[Continuous hemodialysis in the treatment of chronic renal insufficiency in emergencies].

Continuous hemodialysis is advantageous for the treatment of renal failure in critically ill patients. This study reports our experience in the treatment of emergencies during chronic renal failure with continuous hemodialysis using a Cuprofane membrane. Eighteen patients with acute decompensations of chronic renal failure were treated with continuous hemodialysis (14 arteriovenous and 4 veno-venous). Procedures lasted a mean of 44.2 h, blood urea nitrogen decreased from 150.3 +/- 49.8 to 60.6 +/- 30.7 mg/dl, metabolic acidosis was corrected raising serum bicarbonate from 10.1 +/- 44 to 17.8 +/- 3.3 mEq/L and hyperkalemia was corrected. Mean ultrafiltration was 239.6 +/- 124.6 ml/h which allowed to withdraw a mean 10.590 ml of ultrafiltrate. Two patients were complicated with femoral artery pseudoaneurysms and one patient with a catheter related sepsis. Global mortality was 16.7%, which compared favorably with the 32.1% predicted mortality according to the Simplified Acute Physiology Score. It is concluded that continuous hemodialysis, a readily available procedure, is suitable for the treatment of emergencies during chronic renal failure.