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Long-term follow up in chronic hemofiltration.
The International Journal of Artificial Organs
|May 1, 1983
Summary
Hemofiltration effectively manages chronic renal insufficiency, normalizing blood pressure in hypertensive patients. While beneficial for some metabolic parameters, it did not improve neuropathy, with major causes of death being stroke and heart attack.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Chronic renal insufficiency (CRI) poses significant management challenges.
- Hemodialysis can lead to complications like hypotension, hypertension, and overhydration.
- Identifying alternative or adjunctive therapies for CRI is crucial.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of hemofiltration in patients with chronic renal insufficiency.
- To assess the impact of hemofiltration on blood pressure, metabolic parameters, and neuropathy.
- To identify patient selection criteria and contraindications for hemofiltration.
Main Methods:
- Retrospective analysis of 72 patients with CRI undergoing regular hemofiltration for over 6 months.
- Detailed review of treatment outcomes, including blood pressure control, metabolic markers, and neurological status.
- Analysis of patient demographics, reasons for transfer from hemodialysis, and causes of mortality.
Main Results:
- Hemofiltration normalized severe hypertension in 12 patients within 6 weeks.
- Some improvements were noted in lipid and bone metabolism parameters.
- No favorable effect on neuropathy was observed.
- Major causes of death included encephalomalacia and cardiac infarction.
Conclusions:
- Hemofiltration is a viable treatment option for select CRI patients, particularly those with uncontrolled hypertension or fluid overload.
- Vascular access issues and severe catabolism are contraindications for post-dilution hemofiltration.
- Further research is needed to optimize hemofiltration protocols and patient selection.