• Hiroshi Morimatsu, Shigehiko Uchino, Rinaldo Bellomo, and Claudio Ronco.
• Department of Intensive Care, Austin and Repatriation Medical Centre, Melbourne, Victoria.
• Ren Fail. 2002 Sep 1; 24 (5): 645-53.

Background And ObjectivesDifferent techniques of continuous renal replacement therapy (CRRT) might have different effects on azotemic control. Accordingly, we tested whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) would achieve better control of serum creatinine and plasma urea levels.DesignRetrospective controlled study.SettingTwo tertiary Intensive Care Units.PatientsCritically ill patients with acute renal failure (ARF) treated with CVVHDF (n = 49) or CVVH (n = 50).InterventionsRetrieval of daily morning urea and creatinine values before and after the initiation of CRRT for up to 2 weeks of treatment.Measurements And ResultsBefore treatment, serum urea and creatinine concentrations were significantly lower in the CVVH group than in CVVHDF group (urea: 31.0 +/- 15.0 mmol/L for CVVHDF and 24.7 +/- 16.1 mmol/L for CVVH, p = 0.01, creatinine: 547 +/- 308 micromol/L vs. 326 +/- 250 micromol/L, p < 0.0001). These differences were still significant after 48 h of treatment (urea: 20.1 +/- 8.3 mmol/L vs. 14.1 +/- 6.1 mmol/L; p = 0.0003, creatinine: 360 +/- 189pmol/L vs. 215 +/- 118 micromol/L; p < 0.0001). Throughout the duration of therapy, mean urea levels (22.3 +/- 9.0 mmol/L for CVVHDF vs. 16.7 +/- 7.8 mmol/L for CVVH, p < 0.0001) and mean creatinine levels (302 +/- 167 vs. 211 +/- 103 micromol/L, p < 0.0001) were better controlled in the CVVH group.ConclusionsCRRT strategies based on different techniques might have a significantly different impact on azotemic control.

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