Blood Purification Procedures for Acute Renal Failure: Convenient Strategy Related to Clinical Conditions

Abstract

The choice in the renal replacement therapy of acute renal failure (ARF) should match the patients’ individual needs and the characteristics of available therapies. 141 ARF patients, 65 with ‘isolated’ ARF (group I) and 76 with ARF in multiorgan failure (group II), have been treated. In 33 patients of group I standard bicarbonate hemodialysis was used, while acetate-free biofiltration was used for the others. In group II, 42 patients have been treated by continuous arteriovenous hemofiltration and 34 patients by daily recycled bicarbonate hemodialysis. Our data show that acetate-free biofiltration and bicarbonate dialysis were both highly dependable, but acetate-free biofiltration was better tolerated. Continuous arteriovenous hemofiltration is the method of choice in high-risk patients; daily bicarbonate hemodialysis is preferable only in patients with hemorrhagic diathesis. The average survival time is 55.2% with a statistically significant difference between groups I and II, while no difference has been observed within the same group according to the procedure.

Cardiac Function and Oxygen Balance in Septic Patients during Continuous Hemofiltration

“…Nevertheless, continuous extracorporeal treatment modalities are associated with positive and negative effects. Among positive effects we include the right body fluid replacement, especially the extracellular volume, hemodynamic stability [19], reduction of body temperature, removal of inflammatory mediators, infusion of organic buffer that may have profound effects on energy metabolism and myocardial function. Among the negative effects, the prolonged bloodmembrane interaction may enhance protein catabolism and aggravate SIRS [20].…”

Trattamento Emodialitico Dell'insufficienza Renale Acuta

“…--nche se rec entemente so no aI sta ti de scritti miglioramenti nella progno si dei pazienti affetti da insuff icienza renale acuta (IRA) (l ), tale sindrome presenta ancora oggi una prognosi sfavorevole specialmente nel caso in cui comp aia in corso di Multiple Organ Failure (MOF) (2) . Peraltro, il trattamen to emod ialitico dell 'IRA richiede spess o particol ari accorgimenti tecnici a causa dell e condi zioni generali , spess o critiche, di que sti pazienti (3). Le caratteri stich e del tr attam ento sos ti t utivo ideale nei pazienti affetti da IRA sono riportate in Tab ella I.…”

“…Le caratteri stich e del tr attam ento sos ti t utivo ideale nei pazienti affetti da IRA sono riportate in Tab ella I. La scelta dell a metodica dialit ica, pertanto, deve essere eseguita in relazione aile necessita individuali del paziente e aile caratteri sti che delle tecnich e disponibili (3). Tali con siderazioni comprendono il tipo di acce sso vasco lare, il rischio di sanguinamento, Ie condizioni emodinamiche e la nece ssita di rimuovere un eccess o di liquidi (4).…”