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Comparison of continuous and intermittent renal replacement therapy for acute renal failure.
Nephrol Dial Transplant. 2005 Aug; 20(8):1630-7.ND

Abstract

BACKGROUND

Mortality rates of critically ill patients with acute renal failure (ARF) requiring renal replacement therapy (RRT) are high. Intermittent and continuous RRT are available for these patients on the intensive care units (ICUs). It is unknown which technique is superior with respect to patient outcome.

METHODS

We randomized 125 patients to treatment with either continuous venovenous haemodiafiltration (CVVHDF) or intermittent haemodialysis (IHD) from a total of 191 patients with ARF in a tertiary-care university hospital ICU. The primary end-point was ICU and in-hospital mortality, while recovery of renal function and hospital length of stay were secondary end-points.

RESULTS

During 30 months, no patient escaped randomization for medical reasons. Sixty-six patients were not randomized for non-medical reasons. Of the 125 randomized patients, 70 were treated with CVVHDF and 55 with IHD. The two groups were comparable at the start of RRT with respect to age (62+/-15 vs 62+/-15 years, CVVHDF vs IHD), gender (66 vs 73% male sex), number of failed organ systems (2.4+/-1.5 vs 2.5+/-1.6), Simplified Acute Physiology Scores (57+/-17 vs 58+/-23), septicaemia (43 vs 51%), shock (59 vs 58%) or previous surgery (53 vs 45%). Mortality rates in the hospital (47 vs 51%, CVVHDF vs IHD, P = 0.72) or in the ICU (34 vs 38%, P = 0.71) were independent of the technique of RRT applied. Hospital length of stay in the survivors was comparable in patients on CVVHDF [median (range) 20 (6-71) days, n = 36] and in those on IHD [30 (2-89) days, n = 27, P = 0.25]. The duration of RRT required was the same in both groups.

CONCLUSION

The present investigation provides no evidence for a survival benefit of continuous vs intermittent RRT in ICU patients with ARF.

Authors+Show Affiliations

Division of Nephrology/Hypertension, University of Berne, Freiburgstrasse 10, 3010 Bern-Inselspital, Switzerland. uehlinger@mph.unibe.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15886217

Citation

Uehlinger, Dominik E., et al. "Comparison of Continuous and Intermittent Renal Replacement Therapy for Acute Renal Failure." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 20, no. 8, 2005, pp. 1630-7.
Uehlinger DE, Jakob SM, Ferrari P, et al. Comparison of continuous and intermittent renal replacement therapy for acute renal failure. Nephrol Dial Transplant. 2005;20(8):1630-7.
Uehlinger, D. E., Jakob, S. M., Ferrari, P., Eichelberger, M., Huynh-Do, U., Marti, H. P., Mohaupt, M. G., Vogt, B., Rothen, H. U., Regli, B., Takala, J., & Frey, F. J. (2005). Comparison of continuous and intermittent renal replacement therapy for acute renal failure. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 20(8), 1630-7.
Uehlinger DE, et al. Comparison of Continuous and Intermittent Renal Replacement Therapy for Acute Renal Failure. Nephrol Dial Transplant. 2005;20(8):1630-7. PubMed PMID: 15886217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of continuous and intermittent renal replacement therapy for acute renal failure. AU - Uehlinger,Dominik E, AU - Jakob,Stephan M, AU - Ferrari,Paolo, AU - Eichelberger,Markus, AU - Huynh-Do,Uyen, AU - Marti,Hans-Peter, AU - Mohaupt,Markus G, AU - Vogt,Bruno, AU - Rothen,Hans Ulrich, AU - Regli,Bruno, AU - Takala,Jukka, AU - Frey,Felix J, Y1 - 2005/05/10/ PY - 2005/5/12/pubmed PY - 2005/11/16/medline PY - 2005/5/12/entrez SP - 1630 EP - 7 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 20 IS - 8 N2 - BACKGROUND: Mortality rates of critically ill patients with acute renal failure (ARF) requiring renal replacement therapy (RRT) are high. Intermittent and continuous RRT are available for these patients on the intensive care units (ICUs). It is unknown which technique is superior with respect to patient outcome. METHODS: We randomized 125 patients to treatment with either continuous venovenous haemodiafiltration (CVVHDF) or intermittent haemodialysis (IHD) from a total of 191 patients with ARF in a tertiary-care university hospital ICU. The primary end-point was ICU and in-hospital mortality, while recovery of renal function and hospital length of stay were secondary end-points. RESULTS: During 30 months, no patient escaped randomization for medical reasons. Sixty-six patients were not randomized for non-medical reasons. Of the 125 randomized patients, 70 were treated with CVVHDF and 55 with IHD. The two groups were comparable at the start of RRT with respect to age (62+/-15 vs 62+/-15 years, CVVHDF vs IHD), gender (66 vs 73% male sex), number of failed organ systems (2.4+/-1.5 vs 2.5+/-1.6), Simplified Acute Physiology Scores (57+/-17 vs 58+/-23), septicaemia (43 vs 51%), shock (59 vs 58%) or previous surgery (53 vs 45%). Mortality rates in the hospital (47 vs 51%, CVVHDF vs IHD, P = 0.72) or in the ICU (34 vs 38%, P = 0.71) were independent of the technique of RRT applied. Hospital length of stay in the survivors was comparable in patients on CVVHDF [median (range) 20 (6-71) days, n = 36] and in those on IHD [30 (2-89) days, n = 27, P = 0.25]. The duration of RRT required was the same in both groups. CONCLUSION: The present investigation provides no evidence for a survival benefit of continuous vs intermittent RRT in ICU patients with ARF. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/15886217/Comparison_of_continuous_and_intermittent_renal_replacement_therapy_for_acute_renal_failure_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh880 DB - PRIME DP - Unbound Medicine ER -