Document Detail


Brain density changes during renal replacement in critically ill patients with acute renal failure. Continuous hemofiltration versus intermittent hemodialysis.
MedLine Citation:
PMID:  10440514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Computerized tomography (CT) studies of the brain were made on 12 patients with acute renal failure from different origin. Patients were treated for two subsequent days in random sequence with intermittent hemodialysis (HD) (one 4-h session and Kt/V > or = 1) and continuous veno-venous hemofiltration (CVVH) (one 24-h session and Kt/V > or = 1). CT scans were done before and after the HD and CVVH session in each patient. In baseline conditions, the only macroscopic morphological alteration was a slight brain edema in some patients. Significant changes in the density of white and gray matter were observed after the HD session in all patients (gray matter from 52.3 +/- 5.2 to 38.9 +/- 5.3 and white matter from 36.7 +/- 3.5 to 24.8 +/- 3.2 Hounsfield units, average delta -26.7%). No changes were observed after CVVH. We conclude that intermittent HD involves a remarkable degree of "unphysiology", leading to increased water content in the brain after each session. In acute patients this may lead to a post-dialytic brain edematogenic state. The physiological stability provided by continuous therapies such as CVVH avoids this unwanted effect, and suggests that continuous renal replacement therapies should be a first choice in these patients.
Authors:
C Ronco; R Bellomo; A Brendolan; V Pinna; G La Greca
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of nephrology     Volume:  12     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    1999 May-Jun
Date Detail:
Created Date:  1999-09-13     Completed Date:  1999-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  173-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology, St. Bortolo Hospital, Vicenza, Italy. cronco@goldnet.it
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MeSH Terms
Descriptor/Qualifier:
Brain / radiography*
Brain Edema / prevention & control
Cross-Over Studies
Densitometry / methods
Hemofiltration* / methods
Humans
Kidney Failure, Acute / radiography*,  therapy*
Prospective Studies
Renal Dialysis* / methods
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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