Will Crit-Line Catch On?

As all nephrologists know, and many dialyzors suspect the guestimate of a true EDW (estimated dry weight) is an inexact science at best. There is a lot of trial and error along with a healthy sprinkling of a 'fudge-factor' to get to an EDW. This EDW is then used as the 'ideal weight' to aim for post dialysis treatment. Taking too much or too little fluid out of a dialyzor can have obvious consequences.

Accordingly, getting a handle on a more accurate way to measure intravascular status non-invasively and using a more objective means of determining the EDW would be welcomed by the nephrology community. Enter, Crit-Line... Crit-Line is a fluid management and access monitoring tool incorporating photo-optical technology to non-invasively measure absolute hematocrit, percent blood volume change, continuous oxygen saturation and access recirculation.

Last week Hema Metrics put out a press release announcing that a new article has been released in the February 1 edition of Hypertension which indicates that relative plasma volume monitoring during hemodialysis aids the assessment of Dry Weight. The article, written by Arjun D. Sinha, Robert P. Light and Rajiv Agarwal, concludes that the Crit-Line is a simple and widely available tool that can aid in the evaluation of dry weight. Furthermore, the article states that periodic monitoring of relative plasma volume may assist in the management of dry weight and control hypertension among long-term hemodialysis patients.  


"We are excited that a peer reviewed article with such positive results has been published in a respected Journal such as Hypertension" said Patrick Moriarty, CEO of Hema Metrics. "The evidence keeps mounting that the Crit-Line, when used correctly, is a very valuable tool for assessing accurate dry weights and managing hypertension".

Nevertheless, the economics may dampen some of the enthusiasm for the Hema Metrics offering. It appears measuring the relative plamsa volume with Crit-Line to more accurately obtain an EDW is not reimbursable. Furthermore, I doubt the good people at Hema Metrics in their benevolence are giving away their devices for free. So, in this environment of cost containment and cloudy reimbursement rates for hemodialysis, despite the joy for the theoretic possibility of helping patient care with this device, it is unclear how it will be embraced in our community.