Comparison of continuous and intermittent renal replacement therapy for acute renal failure

Objective:To compare the difference between continuous blood purification(CBD) and intermittent haemodialysis(IHD) in curing acute renal failure.Methods:We randomized 145 patients to treatment with either continuous blood purification(CBP,n=78) or intermittent haemodialysis(IHD,n=67),who came from nephropathy department and ICU of the first people's hospital of Shangqiu.The primary end-point was 28 days mortality,while recovery of renal function and hospital length of stay were secondary end-points.Results:Clearance rate of serum creatinine and urea nitrogen was much higher in group CBP than in group IHD(P0.05),and complete recovery of renal function also showed statistical deference(53.8% vs 37.3 %,CBPvs IHD,P=0.04);the dose of noradrenaline for 24 hours and the number of patients requiring no adrenaline in group CBP exceeded group IHD significantly(31vs38,P=0.04;8 300 μg/24 h vs 15 730 μg/24 h,P=0.03,CBPvs IHD).Mortality rates for 28 days in the hospital and ICU(41.8% vs 39.7%,CBP vs IHD,P=0.81)were independent of the technique of RRT applied.Hospital length of stay in the survivors was comparable in patients on CBP[median(range) 21.5(6-71) day] and in those on IHD [29(2-81) days,P=0.29].The duration of RRT required was almost the same between both groups.Conclusion:Compared with IDH,CBP improves renal function significantly and reduce the use of pressor agent,but provides no evidence for a survival benefit of continuous vs intermittent RRT in patients with ARF.