CAVHD VS HEMODIALYSIS TREATMENT IN ACUTE RENAL FAILURE

急性肾功能衰竭的 CAVHD 与血液透析治疗

• 批准号: 3372109
• 负责人: Ravindra L. Mehta
• 金额: $ 39.71万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-30 至 1995-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3372109
• 关键词: acute renal failure; arteriovenous shunt surgery; disease /disorder proneness /risk; health care cost /financing; health care quality; health care service utilization; hemodialysis; human morbidity; human mortality; human subject; human therapy evaluation; kidney disorder diagnosis; nutrition; nutrition related tag; patient care management; statistics /biometry

Seriously ill patients with acute renal failure are usually treated with intermittent hemodialysis. This form of treatment has been associated with rapid "unphysiologic" shifts in fluids and solutes which may be detrimental to a patient's well-being and survival. Recently, there has been a growing consensus that a form of continuous renal replacement therapy, which avoids the rapid solute and fluid shifts, may be the treatment of choice for acute renal failure, particularly in critically ill hemodynamically unstable patients. However, so far these two techniques have not been compared in a controlled manner. This study aims to determine the relative efficacy and cost of continuous arteriovenous hemodialysis as compared to acute intermittent hemodialysis in the treatment of acute renal failure in patients hospitalized in the ICU. In addition, it will identify clinical characteristics which identify subgroups of patients most likely to benefit from either of these treatments and also assess the applicability of severity of illness criteria in predicting patient outcome and potential recovery. The study is designed to allocate eligible patients to receive either continuous or intermittent renal replacement therapy in a randomized manner. Nutritional status will be optimized in both groups and several parameters will be followed to assess "severity of illness", renal functional status, and effect on morbidity and mortality. Data will be analyzed to provide information on the efficacy and relative cost of the two techniques and the applicability of derived criteria for predicting patient outcome and assisting in decisions for appropriate use of resources.

患有急性肾功能衰竭的重病患者通常使用 间歇性血液透析。这种形式的治疗被认为与 液体和溶质的快速“非生理性”变化，可能是有害的 为了病人的福祉和生存。最近，有越来越多的人 共识是一种形式的连续性肾脏替代疗法，它避免了 快速的溶质和液体的转移，可能是治疗急性 肾功能衰竭，特别是血流动力学不稳定的危重患者 病人。然而，到目前为止，这两种技术还没有在 控制的方式。本研究的目的是确定相对疗效和 持续动静脉血液透析与急性血液透析的费用比较 间歇性血液透析治疗急性肾功能衰竭 在ICU住院的患者。此外，它还将确定临床 确定最有可能受益的患者亚群的特征 从这两种治疗中的任何一种，还评估了 疾病严重程度标准在预测患者预后和潜在性中的作用 恢复。这项研究旨在分配符合条件的患者接受 连续性或间歇性肾脏替代治疗的随机对照研究 举止。两组和几个组的营养状况都将得到优化 将遵循参数来评估“疾病的严重程度”，肾脏 功能状态，以及对发病率和死亡率的影响。数据将是 分析，以提供有关有效性和相对成本的信息 预测的两种技术及其衍生准则的适用性 患者结局和协助决定适当地使用 资源。