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[Continuous hemofiltration in peritonitis].

W Mauritz, P Sporn, G Redl

    Acta Medica Austriaca
    |January 1, 1985
    PubMed
    Summary
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    Pump driven continuous hemofiltration (PDHF) offers a stable alternative for acute renal failure (ARF) in septic patients, showing significant BUN and creatinine reduction with manageable complications and improved outcomes compared to intermittent hemodialysis.

    Area of Science:

    • Nephrology
    • Intensive Care Medicine
    • Critical Care

    Context:

    • Acute renal failure (ARF) is a common complication in septic patients, often requiring renal replacement therapy.
    • Intermittent hemodialysis can cause hemodynamic and metabolic disturbances in critically ill septic patients.
    • Pump driven continuous hemofiltration (PDHF) is an alternative treatment modality for ARF in this population.

    Purpose:

    • To evaluate the efficacy and safety of pump driven continuous hemofiltration (PDHF) in patients with acute renal failure (ARF) secondary to peritonitis.
    • To compare the outcomes of PDHF with intermittent hemodialysis in septic patients with ARF.

    Summary:

    • Twenty-seven patients with ARF due to peritonitis were treated with PDHF over 3 years.
    • PDHF demonstrated no significant hemodynamic or metabolic disturbances, unlike intermittent hemodialysis.

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  • Significant reductions in BUN and creatinine levels were observed (p < 0.001).
  • Coagulation disorders occurred in 5 patients but were managed conservatively without surgery.
  • Kidney function recovered in 44.4% of patients, with an overall mortality of 70.4%.

    • Impact:

    • PDHF appears to be a promising alternative for ARF in septic patients, despite higher costs.
    • Outcomes, including mortality, were favorable compared to historical data with intermittent hemodialysis.
    • The study suggests PDHF may be a viable option for managing ARF in complex critical care settings.