A retrospective study of continuous renal replacement therapy versus intermitt ent hemodialysis in severe acute renal failure

Objective To investigate the efficacy of continuous renal replacement therapy (CRRT) versu s intermittent hemodialysis (IHD) in patients with severe acute renal failure (A RF).Methods One hundred and ninety -three severe ARF patients who received renal support be tween December 1978 and December 1998 were involved in this study. Of them, 101 (52.3%) were treated with CRRT (CRRT group), and 92 (47.7%) with IHD (IHD gro up).Results Sixty (59.4%) patients in the CRRT group got through the acute phase of disease and 41 (40.6%) patients did not survive while in the IHD group 59 (64.1%) pat ients survived and 33 (35.9%) patients did not. No significant difference in s urvival rate was found between the two groups. 24 of 64 patients (37.5%) in th e CRRT group with multiple organ dysfunction syndrome (MODS) survived, while in the IHD group, 8 out of 44 (27.3%) survived, their survival rate was much lowe r than that in the CRRT group. Patients in CRRT group were more severely ill, a s manifested by lower mean arterial pressure, higher APACHE Ⅱ score, more dysfu nctioned organs and requiring mechanical ventilation and vasopressor support as compared with patients in the IHD group, CRRT was found to improve hemodynamic stability with a better fluid balance and control of biochemical status, increas ed nutritional intake and a shorter duration of acute renal failure (P<0.05 ). Conclusion CRRT perhaps may be the best choice in the treatment of severe ARF patients, for it can offer several distinct advantages compared to IHD. These may contribute to improving the survival rate of ARF patients, particularly those that are cri tically ill patients.

A retrospective study of continuous renal replacement therapy versus intermitt ent hemodialysis in severe acute renal failure

OBJECTIVE: To investigate the efficacy of continuous renal replacement therapy (CRRT) versus intermittent hemodialysis (IHD) in patients with severe acute renal failure (ARF). METHODS: One hundred and ninety-three severe ARF patients who received renal support between December 1978 and December 1998 were involved in this study. Of them, 101 (52.3%) were treated with CRRT (CRRT group), and 92 (47.7%) with IHD (IHD group). RESULTS: Sixty (59.4%) patients in the CRRT group got through the acute phase of disease and 41 (40.6%) patients did not survive while in the IHD group 59 (64.1%) patients survived and 33 (35.9%) patients did not. No significant difference in survival rate was found between the two groups. 24 of 64 patients (37.5%) in the CRRT group with multiple organ dysfunction syndrome (MODS) survived, while in the IHD group, 8 out of 44 (27.3%) survived, their survival rate was much lower than that in the CRRT group. Patients in CRRT group were more severely ill, as manifested by lower mean arterial pressure, higher APACHE II score, more dysfunctioned organs and requiring mechanical ventilation and vasopressor support as compared with patients in the IHD group, CRRT was found to improve hemodynamic stability with a better fluid balance and control of biochemical status, increased nutritional intake and a shorter duration of acute renal failure (P < 0.05). CONCLUSION: CRRT perhaps may be the best choice in the treatment of severe ARF patients, for it can offer several distinct advantages compared to IHD. These may contribute to improving the survival rate of ARF patients, particularly those that are critically ill patients.