A retrospective study of continuous renal replacement therapy versus intermittent hemodialysis in severe acute renal failure

Objective To investigate the efficacy of continuous renal replacement thera py (CRRT) versus intermittent hemodialysis (IHD) in patients with severe ac ute renal failure (ARF). Methods One hundred and ninety -three severe ARF patients who received rena l support between December 1978 and December 1998 were involved in this stu dy. Of them, 101 (52.3%) were treated with CRRT (CRRT group), and 92 (47.7% ) with IHD (IHD group). Results Sixty (59.4%) patients in the CRRT group got through the acute phas e of disease and 41 (40.6%) patients did not survive while in the IHD group 59 (64.1 %) patients survived and 33 (35.9%) patients did not. No signific ant difference in survival rate was found between the two groups. 24 of 64 patients (37.5%) in the CRRT group with multiple organ dysfunction syndrome (MODS) survived, while in the IHD group, 8 out of 44 (27.3%) survived, the ir survival rate was much lower than that in the CRRT group. Patients in CR RT group were more severely ill, as manifested by lower mean arterial press ure, higher APACHE II score, more dysfunctioned organs and requiring mechan ical ventilation and vasopressor support as compared with patients in the I HD group, CRRT was found to improve hemodynamic stability with a better flu id balance and control of biochemical status, increased nutritional intake and a shorter duration of acute renal failure ( P < 0.05). Conclusion CRRT perhaps may be the best choice in the treatment of severe A RF patients, for it can offer several distinct advantages compared to IHD. These may contribute to improving the survival rate of ARF patients, partic ularly those that are critically ill patients.