High clearance continuous renal replacement therapy with a modified dialysis machine.
Recent studies suggest that the dialysis dose significantly affects survival in acute renal failure (ARF) patients and that bicarbonate dialysate improves acid-base balance during continuous renal replacement therapy (CRRT). These data inspired us to use slow continuous dialysis (SCD) in the treatment of ARF. SCD is defined by the following parameters: (a) blood flow (Q(B)) = 100 to 200 ml/min, (b) dialysate flow (Q(D)) = 100 to 300 ml/min, (c) the use of a modified hemodialysis machine with controlled ultrafiltration and online production of bicarbonate-based dialysate, and (d) continuous or extended daily treatment for 8 to 24 hours. SCD provides a urea clearance in the 70 to 80 ml/min range. Preliminary data from an ongoing clinical trial demonstrate the safety, efficiency, and simplicity of the treatment.
Schlaeper
C
C
Fresenius Medical Care, Lexington, Massachusetts 02420, USA. christian.schlaeper@fmc-na.com
Amerling
R
R
Manns
M
M
Levin
N W
NW
D058186:Acute Kidney Injury / Q000628:therapy; D006801:Humans; D008657:Metabolic Clearance Rate; D006435:Renal Dialysis / Q000295:instrumentation* / Q000592:standards*; D017582:Renal Replacement Therapy / Q000295:instrumentation* / Q000379:methods