Document Detail


Extended daily dialysis vs. continuous hemodialysis for ICU patients with acute renal failure: a two-year single center report.
MedLine Citation:
PMID:  15202814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extended daily dialysis (EDD) is an easily implemented alternative to continuous renal replacement therapy (CRRT) in the intensive care unit (ICU). Since EDD offers most of the advantages of CRRT, we sought to compare the effectiveness of these two modalities. In this 2-year study, 54 ICU patients with ARF were treated with either continuous hemodialysis (CHD) or EDD. Oliguria was present in 64% of patients who received CHD vs. 73% of EDD patients (p=NS) while 93% of CHD and 81% of EDD patients required mechanical ventilation (p=NS). Patients treated with EDD were younger than those who received CHD (47.0 +/- 12.6 vs. 56.7 +/- 13.7, p=0.009), but there were no significant differences in gender or mean APACHE II scores at the time of randomization. Mean arterial blood pressures measured during treatment were maintained between 70 and 80 mmHg for both EDD and CHD and average daily serum electrolyte levels fell within normal ranges for EDD and CHD. Average daily fluid input and output were 5.8 +/- 3.3 L and 6.0 +/- 3.2 L for CHD vs. 3.3 +/- 2.6 and 3.0 +/- 1.7 L for EDD after exclusion of data from 2 burn patients. Hourly heparin anticoagulation rates were 1080 U/hour for CHD and 643 U/hour for EDD, p=0.02. Anticoagulation-free treatments were performed during 43% of all EDD treatments vs. 21% of all CHD treatments, p<0.001. Clotting of the dialyzer or circuit occurred at least once during 51% of all CHD treatment days vs. 22% of EDD treatments (p<0.001). We conclude that EDD is a safe, effective alternative to CRRT that offers comparable hemodynamic stability and excellent small solute control.
Authors:
V A Kumar; J Y Yeun; T A Depner; B R Don
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  27     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-06-18     Completed Date:  2004-10-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  371-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Nephrology, University of California Davis, Sacramento, CA 95817, USA. vakumar@ucdavis.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Intensive Care Units
Kidney Failure, Acute / therapy*
Male
Middle Aged
Prospective Studies
Renal Dialysis / methods*
Treatment Outcome

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


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