Has anyone who does sdd ever thought of adding a Critline to ones tx? I was assessed with a Crit one time in-center and it was the best tx I ever had. I am very serious. It enabled me to remove an entire .9 more than I was able to remove with the unit machines, alone. Thats what Critline does-assists the body to give up more fluid, without symptoms. After my Critline tx, I was able to breathe in about 3 levels deeper. I hadn’t experienced normal breathing like that since I got kidney disease and had to go on dialysis. I had forgotten what it felt like. With the extra fluid off, I felt so great, good appetite and energy- it was like feeling totally normal again. There are units that have put Critlines on every machine, because they have found it is the best way to give a tx. I have wondered many times if a Critline would improve sdd txs even more.
On the Hemametrics website, the Crit-line III is listed at $4,500.
http://www.hemametrics.com/ProductsInfo.jsp?Id=1
All the equipment used in dialysis is covered under Medicare’s composite rate. If a clinic purchased this device, Medicare would not pay extra for it. It would increase the facility’s cost per treatment. Facilities are already complaining that Medicare doesn’t pay enough to offset their costs for dialysis and to compensate, they charge commercial payers a lot more than Medicare allows.
Clinics doing daily dialysis are not reimbursed routinely by Medicare for more than 3 treatments a week. Therefore dialysis clinics that offer more treatments per week incur higher per treatment costs than clinics that treat patients 3 times a week. When patients are treated at home, there is lower overhead.
Even though Medicare would not pay extra for it, I don’t know if a commercial payer would or not. It’s worth asking your insurance company whether it would pay extra if your nephrologist ordered it.
Finally, you might also want to contact the company to find out if any clinics are using the Crit-line with home patients and whether studies have shown improved outcomes (reduced complications, hospitalizations, and improved quality of life and longevity) with its use. This might help you convince your clinic to purchase it whether you have Medicare or other insurance.
Good suggestions, Beth! When I started this thread I didn’t think of these possibilities. I had thought maybe I could have a fundraiser, or if need be, if I knew Critline could significantly improve my tx, and I think it can, I’d pick up cans on the side of the road if need be to afford it lol! I do know that there are some home patients using Crits and I’d like to join their ranks. I am also wondering what would be most beneficial, nocturnal txs without crit or sdd with a Crit???
I am headed for nocturnal txs soon, but have not experienced it yet, so I can’t make a fair comparison. Unless someone has experienced Crit, they can not know how great it is. I have, so really wonder which would be best, nocturnal without Crit (because one can’t use crit for fluid removal on nocturnal although it does measure hct while patient is asleep which is very beneficial) or SDD with Crit. Only someone who has tried both methods described would know.
Depends on what you mean by “best.” On a day-to-day basis, what makes you feel better or worse is fluid removal. The Critline (as you’ve noticed) makes it easier to take off fluid without causing symptoms. I think you’ll find, as others have, that doing either short daily or long nocturnal HD without Critline is as good or better than in-center treatment with it.
In the long term, though, what’s also very important for preventing complications like bone and joint problems, is waste removal. In that area, I strongly suspect that you can’t beat nocturnal, because of the middle molecule removal.
[QUOTE=Dori Schatell;12420]Depends on what you mean by “best.” On a day-to-day basis, what makes you feel better or worse is fluid removal. The Critline (as you’ve noticed) makes it easier to take off fluid without causing symptoms. I think you’ll find, as others have, that doing either short daily or long nocturnal HD without Critline is as good or better than in-center treatment with it.
In the long term, though, what’s also very important for preventing complications like bone and joint problems, is waste removal. In that area, I strongly suspect that you can’t beat nocturnal, because of the middle molecule removal.[/QUOTE]
The way I felt on the in-center txs when I used Crit was amazing. It feels better than I feel as far as fluid removal with SDD. That’s why I say it might enhance SDD txs if it could be used every tx. So, one might actually feel better from day to day with this system then with nocturnal without crit. Of course, I will not know that until I see how I feel on nocturnal. But you are right that the middle molecule clearance with nocturnal is an overriding factor. The question is how how all these factors all measured in terms of mortality-what is best overall.