Intensive Care Medicine

, Volume 33, Issue 5, pp 773–780

Continuous renal replacement therapy is associated with less chronic renal failure than intermittent haemodialysis after acute renal failure

  • Max Bell
  • SWING
  • Fredrik Granath
  • Staffan Schön
  • Anders Ekbom
  • Claes-Roland Martling
Original

DOI: 10.1007/s00134-007-0590-6

Cite this article as:
Bell, M., SWING, Granath, F. et al. Intensive Care Med (2007) 33: 773. doi:10.1007/s00134-007-0590-6

Abstract

Objective

Acute renal failure can be treated with continuous renal replacement therapy (CRRT) or intermittent haemodialysis (IHD). Whether this choice affects renal recovery has been debated, since it has implications on quality of life and costs. Our objective was to determine the impact of CRRT and IHD on renal recovery.

Design

Nationwide retrospective cohort study between the years 1995 and 2004. Follow-up ranged between 3 months and 10 years.

Setting

Thirty-two Swedish intensive care units.

Patients and participants

Eligible subjects were adults treated in Swedish general intensive care units with RRT. A total of 2,642 patients from 32 ICUs were included. We then excluded patients with end-stage renal disease (252) and patients lacking a diagnosis in the in-patient register (188). Thus, 2,202 patients were studied. Follow-up was complete.

Interventions

None.

Measurements and results

The primary outcome was renal recovery. Secondarily we studied the mortality of the cohort. There were no differences between IHD and CRRT patients regarding baseline characteristics, such as age, sex and comorbidities. Of the 1,102 patients surviving 90 days after inclusion in the cohort, 944 (85.7%) were treated with CRRT and 158 (14.3%) were treated with IHD. Seventy-eight patients (8.3%; confidence interval, CI, 6.6–10.2), never recovered their renal function in the CRRT group. The proportion was significantly higher among IHD patients, where 26 subjects or 16.5% (CI 11.0–23.2) developed need for chronic dialysis.

Conclusions

The use of CRRT is associated with better renal recovery than IHD, but mortality does not differ between the groups.

Keywords

Kidney failure, acute Kidney failure, chronic Hemodialysis Intensive care Outcome studies 

Supplementary material

134_2007_590_MOESM1_ESM.xls (25 kb)
Electronic Supplementary Material (XLS 25K)
134_2007_590_MOESM2_ESM.doc (48 kb)
Electronic Supplementary Material (DOC 48K)

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Max Bell
    • 1
  • SWING
    • 2
  • Fredrik Granath
    • 3
  • Staffan Schön
    • 4
  • Anders Ekbom
    • 3
  • Claes-Roland Martling
    • 1
  1. 1.Department of Anaesthesiology and Intensive CareKarolinska University HospitalSolnaSweden
  2. 2.SWING is the Swedish Intensive care Nephrology Group, whose member hospitals are tabulated in the appendixesn.a.Sweden
  3. 3.Department of Medicine, Clinical Epidemiology UnitKarolinska University HospitalSolnaSweden
  4. 4.Swedish Register of Active Treatment of Uraemia, Department of NephrologyKärnhospitalSkövdeSweden

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