Articles: renal-dialysis-methods.
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Randomized Controlled Trial Multicenter Study
Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial.
Whether continuous renal replacement therapy is better than intermittent haemodialysis for the treatment of acute renal failure in critically ill patients is controversial. In this study, we compare the effect of intermittent haemodialysis and continuous venovenous haemodiafiltration on survival rates in critically ill patients with acute renal failure as part of multiple-organ dysfunction syndrome. ⋯ These data suggest that, provided strict guidelines to improve tolerance and metabolic control are used, almost all patients with acute renal failure as part of multiple-organ dysfunction syndrome can be treated with intermittent haemodialysis.
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Scand J Urol Nephrol · Jan 2006
Multicenter Study Comparative StudyUse of the osmolal gap to guide the start and duration of dialysis in methanol poisoning.
Rapid diagnosis and treatment of methanol poisoning is mandatory. Dependence on serum methanol analysis in this situation may delay diagnosis and treatment. The anion and osmolal gaps have been recommended for use as diagnostic tools, but the use of these gaps to evaluate the length of hemodialysis treatment has only been emphasized in a few reports. We evaluated the usefulness of the osmolal gap in estimating the need for dialysis and the duration of this treatment in 17 methanol-poisoned subjects. ⋯ In the absence of serum methanol analyses, the osmolal gap is useful to assess the indication for and duration of hemodialysis in methanol-poisoned patients. In mass poisoning situations, use of the osmolal gap makes it possible to reduce the duration of dialysis in a safe manner.
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Intensive care medicine · Oct 2002
Multicenter StudyIntermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey.
To describe the current practice of hemodialysis in acute renal failure (ARF) and to estimate the impact of hemodialysis modality on patient outcome. ⋯ Renal replacement therapy mode was not found to have any prognostic value. Randomized controlled trials should be undertaken to assess this important question.
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Kidney international · Sep 2001
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA randomized clinical trial of continuous versus intermittent dialysis for acute renal failure.
Acute renal failure (ARF) requiring dialysis in critically ill patients is associated with an in-hospital mortality rate of 50 to 80%. The worldwide standard for renal replacement therapy is intermittent hemodialysis (IHD). Continuous hemodialysis and hemofiltration techniques have recently emerged as alternative modalities. These two therapies have not been directly compared. ⋯ A randomized controlled trial of alternative dialysis modalities in ARF is feasible. Despite the potential advantages of continuous techniques, this study provides no evidence of a survival benefit of continuous hemodiafiltration compared with IHD. This study did not control for other major clinical decisions or other supportive management strategies that are widely variable (for example, nutrition support, hemodynamic support, timing of initiation, and dose of dialysis) and might materially influence outcomes in ARF. Standardization of several aspects of care or extremely large sample sizes will be required to answer optimally the questions originally posed by this investigation.