Impact of Dialysis Modalities on Survival of Acute Renal Failure in Intensive Care Unit

Park, Geun Ho; Song, Joon Ho; Yi, Hyeon Gyu; Lee, Sun Young; Lee, Seoung Woo; Kim, Moon Jae

Abstract

BACKGROUND
Although continuous renal replacement therapy (CRRT) has several theoretical advantages compared with intermittent hemodialysis (IHD), including enhanced hemodynamic stability, increased solute removal, and greater ultrafiltration capacity, what method of renal replacement therapy should be used in ICU patients with ARF is still unanswered. We performed the following study to estimate the impact of hemodialysis modality on survival. METHODS: The 63 patients who underwent renal replacement therapy in ICU, InHa Hospital between April 1997 and March 2001, were classified according to disease severity (Cleveland Clinic Foundation Score, mild 1-7, moderate 8-14, severe 15-20) and predialytic systolic BP (unstable <105, borderline 105-120, stable >120 mmHg). Then survival rates of each group were compared by hemodialysis modalities. RESULTS: Total cumulative survival rate of CRRT is low than that of IHD (38.5 vs 50.0%, p<0.05). However, cumulative survival rate on CRRT is higher in the group that predialytic systolic BP ranged from 110 to 125 mmHg than in the group of IHD (70.0 vs 25.0%, p<0.05). Cumulative survival rate on CRRT is also higher in the group that CCF score ranged from 8 to 14 than in the group of IHD (47.1 vs 25.0%, p=0.073). CONCLUSION: In patients with moderate disease severity and borderline predialytic systolic BP, more extended application of CRRT would improve survival rate.