Document Detail

Acute dialytic support for the critically ill: intermittent hemodialysis versus continuous arteriovenous hemodiafiltration.
MedLine Citation:
PMID:  7618643     Owner:  NLM     Status:  MEDLINE    
There is still debate about whether continuous renal replacement therapy is superior to intermittent hemodialysis (IHD) as dialytic support for the critically ill patient with acute renal failure, mainly because of lack of comparative data. We sought to address this issue by reviewing the medical records of such patients admitted to a single surgical intensive care unit treated with either continuous arteriovenous hemodiafiltration (CAVHD) or IHD between January 1, 1986, and August 31, 1993. Of 94 consecutive patients who received dialytic support for severe acute renal failure, 34 (36%) patients were treated with IHD and 60 (64%) patients with CAVHD. The patients were comparable in terms of age or gender and represented a similar case mix. Patients treated with CAVHD were more severely ill as manifested by a lower mean arterial pressure (75 +/- 3 vs. 86 +/- 5 mm Hg; p < 0.05), higher Apache II score (26.5 +/- 0.5 vs. 22.2 +/- 0.3; p < 0.05), and a higher number of organ system failures (3.4 +/ 0.2 vs. 2.6 +/- 0.3; p < 0.05). Despite greater illness severity and a higher probability of death (55 +/- 2.6 vs. 33 +/- 2.5%; p < 0.0001), in those treated with CAVHD, no difference in outcome was observed between groups: CAVHD 26/60 (43%) vs. IHD 20/34 (59%; NS). The mean Apache II score of patients treated with CAVHD who survived was similar to that of patients treated with IHD who died (24.5 +/- 0.3 vs. 24.2 +/- 0.4; NS).(ABSTRACT TRUNCATED AT 250 WORDS)
E van Bommel; N D Bouvy; K L So; R Zietse; H H Vincent; H A Bruining; W Weimar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of nephrology     Volume:  15     ISSN:  0250-8095     ISO Abbreviation:  Am. J. Nephrol.     Publication Date:  1995  
Date Detail:
Created Date:  1995-08-24     Completed Date:  1995-08-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  192-200     Citation Subset:  IM    
Department of Internal Medicine I, University Hospital Rotterdam Dijkzigt, The Netherlands.
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MeSH Terms
Case-Control Studies
Costs and Cost Analysis
Critical Care / economics
Hemodynamics / physiology
Hemofiltration* / economics
Kidney Failure, Acute / mortality,  therapy*
Middle Aged
Renal Dialysis / economics,  methods*
Survival Rate
Treatment Outcome
Water-Electrolyte Balance / physiology

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