[Acute renal failure in abdominal infection. Comparison of hemodialysis and continuous arteriovenous hemofiltration]

Abstract

58 patients with peritonitis and acute renal failure (ARF) were treated either by haemodialysis (HD, n = 22), continuous arteriovenous haemofiltration (CAVH, n = 9), or continuous pump-driven haemofiltration (CPDHF, n = 27). In contrast to HD, which led to severe hypotension in 31.9% of procedures and to cardiac arrest in 3 cases, CPDHF caused neither haemodynamic nor metabolic alterations. Control of uraemia was most effective in the CPDHF group, too. Mean daily BUN and creatinine values fell significantly (p less than 0.005) and remained at 60 mg % and 2.0 mg %, respectively, whereas during HD no significant changes were found. During CAVH serum creatinine showed an insignificant decline, whereas BUN even increased. Despite higher costs CPDHF seems to be a promising alternative to HD or CAVH for treatment of ARF in septic patients, as mortality was lower in the CPDHF group and recovery of renal function occurred in 48.2%, whereas during HD only 27.3% recovered from ARF.