Nutrition in Acute Renal Failure: Treatment Made Possible by Continuous Arteriovenous Hemofiltration (CAVH)
Continuous AV hemofiltration provides an exciting new approach to acute renal failure because of its simplicity and ability to handle large volume of fluids and electrolytes, but primarily because of the possibility of providing full nutritional support for renal failure patients. It is possible to feed patients using dialysis as a renal support system to be sure, but the hypermetabolic effects of hemodialysis, and other limitations of this technique have resulted in limiting protein and energy supply to critically ill patients with renal failure. With the advent of continuous arteriovenous hemofiltration (CAVH), full nutritional support is now possible, and several groups are just beginning to explore the effects of the feeding (and conversely the effects of our current treatment— starvation) in acute renal failure (1).
KeywordsMetabolic Rate Acute Renal Failure Multiple Organ Failure Continuous Renal Replacement Therapy Protein Catabolic
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- 1.Mault JR, Kresowik TF, Dechert RE, Arnoldi DK, Swartz RD, Bartlett RH: Continuous arteriovenous hemofiltra-tion: The answer to starvation in acute renal failure? Trans Am Soc Artif Intern Organs 30: In press, 1984.Google Scholar
- 2.Mault JR, Dechert RE, Bartlett RH, Swartz RD, Ferguson SK: Oxygen consumption during hemodialysis for acute renal failure. Trans Am Soc Artif Intern Organs 28:514, 1982.Google Scholar
- 3.Mault JR, Bartlett RH, Dechert RE, Clark SF, Swartz RD: Starvation: A major contributor to mortality in acute renal failure? Trans Am Artif Intern Organs 29:390–394, 1983.Google Scholar
- 4.Wilmore DW: The metabolic management of the critically ill. Plenum Medical Book Co., New York, 1977.Google Scholar
- 7.Baracos V, Rodemann HP, Dinarello CA, Goldberg AL: Stimulation of muscle protein degradation and prosta-glandin E2 release by leukocyte pyrogen (interleukin-1). N Engl J Med 308:553–558.Google Scholar
- 9.Kresowik TF, Dechert RE, Mault JR, Arnoldi DK, White-house WM Jr, Bartlett RH: Does nutritional support affect survival in critically ill patients? Surg Form 35:108, 1984.Google Scholar
- 10.Bartlett RH, Dechert RE, Mault JR, Clark SF: Metabolic studies in chest trauma. J Thor Cardio Surg 87:503–508, 1984.Google Scholar
- 11.Askanazi J, Nordenstrom J, Rosenbaum SH, et al: Nutrition for the patient with respiratory failure. Glucose vs fat. Anesthesiology 54:1373–1377, 1981.Google Scholar
- 17.Lauer A, Saccaggi A, Ronco C, Belledonne M, Glabman S, Bosch JP: Continuous arteriovenous hemofiltration in the critically ill patient. Ann Intern Med 99:450–460, 1983.Google Scholar