Abstract:

Objective To observe the therapeutic effects of high volume hemofiltration (HVHF) in the treatment of acute renal failure complicated with multiple organ dysfunction syndrome. Methods Patients with acute renal failure complicated with multiple organ dysfunction syndrome were randomly divided into 2 groups of which the APACHE II (acute physiology and chronic II) scores had no statistical difference. Thirteen cases in group A were treated with HVHF, and eleven cases in group B with continuous venous-venous hemofiltration. Changes of BUN and serum Cr, K+, Na+, Ca2+, CO2, IL-6 and TNF- were compared between the 2 groups before and after the treatment. Mean arterial pressure, central venous pressure and heart rate were monitored during the treatment. Results In group A, 8 cases survived and the mortality rate was 38.5%. In group B, 6 cases survived and the mortality was 45.5% (P>0.05, as compared with the mortality rate of group A). Patients in group A showed stable blood flow dynamics and favorable changes of BUN, Cr, electrolytes and acid-base balance (P>0.05, as compared with those of group B). However, serum IL-6 and TNF- decreased more in group A than in group B after the treatment (P<0.05). Conclusion Although both HVHF and continuous venous-venous hemofiltration effectively excreted extra solutes and water and appropriately adjusted ionic and acid-base balance with little disturbance on blood flow dynamics, HVHF has better ability in the elimination of inflammatory factors of medium and large sizes.

Key words: Acute renal failure, Multiple organ dysfunction syndrome