[Continuous veno-venous hemofiltration in acute renal insufficiency].

A fully pump-assisted continuous veno-venous hemodiafiltration system (CVVHDF) was studied in 10 acute renal failure patients. A counter current pump system ensured slow dialysis at a mean flow rate of 24.6 +/- 0.6 ml/min (single pass) and guaranteed recovery of 97% of dialysate. Ultrafiltration rates were controlled by a separate occlusive pump, connected to the dialysate compartment. Blood was circulated by mean of a third pump at flow rates ranging form 100 to 150 ml/min. Mean duration of CVVHDF was 197 +/- 32 h (range 96-336). Mean serum creatinine and urea before initiation of CVVHDF were 525 +/- 52 mumol/l and 36 +/- 14 mmol/l and stabilized after 4-7 days of CVVHDF at 280 +/- 27 mumol/l and 14 +/- 3 mmol/l. Hemodynamic parameters remained stable. Glucose and phosphate removal by CVVHDF was 296 +/- 42 mmol/day and 33 +/- 6 mmol/day respectively. Fractional losses of aminoacids given by parenteral nutriton averaged 8 +/- 1%. An 69 filters induced no significant changes in leucocyte and thrombocyte counts and only a slight decrease in pO2 (-0.78 +/- 0.30 K Pa at 60 min). We conclude that CVVHDF is a safe, efficient and reliable treatment modality, allowing a good control of the fluid balance.