Continuous renal replacement therapy: Does technique influence azotemic control?

Hiroshi Morimatsu, Shigehiko Uchino, Rinaldo Bellomo, Claudio Ronco

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Objectives: Different techniques of continuous renal replacement therapy (CRRT) might have different effects on azotemic control. Accordingly, we tested whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) would achieve better control of serum creatinine and plasma urea levels. Design: Retrospective controlled study. Setting: Two tertiary Intensive Care Units. Patients: Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50). Interventions: Retrieval of daily morning urea and creatinine values before and after the initiation of CRRT for up to 2 weeks of treatment. Measurements and Results: Before treatment, serum urea and creatinine concentrations were significantly lower in the CVVH group than in CVVHDF group (urea: 31.0 ± 15.0 mmol/L for CVVHDF and 24.7 ± 16.1 mmol/L for CVVH, p = 0.01, creatinine: 547 ± 308 μmol/L vs. 326 ± 250 μmol/L, p < 0.0001). These differences were still significant after 48 h of treatment (urea: 20.1 ± 8.3 mmol/L vs. 14.1 ± 6.1 mmol/L; p = 0.0003, creatinine: 360 ± 189 μmol/L vs. 215 ± 118 μmol/L; p < 0.0001). Throughout the duration of therapy, mean urea levels (22.3 ± 9.0 mmol/L for CVVHDF vs. 16.7 ± 7.8 mmol/L for CVVH, p < 0.0001) and mean creatinine levels (302 ± 167 vs. 211 ± 103 μmol/L, p < 0.0001) were better controlled in the CVVH group. Conclusions: CRRT strategies based on different techniques might have a significantly different impact on azotemic control.

Original languageEnglish
Pages (from-to)645-653
Number of pages9
JournalRenal failure
Volume24
Issue number5
DOIs
Publication statusPublished - Oct 12 2002
Externally publishedYes

Keywords

  • Acute renal failure
  • Creatinine
  • Critical illness
  • Hemodialysis
  • Hemofiltration
  • Urea
  • Uremia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nephrology

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