Comparison of continuous and intermittent renal replacement therapy for acute renal failure.
نویسندگان
چکیده
BACKGROUND Mortality rates of critically ill patients with acute renal failure (ARF) requiring renal replacement therapy (RRT) are high. Intermittent and continuous RRT are available for these patients on the intensive care units (ICUs). It is unknown which technique is superior with respect to patient outcome. METHODS We randomized 125 patients to treatment with either continuous venovenous haemodiafiltration (CVVHDF) or intermittent haemodialysis (IHD) from a total of 191 patients with ARF in a tertiary-care university hospital ICU. The primary end-point was ICU and in-hospital mortality, while recovery of renal function and hospital length of stay were secondary end-points. RESULTS During 30 months, no patient escaped randomization for medical reasons. Sixty-six patients were not randomized for non-medical reasons. Of the 125 randomized patients, 70 were treated with CVVHDF and 55 with IHD. The two groups were comparable at the start of RRT with respect to age (62+/-15 vs 62+/-15 years, CVVHDF vs IHD), gender (66 vs 73% male sex), number of failed organ systems (2.4+/-1.5 vs 2.5+/-1.6), Simplified Acute Physiology Scores (57+/-17 vs 58+/-23), septicaemia (43 vs 51%), shock (59 vs 58%) or previous surgery (53 vs 45%). Mortality rates in the hospital (47 vs 51%, CVVHDF vs IHD, P = 0.72) or in the ICU (34 vs 38%, P = 0.71) were independent of the technique of RRT applied. Hospital length of stay in the survivors was comparable in patients on CVVHDF [median (range) 20 (6-71) days, n = 36] and in those on IHD [30 (2-89) days, n = 27, P = 0.25]. The duration of RRT required was the same in both groups. CONCLUSION The present investigation provides no evidence for a survival benefit of continuous vs intermittent RRT in ICU patients with ARF.
منابع مشابه
Continuous renal replacement therapy in intensive care unit
Acute renal failure (ARF) requiring dialysis is a common complication of patients in intensive care unit (ICU). Dialysis can be performed with either intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). CRRT is associated with less hemodynamic instability. Therefore, it is preferred in critically ill and hypotensive patients in ICU. However, current evidence does not ...
متن کاملHemodialysis Systems for Intermittent, Semi-Continuous, and Continuous Therapies in Acute Renal Failure.
As is the case in end-stage renal disease (ESRD), both intermittent and continuous renal replacement therapies (RRTs) are employed in acute renal failure (ARF). In fact, a continuum of treatment options is available in ARF. At one end of the ARF RRT spectrum is conventional intermittent hemodialysis (IHD), in which relatively high blood and dialysate flow rates are used (typically ≥250 and 500 ...
متن کاملDoes continuous renal replacement therapy favourably influence the outcome of the patients?
Continuous haemodialysis and continuous haemofiltration are efficient and safe techniques for the treatment of acute renal failure. Theoretical advantages are improved haemodynamic stability and easier fluid removal. All 15 available studies comparing intermittent (522 patients) with continuous (651 patients) renal replacement therapy have been reviewed. From these studies it cannot be establis...
متن کاملContinuous versus intermittent renal replacement therapy in the treatment of acute renal failure.
متن کامل
Continuous renal replacement therapy.
Continuous renal replacement therapy (CRRT) is a blood purification modality that uses a combination of convection and diffusion to eliminate uremic toxins and correct electrolyte imbalances. Although CRRT is usually associated with the treatment of acute renal failure, it can also be useful in treating many types of toxicoses and drug overdoses. Unlike intermittent hemodialysis, in which the p...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
دوره 20 8 شماره
صفحات -
تاریخ انتشار 2005