engleski

The possible effect of the dialyzer membrane on outcome of acute renal failure patients

Recent studies indicated that recovery from acute renal failure (ARF) might be influenced by the nature of the dialysis membrane. This prospective randomized study investigated the influence of different degrees of biocompatibility and permeability of dialysis membranes on survival and recovery of renal function in ARF patients requiring HD. From January 1991 to December 2000, 297 patients were randomized to one of four type of dialysis membranes: 113 patients to low-flux modified cellulose (LF-MC) ; 36 to high flux modified cellulose (HF-MC) ; 118 to low-flux synthetic (LF-S) and 30 to high-flux synthetic (HF-S) membranes. There were no significant differences between subgroups (LF-MC or LF-S ; HF-MC or HF-S HD membranes) in demographic data to severity of illness that was determined accordin to the APACHE II score. In the LF membranes group, causes of ARF were medical, surgical or obstetric, while all patients treated with HF membranes developed ARF after the open-heart surgery. Patients treated with HF membranes received significantly higher dialysis doses when compared to the LF group. The survival rate was 59.3% in the LF-MC group, 61% in the LF-S group , 55.6% inthe HF-MC and 53.5% in the HF-S group. There was no difference between the same flux type groups in the recovery of renal function (LF-MC 47.8% vs. LF-S 48.6%, and HF-MC 90% vs. HF-S100%). There were no significant differences in number of HD sessions, duration of HD treatment, or duration of hospitalization. The main cause of death in ARF patients treated with LF-MC or or LF-S membranes was multiorgan damage syndrome(MODS) folloved by sepsis, while it was heart failure followed by MODS in patients who developed ARF after the open heart surgery and were treated with HF membranes. In conclusion, there were no significant differences in survival rate, recovery of renal function, duration of hemodialysis treatment and hospitalization, with the use of the S(LF or HF) as compared with the MC(LF or HF) dialysis membranes.

dialyzer membrane; acute renal failure; outcome

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