Treatment of acute renal failure in intensive care patients by continuous arteriovenous hemofiltration (CAVH): two years' experience in two centres.

Abstract

The study objective was to evaluate the outcome of continuous arteriovenous hemofiltration (CAVH) as a first choice treatment for acute renal failure (ARF) in critically ill intensive care patients in two centres with a long experience in the field of continuous renal replacement therapies. Sixty consecutive intensive-care ARF patients from Uppsala Centre and 71 consecutive ARF patients from Vicenza Centre were included during a period of two years. Their age range was 58 +/- 16 and 52 +/- 15 years in Uppsala and Vicenza, respectively. CAVH was performed in the postdilution form using different types of hemofilters. Three choices of vascular access were utilised in each centre, namely: the Buselmeier shunt, femoral vessel catheter and the Scribner shunt. The pre-treatment serum urea level (mean +/- SD) in the Uppsala patients (30 +/- 14 mmol/l) was significantly higher (p < 0.001) than that of the Vicenza patients (17 +/- 10 mmol/l). The Uppsala patients had a longer treatment duration than the Vicenza patients; 8 +/- 6 vs 5 +/- 5 days (p < 0.05) perhaps because they were much older than the Vicenza patients (p < 0.05) in addition to their multi-organ failure. However, the total outcome of CAVH in the two centers was not significantly different (52 and 58% patient's survival in Uppsala and Vicenza, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)