Influencing Hemostasis during Continuous Venovenous Hemofiltration after Acute Renal Failure: Comparison with Intermittent Hemodialysis

2015 ◽  
pp. 140-144 ◽  
Author(s):  
Ioannis Stefanidis ◽  
Johannes H�gel ◽  
Horst Kierdorf ◽  
Norbert Maurin
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Intermittent Hemodialysis ◽  
Continuous Venovenous Hemofiltration

Continuous Hemodiafiltration in Children

PEDIATRICS ◽  
1990 ◽  
Vol 85 (5) ◽  
pp. 819-823
Author(s):  
Nancy A. Bishof ◽  
Thomas R. Welch ◽  
C. Frederic Strife ◽  
Frederick C. Ryckman
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Effective Means ◽  
Tumor Lysis Syndrome ◽  
Intermittent Hemodialysis ◽  
Tumor Lysis ◽  
Continuous Arteriovenous Hemofiltration

Continuous arteriovenous hemofiltration is a form of renal replacement therapy whereby small molecular weight solutes and water are removed from the blood via convection, alleviating fluid overload and, to a degree, azotemia. It has been used in many adults and several children. However, in patients with multisystem organ dysfunction and acute renal failure, continuous arteriovenous hemofiltration alone may not be sufficient for control of azotemia; intermittent hemodialysis or peritoneal dialysis may be undesirable in such unstable patients. Recently, the technique of continuous arteriovenous hemodiafiltration has been used in many severely ill adults. We have used continuous arteriovenous hemodiafiltration in four patients at Children's Hospital Medical Center. Patient 1 suffered perinatal asphyxia and oliguria while on extracorporeal membrane oxygenation. Patients 2 and 4 both had Burkitt lymphoma and tumor lysis syndrome. Patient 3 had septic shock several months after a bone marrow transplant. All had acute renal failure and contraindications to hemodialysis or peritoneal dialysis. A blood pump was used in three of the four patients, while spontaneous arterial flow was adequate in one. Continuous arteriovenous hemodiafiltration was performed for varying lengths of time, from 11 hours to 7 days. No patient had worsening of cardiovascular status or required increased pressor support during continuous arteriovenous hemodiafiltration. The two survivors (patients 2 and 4) eventually recovered normal renal function. Continuous arteriovenous hemodiafiltration is a safe and effective means of renal replacement therapy in the critically ill child. It may be ideal for control of the metabolic and electrolyte abnormalities of the tumor lysis syndrome.

Intradialytic Complications in Dogs with Acute Renal Failure Submitted to Intermittent Hemodialysis

2017 ◽  
Vol 12 (6) ◽  
pp. 288-293
Author(s):  
Alessandra Melchert ◽  
Pasqual Barretti ◽  
Priscylla Tatiana Ch ◽  
Andre Luis Balbi ◽  
Luis Cuadrado M ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Intermittent Hemodialysis

IONIZED SERUM CALCIUM LEVELS DURING ACUTE RENAL FAILURE: INTERMITTENT HEMODIALYSIS VS. CONTINUOUS HEMODIAFILTRATION

Renal Failure ◽  
2002 ◽  
Vol 24 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Han Khim Tan ◽  
Rinaldo Bellomo ◽  
Debrah A. M’Pisi ◽  
Claudio Ronco
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Calcium ◽  
Intermittent Hemodialysis ◽  
Continuous Hemodiafiltration

Phosphatemic Control during Acute Renal Failure: Intermittent Hemodialysis versus Continuous Hemodiafiltration

2001 ◽  
Vol 24 (4) ◽  
pp. 186-191 ◽  
Author(s):  
H.K. Tan ◽  
R. Bellomo ◽  
D.A. M'Pisi ◽  
C. Ronco
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Normal Serum ◽  
Serum Phosphate ◽  
Phosphate Concentration ◽  
Intermittent Hemodialysis ◽  
Normal Range ◽  
Continuous Hemodiafiltration ◽  
Intensive Care Patients ◽  
Blood Tests

Background Achieving “adequacy of dialysis” includes the maintenance of normal serum phosphate concentrations and is an important therapeutic goal in the treatment of acute renal failure (ARF). It is unknown whether this goal is best achieved with intermittent or continuous renal replacement therapy. Methods We compared the effects of continuous veno-venous hemodiafiltration (CVVHDF) and intermittent hemodialysis (IHD) on serum phosphate concentrations using daily morning blood tests in 88 consecutive intensive care patients half of which were treated with IHD and half with CRRT. Results Mean patient age was 54 ± 14 years for IHD and 60 ± 14 years for CVVHDF (NS). However, patients who received CVVHDF were more critically ill (mean APACHE II scores: 24.4 ± 5.1 for IHD vs. 29.2 ± 5.7 for CVVHDF, p<0.003). Before treatment, the serum phosphate concentration was 2.04 ± 0.16 mmoll L for IHD and 1.96 ± 0.17 mmoll L for CVVHDF (NS), with abnormal values in 79.4% of IHD patients and in 64.8% of CVVHDF patients (NS). During treatment, CVVHDF induced a greater reduction in serum phosphate (p=0.02) during the first 48 hours and conferred superior subsequent control of hyperphosphatemia (achieved in 64.6% of observations during CVVHDF vs. 41.8% during IHD; p<0.0001). The serum phosphate concentration was also more likely to be within the normal range during CVVHDF (55.3% vs.36.2%; p<0.0001). There was a trend toward more frequent hypophosphatemia (9.3% vs. 5.6%; P<0.1) during CVVHDF. Conclusions Abnormal serum phosphate concentrations are frequent in ARF patients before and during renal replacement, however, normalization of phosphatemia is achieved more frequently with CVVHDF.

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