EMPLOYMENT AGREEMENT



      This Employment Agreement (the "Agreement") is entered into as of

November 1, 2002 (the "Effective Date") by and between NxStage Medical, Inc., a

Delaware corporation (the "Company" or "NxStage"), and Christopher Manos, an

individual ("Mr. Manos"), residing at Forest Road, Lincoln, MA.



                              W I T N E S S E T H



      WHEREAS, the Company desires to employ Mr. Manos to provide certain

services to the Company subject to the terms set forth herein; and



      WHEREAS, Mr. Manos desires to be employed by the Company in return for

certain compensation and benefits.



      NOW, THEREFORE, in consideration of the mutual covenants and agreements

set forth herein and for other good and valuable consideration, the receipt and

sufficiency of which are hereby acknowledged, the parties agree as follows:



1. EMPLOYMENT BY THE COMPANY.



Subject to the terms and conditions set forth in this Agreement, the Company

agrees to employ Mr. Manos to render full-time services to the Company as its

Vice President and Chief Financial Officer. Mr. Manos shall perform the duties

and have the responsibilities and authorities that are customarily associated

with his then current title, and such other duties of an executive nature as may

be assigned from time to time by the President of the Company, consistent with

the Bylaws of the Company. As Chief Financial Officer, Mr. Manos agrees to

devote his best efforts and substantially all of his business time and attention

(except for vacation periods as set forth herein and reasonable periods of

illness or other incapacities permitted by the Company's general employment

policies or, in the absence of such policies, consistent with the employment

policies common to the industry at large) to the business of the Company and to

use the highest degree of professionalism in performing services for the

Company.



2. COMPENSATION.



      2.1 Salary. During the term of this Agreement, as compensation for the

proper and satisfactory performance of all duties to be performed and services

to be provided under this Agreement, the Company agrees to pay Mr. Manos a base

salary ("Base Salary") in the amount of One Hundred Ninety Five Thousand Dollars

($195,000) per year of employment, payable on a semi-monthly basis and in

accordance with the Company's standard payroll practices, less required

deductions for state and federal withholding taxes, Social Security and all

other employee taxes and payroll deductions (the "Semi-Monthly Base Payment").

In addition beginning in calendar year 2003, Mr. Manos shall be eligible to

receive bonus compensation in an amount up to 20% of his Base Salary at the

discretion of the Board, dependent upon Mr. Manos' achievement of certain

objectives and the overall performance of the Company.



<PAGE>



Mr. Manos's base salary shall be reviewed annually by the President and may be

increased or decreased in the sole discretion of the President; provided,

however, that if at any time during the Period of Employment Mr. Manos's Base

Salary is reduced by more than 15% from the previous fiscal year, except for

across-the-board salary reductions similarly affecting all or substantially all

management employees and reductions related to the his job performance, then Mr.

Manos shall be entitled to terminate his employment with the Company and such

termination shall be considered a Company initiated termination without cause in

accordance with Section 6.



      2.2 Equity.



            (a) As of the Effective Date and subject to the terms of this

Agreement, the Company shall grant to Mr. Manos an Incentive stock option,

exercisable at any time during the Period of Employment (as defined below) and

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