Patient survival and renal recovery in acute renal failure: Randomized comparison of cellulose acetate and polysulfone membrane dialyzers

Objective: To investigate survival and renal recovery after dialysis in pat ients with acute renal failure with use of synthetic membranes compared wit h substituted cellulose membranes. Patients and Methods: We prospectively studied survival and recovery of ren al function of 66 patients with acute renal failure who required intermitte nt hemodialysis, Patients were randomized to exclusive treatment with eithe r cellulose acetate (CA) or polysulfone (PS) hemodialysis membranes. Additi onally, markers of biocompatibility (complement, leukocyte counts, cytokine concentration) were measured at initiation and 1 hour after initiation of dialysis among 10 patients equally distributed between the CA and PS groups . Results: The cohorts were indistinguishable with respect to age, sex, prese nce of diabetes mellitus, Acute Physiology and Chronic Health Evaluation II scores, percentage in the intensive care unit (ICU), and adequacy of dialy sis, Survival (76% CA, 73% PS; P=.78) and recovery of renal function at 30 days (58% CA, 39% PS; P=.14) were not statistically different in the 2 grou ps. Among 26 CA patients and 27 PS patients treated in the ICU, survival wa s not statistically different (73% CA, 67% PS; P=.61); however, the proport ion of patients recovering renal function suggested a benefit favoring CA m embranes (65% CA, 37% PS; P=.04), Additionally, markers of biocompatibility were not significantly different between groups among the 10 patients equa lly distributed between the CA and PS groups. Conclusions: Overall clinical outcomes among patients with acute renal fail ure treated with CA hemodialysis membranes and those treated with PS membra nes were not significantly different. The observed advantage favoring renal recovery among this ICU population treated with CA hemodialysis membranes warrants further investigation.