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Continuous renal replacement therapy improves renal recovery from acute renal failure.
Can J Anaesth. 2005 Mar; 52(3):327-32.CJ

Abstract

BACKGROUND

Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery.

METHODS

We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate.

RESULTS

116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial.

CONCLUSIONS

Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.

Authors+Show Affiliations

Department of Anesthesiology, University of Alberta Hospitals, 32B2.32 Walter C. Mackenzie Health Sciences Centre, Edmonton, Alberta T6G 2B7, Canada. mjacka@ualberta.caNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15753507

Citation

Jacka, Michael J., et al. "Continuous Renal Replacement Therapy Improves Renal Recovery From Acute Renal Failure." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 52, no. 3, 2005, pp. 327-32.
Jacka MJ, Ivancinova X, Gibney RT. Continuous renal replacement therapy improves renal recovery from acute renal failure. Can J Anaesth. 2005;52(3):327-32.
Jacka, M. J., Ivancinova, X., & Gibney, R. T. (2005). Continuous renal replacement therapy improves renal recovery from acute renal failure. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 52(3), 327-32.
Jacka MJ, Ivancinova X, Gibney RT. Continuous Renal Replacement Therapy Improves Renal Recovery From Acute Renal Failure. Can J Anaesth. 2005;52(3):327-32. PubMed PMID: 15753507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuous renal replacement therapy improves renal recovery from acute renal failure. AU - Jacka,Michael J, AU - Ivancinova,Xenia, AU - Gibney,R T Noel, PY - 2005/3/9/pubmed PY - 2005/7/13/medline PY - 2005/3/9/entrez SP - 327 EP - 32 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 52 IS - 3 N2 - BACKGROUND: Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery. METHODS: We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate. RESULTS: 116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial. CONCLUSIONS: Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/15753507/Continuous_renal_replacement_therapy_improves_renal_recovery_from_acute_renal_failure_ L2 - https://doi.org/10.1007/BF03016071 DB - PRIME DP - Unbound Medicine ER -