The change in renal replacement therapy on acute renal failure in a general intensive care unit in a university hospital and its clinical efficacy: a Japanese experience.
The aim of our study was to examine renal replacement therapies (RRT) that have been used for acute renal failure (ARF) in our intensive care unit (ICU) patients and to compare their outcomes. Sixteen patients who underwent intermittent hemodialysis (IHD), 14 patients who underwent continuous hemofiltration (CHF) in combination with IHD (CHF + IHD), and 38 patients who underwent continuous hemodiafiltration (CHDF) were evaluated. Regarding the effects of blood purification on hemodynamics and renal function, the percentage increase in blood pressure and percent rapid increase in urinary output were the greatest in the CHDF group. The hourly urinary output after the start of initial blood purification increased only in the CHDF group. The survival rate was significantly higher in the CHDF group. These results suggest that CHDF should be the first-line therapy for patients with ARF and that we are moving in the right direction regarding the application of RRT to treat ARF in ICU patients.
Hirayama
Yoh
Y
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chuou, Chiba, Japan. yoh2405@xa3.so-net.ne.jp
Hirasawa
Hiroyuki
H
Oda
Shigeto
S
Shiga
Hidetoshi
H
Nakanishi
Kazuya
K
Matsuda
Kenichi
K
Nakamura
Masataka
M
Hirano
Takeshi
T
Moriguchi
Takeshi
T
Watanabe
Eizo
E
Nitta
Masakazu
M
Abe
Ryuzo
R
Nakada
Takaaki
T
D058186:Acute Kidney Injury / Q000628:therapy*; D005260:Female; D006436:Hemodialysis Units, Hospital; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007564:Japan; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017582:Renal Replacement Therapy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome