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Before implementing continuous renal replacement therapy (CRRT), acute renal failure (ARF) in critically ill, multiple organ failure patients was managed by intermittent hemodialysis and the mortality rate was very high. [4] Hemodialysis is effective in clearance and ultrafiltration, but it has deleterious effects on hemodynamic stability. [5]
Hemofiltration is sometimes used in combination with hemodialysis, when it is termed hemodiafiltration. Blood is pumped through the blood compartment of a high flux dialyzer, and a high rate of ultrafiltration is used, so there is a high rate of movement of water and solutes from blood to dialysate that must be replaced by substitution fluid that is infused directly into the blood line.
Anti-coagulation therapy is often used with aquapheresis to prevent blood from clotting the ultrafiltration filter. Patients must discontinue any anticoagulant medications before starting aquapheresis so they can be placed on intravenous heparin therapy. Once the Heparin therapy is initiated, the patient's PTT (partial thromboplastin time ...
This increase in reimbursement corresponds with the reassignment of therapeutic ultrafiltration CPT code 0692T from APC 5241 to APC 5242. The decision by CMS marks a significant milestone in the recognition of the value and effectiveness of Aquadex SmartFlow ultrafiltration therapy for treating fluid overload in heart failure patients.
The total number of ADHF readmissions in the 30 days following ultrafiltration therapy decreased by 40%, and by 59% in the subsequent 60 days. Stable Renal Function: Serum creatinine levels at 72 hours post-ultrafiltration did not change significantly (-0.01 mg/dL, 95% CI -0.26, 0.23).
Home hemodialysis (HHD) is the provision of hemodialysis to purify the blood of a person whose kidneys are not working normally, in their own home. One advantage to doing dialysis at home is that it can be done more frequently and slowly, which reduces the "washed out" feeling and other symptoms caused by rapid ultrafiltration, and it can often be done at night, while the person is sleeping.
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