to a dialysis center when a patient accidentally pulls out the line you can imagine why. They are thick lines that will rapidly make a huge mess.

I guess though a backpack version probably could be more like an always attached glucose device with just a tiny line.

My dad tried out a 24/7 IV for a heart medicine. The pump and a bag with a 1 week supply of the medicine fit in a fanny pack sized bag. It worked well, but he's 90 and pulled out the IV line in the middle of the night. He didn't remember doing it. So we decided to discontinue the meds. But I'm sure it would have been fine for a younger, less confused person. Just a bit inconvenient for showering, etc.

There is peritoneal dialysis, which is pretty portable and doesn’t filter the blood (it exchanges peritoneal fluid, which is a lot less invasive). It’s actually quite fascinating how simple the machine is — and in fact, the simplest version of the machine is literally two bags and a couple of valves, completely operated by gravity. Everyone is not eligible for this type of dialysis, however. I don’t remember why.

Oh, also, if you do peritoneal dialysis, it’s daily, whereas hemo dialysis is generally two or three times a week.

You have to be very reliable on a lot of fronts for peritoneal dialysis to work. Sterility is hard to maintain; you can't just wipe it off with alcohol like we do with small IV's because replacing a PD catheter involves going to the hospital for surgery. You have to remember to place and drain your dialysate. And so on.

For someone with meticulousness, educability on maintaining the pieces that go into PD, and a good living situation, it's far better than hemodialysis. But people like that are rarely the ones whose kidneys fail.

It's not the size of a backpack but my wife did home hemo dialysis with a machine that had a handle and was portable. We even took it on trips a few times. I forget the weight, but, from memory, was around 10 pounds / 4.5 kg I think. Wife has had a transplant so my home hemo experience is from a few years ago. It may have changed since then.

The machine's portability wasn't the only factor. Needed a clean space to set up. There was a second machine hooked up to the house water lines. It would be used to create dialysate which was pumped into the dialysis machine. You could travel without the water pump, but to replace it, you needed these massive disposable bags of dialysate. Each bag was heavier than the machine itself and they were essential.

I guess with car trips, you could take the pump too to generate dialysate on site but it wasn't designed for portability as much as the main dialysis machine was. Was heavier. We kept it on rollers.

There were other supplies needed too. Saline bags. The dialysis machine had one-time use cartridges that were quite convenient but took up a fair bit of space. All added up to considerable bulk.

We only used the machine at distant locations when we knew we were going to be there for a week or more. One factor that made things a little easier was the the dialysis company was willing to deliver supplies to wherever we were, as long as it was within the US. We didn't have to take weeks worth of supplies. But we did have to take enough supplies to get through the first few days before delivery.

Vacations were rare but doable if we were going by car or if there was a dialysis center at the location. I guess we could have flown with the machine but we didn't trust airline baggage handlers enough to risk it.

> wouldn't mind 10x a day injections if it keeps Alzheimer's at bay. Actually, I wouldn't mind a continuous IV drip.

There seems to be a much better way:

https://publichealth.jhu.edu/2025/small-amounts-of-moderate-...

"The researchers found that engaging in as little as 35 minutes of moderate to vigorous physical activity per week, compared to zero minutes per week, was associated with a 41% lower risk of developing dementia over an average four-year follow-up period. Even for frail older adults—those at elevated risk of adverse health outcomes—greater activity was associated with lower dementia risks.

The researchers found dementia risk decreased with higher amounts of physical activity. Dementia risks were 60% lower in participants in the 35 to 69.9 minutes of physical activity/week category; 63% lower in the 70 to 139.9 minutes/week category; and 69% lower in the 140 and over minutes/week category."

People keep telling they'd sacrifice everyting for an hypothetical silver bullets while doing nothing in their day to day life to mitigate all these disease. Eat clean, exercise, 8 hours of deep good uninterrupted sleep, &c.

3/4th of people are obese or overweight, the average Joe walks like 4k steps a day, people, at large, don't give a shit about health until they get a terminal diagnosis

>the average Joe walks like 4k steps a day

Which is not that bad. 10k/steps was a made up marketing goal from a speedometer company. The sweet spot is around 7k/steps day, but 4k/steps day is already seeing benefits.

Not everyone can just choose to get 8 hours of uninterrupted sleep! I’d love to.

Apples and oranges.

You're talking about prevention, but this is about cure / treatment.

Once you have already have Alzheimer's, exercise isn't going to save you.

>You're talking about prevention, but this is about cure / treatment

Not "apples vs oranges". More like "diabetes vs healthy diet".

Most wouldn't need treatment if they worked at prevention.

What am I to infer from this? That people prone to dementia tend to have less energy for voluntary vigorous physical activity?

If not, why not?

>vigorous physical activity

140 minutes/week is really really far from vigorous.

Might be confusing terms here. Vigorous exercise tends to describe high intensity rather than high volume.

"vigorous" isn't a period of time or an amount of time per week. It describes the level of physical activity, not the amount.

Doesn't fully correct for different biaises like healthy user bias so it proves association more than causality.

My father was very active well into his 80s, going for 10+km bike rides almost every day, until he got heart trouble. He would still walk for hours every day, often taking the stairs up the local hill, 400+ steps. He still got Alzheimer's. A lighter, later case than he would otherwise had, I'm sure, but still, he doesn't remember what he said 2 minutes ago, asking about the same things over and over again.

So while there are lots of excellent reasons to stay active into old age, it's not a replacement for treatment.

If it was effective on humans I think people would accept daily treatments, were it to be necessary - Alzheimer’s is just that awful.

The alternative is 24/7 care in a long-term care facility with multiple RCWs per floor and a couple of RNs. There are definitely enough Human Resources available to support this initiative.

Of course, but that’s assuming:

1. There aren’t serious side effects that make it more of a tradeoff

2. The price isn’t on the order of 6-7 figures (or possibly less for some)

As someone close to a severe Alzheimer’s case - I would personally write a check for $100K in a heartbeat for a treatment that worked.

And yes - I mean I would do that every 6 months.

I’m curious: Do you have any idea what care for such situations costs today?

I don’t, no.

But my point isn’t so much about willingness to pay for such a treatment, but ability to pay for such a treatment.

My understanding is that some treatments like this are sometimes not covered by insurance, so only high income individuals are able to afford them.

On the other hand, long-term care often is covered by insurance, and the insurance is more affordable.

Close to nothing if you live in a multi generational house where people are close by and can take care of each other, thousands per month if you delegate everything to medical practices. I've witnessed both cases, many times

The fact that no money exchanges hands doesn't mean that it costs nothing. The work is still the same. In multigenerational house younger generations pay with their life opportunities for the care.

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