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Chinese Journal of Blood Purification ›› 2003, Vol. 2 ›› Issue (1) : 28-31.

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Abstract

【Abstract】Objective To evaluate the effects and complications of different blood purification methods for acute renal failure(ARF) in ICU. Methods 20 patients who underwent blood purification therapy due to ARF in ICU were reviewed. The indication, effect and complication of different blood purification methods, namely the intermittent hemodialysis(IHD), continuous renal replacement therapy(CRRT) and pasma exchange(PE) were studied and compared. Results 5 patients received IHD. Three of them were cured and two died. Blood urea nitrogen(BUN), creatinine(Cr) and potassium dropped down rapidly after IHD, but with big fluctuation during dialysis interval. Fluid supplement was restricted. Two patients developed severe complications after IHD and died of them. CRRT was performed for 13 patients. BUN, Cr and potassium was cleared relatively slower but with less fluctuation, maintaining at a acceptable low level. Large amount of fluid supplement was allowed. CRRT improved hemodynamic situation and did not worsened the consciousness state of those with cerebral edema. 2 patients of acute severe pancreatitis accompanied by severe hyperlipidemia received unselective plasma exchange(PE) and CRRT. Pancreatitis were controlled and renal function recovered. Conclusion The common IHD should be chosen carefully for severe case of ARF in ICU. CRRT seemed to be more suitable for them because of its efficacy and less complication. PE plus CRRT may be a good method for ARF caused by acute severe pancreatitis with hyperlipidemia.