Urea removal during continuous hemodiafiltration
| Autor: | M. M. Badellino, C E Wiles rd, H. N. Reynolds, J H Siegel, David C. Frankenfield |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Multiple Organ Failure Urology Urine Hemodiafiltration Critical Care and Intensive Care Medicine Infections Blood Urea Nitrogen chemistry.chemical_compound Continuous hemodiafiltration medicine Humans Prospective Studies Amino Acids Prospective cohort study Blood urea nitrogen Creatinine Analysis of Variance business.industry Critically ill Acute Kidney Injury Middle Aged Control subjects Surgery chemistry Urea Regression Analysis Female business |
| Zdroj: | Critical care medicine. 22(3) |
| ISSN: | 0090-3493 |
| Popis: | To compare urea nitrogen removal by continuous hemodiafiltration vs. functional native kidneys in critically ill, septic patients receiving2 g of amino acids/kg body weight per day.Prospective, comparative, unblinded study.Trauma critical care units of a Level I adult trauma hospital.Fifteen septic patients with multiple organ failure including renal failure who were receiving continuous hemodiafiltration; 11 septic patients with multiple organ failure without renal failure (control group). Ages of patients ranged from 18 to 60 yrs.Collection of effluent (dialysate + ultrafiltrate) from hemodiafilters. Collection of urine from control patients.Urea nitrogen and creatinine concentrations in blood, urine, and the hemodiafiltration effluent, measured every 24 hrs for 6 days. Effluent and urine volumes were measured.Hemodiafilters were operational for 21.8 +/- 3.0 hrs/day. Mean urea nitrogen removal in the renal failure group was 28 +/- 10 g/day. Blood urea nitrogen was stable over the 6-day study period. In control subjects, urea nitrogen removal was 27 +/- 9 g/day, which was not significantly different from the continuous hemodiafiltration group. Blood urea nitrogen concentrations in control patients increased over the 6-day study period (p.05). Urea nitrogen removal correlated moderately well with amino acid intake in the control group (r2 = .30), but not in the continuous hemodiafiltration group (r2 = .0004). In patients receiving continuous hemodiafiltration, effluent volume was most significantly correlated with urea nitrogen removal (r2 = .69).The technique of continuous hemodiafiltration can remove substantial amounts of urea nitrogen, similar to that of normal native kidneys. In addition, at amino acid intake rates of2 g/kg body weight/day, urea nitrogen removal during continuous hemodiafiltration remains a function of effluent volume, so there is no need to restrict amino acid intake in acute renal failure patients supported with continuous hemodiafiltration. |
| Databáze: | OpenAIRE |
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