[Hybrid or continuous renal replacement techniques for unstable haemodynamic patients in the intensive care unit].

OBJECTIVE Comparative study to evaluate the impact of a hybrid renal replacement technique (HRRT) vs a continuous renal replacement technique (haemodiafiltration) on hemodynamic tolerance, azotemic control, and mortality in critical care patients with acute renal failure. SETTING a 14-bed Intensive Care Unit (ICU). MATERIAL AND METHODS Two groups of patients were retrospectively compared: patients submitted to continuous renal replacement techniques (CRRT) in 2003 (n = 26) and patients who underwent HRRT in 2004 (n = 27). Both groups had similar severity scores and underlying diseases, and were haemodynamically unstable. Urea and creatinine reduction ratio (URR and CRR) in both groups were evaluated. RESULTS Patients treated with HRRT presented a lower mortality (62% vs 84%), less heparin use, and a higher URR and CRR. Univariate logistic regression showed that an increase in APACHE II was related to an increase in mortality (CI 95%, 1.03-1.26). Odds for mortality for CRRT group were about 3 times higher (CI 95%, 0.86-12.11), but not statistically significant (p = 0.074). CONCLUSION HRRT is a valid alternative to CRRT in haemodynamically unstable critically ill patients.