Pettilä V, Tiula E
Department of Surgery, and Helsinki University Central Hospital, Espoo, Finland.
Clin Nephrol. 2001 Oct;56(4):324-31.
The objective was to study the effects of daily intermittent on-line predilution hemodiafiltration (IHDF) on laboratory parameters, and on multiple organ dysfunction score (MODS), compared with intermittent hemodialysis (IHD).
Prospective, randomized, non-blinded study.
A 10-bed medical-surgical intensive care unit in a tertiary-care hospital, 39 patients with acute renal failure.
IHDF or IHD was performed daily with the same equipment: AK 100 Ultra, and Polyflux 17 hemodiafilter up to day 30. Laboratory parameters, MODS, survived days free of acute renal failure treatment, number and complications of treatments, and hospital mortality were recorded.
Effects of treatments were equal as to urea reduction ratio and changes in serum creatinine, calcium, phosphate and bicarbonate. Survived days free of acute renal failure treatment were fewer for the IHDF (4.8 vs. 10.3 days for the IHD, p = 0.036, Mann-Whitney test). The overall hospital mortality of all patients was 34% (95% CI 18-50%).
This study demonstrated equal control of azotemia, acidosis, and calcium-phosphate balance in both treatment groups with no treatment-specific complications of IHDF.
旨在研究每日间歇性在线预稀释血液透析滤过（IHDF）与间歇性血液透析（IHD）相比，对实验室参数及多器官功能障碍评分（MODS）的影响。
前瞻性、随机、非盲研究。
一家三级医院的拥有10张床位的内科-外科重症监护病房，39例急性肾衰竭患者。
使用相同设备（AK 100 Ultra及Polyflux 17血液透析滤过器）每日进行IHDF或IHD，持续至第30天。记录实验室参数、MODS、无急性肾衰竭治疗的存活天数、治疗次数及并发症，以及医院死亡率。
在尿素清除率及血清肌酐、钙、磷和碳酸氢盐变化方面，两种治疗效果相当。IHDF无急性肾衰竭治疗的存活天数较少（IHDF为4.8天，IHD为10.3天，p = 0.036，曼-惠特尼检验）。所有患者的总体医院死亡率为34%（95%CI 18 - 50%）。
本研究表明，两个治疗组在氮质血症、酸中毒及钙磷平衡控制方面效果相当，且IHDF无特定治疗并发症。
