Document Detail

Acetate-free biofiltration for acute renal failure.
MedLine Citation:
PMID:  9606737     Owner:  NLM     Status:  MEDLINE    
The characteristics of acetate-free biofiltration (AFB) are now well documented in patients with chronic renal failure: hemodynamic tolerance, correction of acid-base imbalance, buffer-free dialysate (without acetate) and absence of backfiltration. This hemodialysis technique can be beneficial to patients with acute renal failure (ARF). In our intensive care unit, we prospectively studied 29 patients with isolated ARF or ARF associated with failure of other organs. All eligible patients were randomly assigned to undergo dialysis with bicarbonate hemodialysis (BH) or with (AFB). All used the same high flux biocompatible dialysis membranes. Effectiveness and hemodynamic tolerance of hemodialysis sessions and evolution of patients were analyzed. Correction of metabolic disorders, although better in the AFB group was not statistically different from that in the BH group. Re-equilibration of acid-base balance was also similar, with or without mechanical ventilation. Heparin consumption was significantly higher in the AFB group, with no effect on haemorrhagic complications. Analysis of hypo- and hypertensive episodes, defined as arterial pressure (AP) variations 20% greater than initial pressure, showed no difference in terms of number or degree of AP variation. However, weight loss and the rate of ultrafiltration led to a higher hypotensive risk in the BH group (p < 0.05). Finally, the clinical course and prognosis was similar in both groups. In summary, AFB may be considered as effective a hemodialysis technique as BH in patients with ARF. Weight loss was better tolerated in the AFB group and can be a favorable factor considering the deleterious effect of overhydration in patients admitted to an intensive care unit. This study invites a comparison of longer dialysis session of AFB therapy and continuous hemodiafiltration.
M Bret; J M Hurot; A Mercatello; B Coronel; D Dorez; M Laville; J F Moskovtchenko
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Renal failure     Volume:  20     ISSN:  0886-022X     ISO Abbreviation:  Ren Fail     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-08-25     Completed Date:  1998-08-25     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  493-503     Citation Subset:  IM    
Department of Nephrology, Hôpital Edouard Herriot, Lyon, France.
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MeSH Terms
Acid-Base Equilibrium
Kidney Failure, Acute / therapy*
Membranes, Artificial
Middle Aged
Prospective Studies
Renal Dialysis
Weight Loss
Reg. No./Substance:
0/Bicarbonates; 0/Membranes, Artificial

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