EMPLOYMENT AGREEMENT

                                  DAVID N. GILL



      THIS EMPLOYMENT AGREEMENT (the "Agreement") is entered into this 19th day

of October, 2005 (the "Effective Date") by and between NxStage Medical, Inc.

(the "Company"), a Delaware corporation with its principal place of business at

439 South Union Street, Lawrence, MA 01843 and David N. Gill, of 8513 River Club

Way, Knoxville, TN 37922 (the "Executive").



      WHEREAS, the Company desires to continue to employ Executive, and

Executive desires to continue to be employed by the Company upon the terms and

conditions hereinafter set forth;



      NOW, THEREFORE, the parties hereto, intending to be legally bound, hereby

agree as follows:



1. Employment. The Company hereby agrees to continue to employ Executive, and

Executive hereby accepts such employment and agrees to perform Executive's

duties and responsibilities, in accordance with the terms, conditions and

provisions hereinafter set forth. This Agreement shall be effective as of the

Effective Date and shall continue until terminated in accordance with Section 2

hereof. Nothing in this Agreement shall be construed as giving Executive any

right to be retained in the employ of the Company, and Executive specifically

acknowledges that Executive shall be an employee-at-will of the Company, and

thus subject to discharge at any time by the Company with or without cause and

without compensation of any nature except as provided in Section 2 below.



      1.1 Duties and Responsibilities. Commencing on the Effective Date,

Executive shall continue to serve as Senior Vice President and Chief Financial

Officer of the Company and shall perform all duties and accept all

responsibilities incident to such position as may be reasonably assigned to

Executive by the Company's Board of Directors (the "Board") or by the Chief

Executive Officer ("CEO") of the Company. Executive shall be based at the

Company's headquarters in Massachusetts, or such place or places in the

continental United States as the Board shall determine.



      1.2 Extent of Service. Executive agrees to use Executive's best efforts to

carry out Executive's duties and responsibilities under Section 1.1 hereof and,

consistent with the other provisions of this Agreement, to devote substantially

all of Executive's business time, attention and energy thereto. The foregoing

shall not be construed as preventing Executive from making passive investments

in other businesses or enterprises, provided that Executive agrees not to become

engaged in any other business activity which, in the reasonable judgment of the

Board, is likely to interfere with Executive's ability to discharge Executive's

duties and responsibilities to the Company. The foregoing shall also not be

construed as preventing Executive from participating as a member of a board of

directors or in some other capacity with another organization, including a

public company, provided that Executive shall have received prior approval of

the Board.



<PAGE>



      1.3 Base Salary. For all the services rendered by Executive hereunder, the

Company shall pay Executive a base salary ("Base Salary") at the annual rate of

$225,000, less applicable taxes and withholdings, payable bi-weekly in

installments at such times as the Company customarily pays its other senior

level executives. Executive's Base Salary shall be reviewed annually for

appropriate increases by the Board, CEO, or compensation committee pursuant to

the normal performance review policies for senior level executives.



      1.4 Incentive Compensation. The Executive shall participate in short-term

and long-term incentive programs established by the Company for its senior level

executives generally, at levels determined by the Board or the compensation

committee. Executive's incentive compensation shall be subject to the terms of

the applicable plans and shall be determined based on Executive's individual

performance and Company performance as determined by the Board or the

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