Intermittent hemodiafiltration in acute renal failure in critically ill patients.

AIMS

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).

DESIGN

Prospective, randomized, non-blinded study.

SETTING

A 10-bed medical-surgical intensive care unit in a tertiary-care hospital, 39 patients with acute renal failure.

METHODS

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.

RESULTS

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%).

CONCLUSIONS

This study demonstrated equal control of azotemia, acidosis, and calcium-phosphate balance in both treatment groups with no treatment-specific complications of IHDF.