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Evaluation of the Tolerability and Efficacy of the Main Hemodialysis Techniques in Intensive Care

DOI: 10.4236/ojneph.2025.151012, PP. 128-144

Keywords: Intermittent Hemodialysis (IHD), Continuous Veno-Venous Hemofiltration (CVVH), Intensive Care, Hemodynamic Stability, Biological Efficacy

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Abstract:

Introduction: Acute renal failure in intensive care often necessitates extracorporeal renal replacement therapy. Intermittent hemodialysis (IHD) and continuous veno-venous hemofiltration (CVVH) are the two primary techniques employed, yet their relative efficacy and tolerability remain subjects of debate. This study compares these modalities in terms of hemodynamic stability, biological efficacy, and patient survival. Patients and Methods: This retrospective study, conducted in a multipurpose intensive care unit, included 51 adult patients who underwent either IHD or CVVH. Clinical, biological, and survival data were analyzed, and factors influencing outcomes were assessed using appropriate statistical methods. Results: CVVH, utilized in 69% of patients, demonstrated better biological stabilization, as indicated by significantly lower creatinine levels at discharge (p = 0.026). However, IHD was associated with a significantly higher survival rate (81% vs. 43%, p = 0.024). Patients receiving CVVH exhibited greater clinical severity. Conclusion: CVVH appears more suitable for hemodynamically unstable patients, whereas IHD, which is well tolerated, is associated with improved survival outcomes. The selection of renal replacement therapy should be individualized based on the patient’s clinical profile. Further prospective studies are warranted to validate these findings.

References

[1]  Orieux, A., Boyer, A., Dewitte, A., Combe, C. and Rubin, S. (2022) Insuffisance rénale aiguë en soins intensifs-réanimation et ses conséquences: Mise au point. Néphrologie & Thérapeutique, 18, 7-20.
https://doi.org/10.1016/j.nephro.2021.07.324
[2]  Neyra, J.A., Lambert, J., Ortiz-Soriano, V., Cleland, D., Colquitt, J., Adams, P., et al. (2022) Assessment of Prescribed vs. Achieved Fluid Balance during Continuous Renal Replacement Therapy and Mortality Outcome. PLOS ONE, 17, e0272913.
https://doi.org/10.1371/journal.pone.0272913
[3]  Chan, R.J., Helmeczi, W., Canney, M. and Clark, E.G. (2023) Management of Intermittent Hemodialysis in the Critically Ill Patient. Clinical Journal of the American Society of Nephrology, 18, 245-255.
https://doi.org/10.2215/cjn.04000422
[4]  Ronco, C., Bellomo, R. and Kellum, J.A. (2019) Acute Kidney Injury. The Lancet, 394, 1949-1964.
https://doi.org/10.1016/s0140-6736(19)32563-2
[5]  Gaudry, S., Grolleau, F., Barbar, S., Martin-Lefevre, L., Pons, B., Boulet, É., et al. (2022) Continuous Renal Replacement Therapy versus Intermittent Hemodialysis as First Modality for Renal Replacement Therapy in Severe Acute Kidney Injury: A Secondary Analysis of AKIKI and IDEAL-ICU Studies. Critical Care, 26, Article No. 93.
https://doi.org/10.1186/s13054-022-03955-9
[6]  Grolleau, F., Porcher, R., Barbar, S., Hajage, D., Bourredjem, A., Quenot, J., et al. (2022) Personalization of Renal Replacement Therapy Initiation: A Secondary Analysis of the AKIKI and IDEAL-ICU Trials. Critical Care, 26, Article No. 64.
https://doi.org/10.1186/s13054-022-03936-y
[7]  Schneider, A.G., Bellomo, R., Bagshaw, S.M., Glassford, N.J., Lo, S., Jun, M., et al. (2013) Choice of Renal Replacement Therapy Modality and Dialysis Dependence after Acute Kidney Injury: A Systematic Review and Meta-Analysis. Intensive Care Medicine, 39, 987-997.
https://doi.org/10.1007/s00134-013-2864-5
[8]  Zhao, Y. and Chen, Y. (2020) Effect of Renal Replacement Therapy Modalities on Renal Recovery and Mortality for Acute Kidney Injury: A Prisma‐Compliant Systematic Review and Meta‐Analysis. Seminars in Dialysis, 33, 127-132.
https://doi.org/10.1111/sdi.12861
[9]  Legrand, M., Darmon, M., Joannidis, M. and Payen, D. (2012) Management of Renal Replacement Therapy in ICU Patients: An International Survey. Intensive Care Medicine, 39, 101-108.
https://doi.org/10.1007/s00134-012-2706-x
[10]  Truche, A., Darmon, M., Bailly, S., Clec’h, C., Dupuis, C., Misset, B., et al. (2016) Continuous Renal Replacement Therapy versus Intermittent Hemodialysis in Intensive Care Patients: Impact on Mortality and Renal Recovery. Intensive Care Medicine, 42, 1408-1417.
https://doi.org/10.1007/s00134-016-4404-6
[11]  Badhe, Y.K., Patel, U.N. and Suryatale, A.S. (2023) Clinical Profile and Prognostic Factors of Acute Kidney Injury in Critically Ill Patients. European Journal of Cardiovascular Medicine, 13, 397-403.
[12]  Igiraneza, G., Ndayishimiye, B., Nkeshimana, M., Dusabejambo, V. and Ogbuagu, O. (2018) Clinical Profile and Outcome of Patients with Acute Kidney Injury Requiring Hemodialysis: Two Years’ Experience at a Tertiary Hospital in Rwanda. BioMed Research International, 2018, Article 1716420.
https://doi.org/10.1155/2018/1716420
[13]  SindhuriPulipaka, K. (2022) Abstract No.: ABS0279: Retrospective Analysis of Acute Dialysis in ICU Setting in a Tertiary Care Hospital. Indian Journal of Anaesthesia, 66, S44-S44.
https://doi.org/10.4103/0019-5049.340677
[14]  Brown, P.M., Redford, L. and Omar, S. (2021) The Indications for and Timing of Haemodialysis in Critically Ill Patients with Acute Kidney Injury in Johannesburg, Southern African Journal of Critical Care, 37, 51-55.
[15]  Uchino, S., Bellomo, R., Morimatsu, H., Morgera, S., Schetz, M., Tan, I., et al. (2007) Continuous Renal Replacement Therapy: A Worldwide Practice Survey. Intensive Care Medicine, 33, 1563-1570.
https://doi.org/10.1007/s00134-007-0754-4
[16]  Bagshaw, S.M., Berthiaume, L.R., Delaney, A. and Bellomo, R. (2008) Continuous versus Intermittent Renal Replacement Therapy for Critically Ill Patients with Acute Kidney Injury: A Meta-Analysis. Critical Care Medicine, 36, 610-617.
https://doi.org/10.1097/01.ccm.0b013e3181611f552
[17]  Akhoundi, A., Singh, B., Vela, M., Chaudhary, S., Monaghan, M., Wilson, G.A., et al. (2015) Incidence of Adverse Events during Continuous Renal Replacement Therapy. Blood Purification, 39, 333-339.
https://doi.org/10.1159/000380903
[18]  Chazot, G., Bitker, L., Mezidi, M., Chebib, N., Chabert, P., Chauvelot, L., et al. (2021) Prevalence and Risk Factors of Hemodynamic Instability Associated with Preload-Dependence during Continuous Renal Replacement Therapy in a Prospective Observational Cohort of Critically Ill Patients. Annals of Intensive Care, 11, Article No. 95.
https://doi.org/10.1186/s13613-021-00883-9
[19]  Russo, D.S., Eugenio, C.S., Balestrin, I.G., Rodrigues, C.G., Rosa, R.G., Teixeira, C., et al. (2022) Comparison of Hemodynamic Instability among Continuous, Intermittent and Hybrid Renal Replacement Therapy in Acute Kidney Injury: A Systematic Review of Randomized Clinical Trials. Journal of Critical Care, 69, Article 153998.
https://doi.org/10.1016/j.jcrc.2022.153998
[20]  Chander, S., Luhana, S., Sadarat, F., Parkash, O., Rahaman, Z., Wang, H.Y., et al. (2024) Mortality and Mode of Dialysis: Meta-Analysis and Systematic Review. BMC Nephrology, 25, Article No. 1.
https://doi.org/10.1186/s12882-023-03435-4
[21]  Lee, K., Ou, S., Tsai, M., Tseng, W., Yang, C., Lin, Y., et al. (2021) AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome. Membranes, 11, Article 837.
https://doi.org/10.3390/membranes11110837

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