CAVHD VS HEMODIALYSIS TREATMENT IN ACUTE RENAL FAILURE

急性肾功能衰竭的严重患者通常接受以下治疗： 间歇性血液透析这种治疗方式与 液体和溶质的快速“非生理性”变化可能是有害的 病人的健康和生存最近，越来越多的 一致认为，一种形式的连续性肾脏替代治疗， 快速的溶质和液体转移，可能是治疗急性 肾衰竭，尤其是在血流动力学不稳定的危重病患者中 患者然而，到目前为止，这两种技术还没有进行比较， 控制的方式。本研究旨在确定相对疗效和 连续性动静脉血液透析的成本与急性 间歇性血液透析治疗急性肾功能衰竭 患者在ICU住院。此外，它将确定临床 确定最有可能受益的患者亚组的特征 从这些治疗的任何一个，也评估适用性， 疾病严重程度标准在预测患者结局和潜在 复苏这项研究旨在分配合格的患者接受 随机选择连续或间歇性肾脏替代治疗 方式营养状况将在两组中得到优化， 将遵循参数以评估“疾病严重程度”、肾功能 功能状态以及对发病率和死亡率的影响。数据将 分析，以提供有关疗效和相对成本的信息， 两种技术和适用性的衍生标准预测 患者结局并协助决定是否适当使用 资源

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.