Korean Journal of Nephrology 1992;11(2):146-152.

급성신부전 및 난치성부종의 치료로서 지속적 동정맥 혈액여과법 지속적 정정맥혈액여과법의 비교 연구

김현철 , 이수형 , 박성배

Abstract

Continuous arteriovenous hemofiltration (CAVH) introduced by Kramer is used to treat hemodynamically unstable patients with renal failure and refractory edema. CAVH is an attractive modality to treat criti- cally ill patients with renal failure. However, it has several disadvantages including frequent filter clotting and the specific risk of arterial cannulation. All these problems can be improved with pump-assisted continu- ous venovenous hemofiltration (PA-CVVH). We compared CAVH and PA-CVVH in the treatment of 58 critically ill patients with renal failure and refractory edema. Thirty-three patients received CAVH and 25 patients received PA-CVVH. Age and duration of treat- ment were comparable in both groups (mean age: 35 vs. 41, duration: 49h vs 45h). Changes in blood chemistry and hemodynamics before and after treatment were comparable in both groups, but the mean ultrafiltration rate was significantly higher in the CVVH group (CAVH: 428 ml/h, CVVH: 799ml/h, p<0.001). The rate of hypotension was 21.1% in the CAVH and 24.0% in the CVVH group. The rate of filter clotting was 27.3%, in the CAVH and 8.0% in the CVVH group. These values were not significantly different. Our results suggest that both CAVH and PA-CVVH can be used in critically ill patients with renal failure and refractory edema. CVVH may be preferable to CAVH in patients with marked fluid overload and moderate azotemia.