Continuous renal replacement therapy: Does technique influence electrolyte and bicarbonate control?

H. Morimatsu, S. Uchino, Rinaldo Bellomo, C. Ronco

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)

Abstract

Background and objectives: Different techniques of continuous renal replacement therapy (CRRT) might have different effects on electrolyte and acid-base control. The aim of this study was to determine whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) achieve better control of serum sodium, potassium and bicarbonate concentrations. Design: Retrospective controlled study. Setting: Two tertiary intensive care units. Patients: Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50). Interventions: Retrieval of daily morning sodium and potassium values and arterial bicarbonate levels from computerized biochemical records before and after the initiation of CRRT for up to 2 weeks of treatment. Statistical comparison of findings. Measurements and results: Before treatment, abnormal (high or low) values were frequently observed for sodium (65.1% for CVVHDF vs. 80.0% for CVVH; NS), potassium (45.9% vs. 34.0%; NS), and bicarbonate (73.3% vs. 68.0%; NS). After treatment, however, CVVHDF was more likely to achieve serum sodium concentrations within the normal range (74.1% vs. 62.9%; p=0.0026). Both treatments decreased the mean serum potassium concentration over the first 48 h (p=0.0059 and p>0.0001, respectively), but there was no difference in terms of the normalization of serum potassium concentration during the entire treatment period (88.3% vs. 90.5%; NS). Both treatments increased the mean arterial bicarbonate concentration over the first 48 hours (p=0.011 and p<0.0001, respectively). However, CVVH was associated with a lower incidence of metabolic acidosis (13.8% for CVVH vs. 34.5% for CVVHDF; p<0.0001) and a higher incidence of metabolic alkalosis (38.9% vs. 1.1%; p<0.0001) during the entire treatment period. Conclusions: CRRT strategies based on different techniques have a significantly different impact on sodium and bicarbonate control.

Original languageEnglish
Pages (from-to)289-296
Number of pages8
JournalInternational Journal of Artificial Organs
Volume26
Issue number4
Publication statusPublished - 1 Apr 2003
Externally publishedYes

Keywords

  • Acute renal failure
  • Bicarbonate
  • Hemodialysis
  • Hemofiltration
  • Potassium
  • Sodium

Cite this

@article{340981b4bfb44bfab5bd7071adc8ecd3,
title = "Continuous renal replacement therapy: Does technique influence electrolyte and bicarbonate control?",
abstract = "Background and objectives: Different techniques of continuous renal replacement therapy (CRRT) might have different effects on electrolyte and acid-base control. The aim of this study was to determine whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) achieve better control of serum sodium, potassium and bicarbonate concentrations. Design: Retrospective controlled study. Setting: Two tertiary intensive care units. Patients: Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50). Interventions: Retrieval of daily morning sodium and potassium values and arterial bicarbonate levels from computerized biochemical records before and after the initiation of CRRT for up to 2 weeks of treatment. Statistical comparison of findings. Measurements and results: Before treatment, abnormal (high or low) values were frequently observed for sodium (65.1{\%} for CVVHDF vs. 80.0{\%} for CVVH; NS), potassium (45.9{\%} vs. 34.0{\%}; NS), and bicarbonate (73.3{\%} vs. 68.0{\%}; NS). After treatment, however, CVVHDF was more likely to achieve serum sodium concentrations within the normal range (74.1{\%} vs. 62.9{\%}; p=0.0026). Both treatments decreased the mean serum potassium concentration over the first 48 h (p=0.0059 and p>0.0001, respectively), but there was no difference in terms of the normalization of serum potassium concentration during the entire treatment period (88.3{\%} vs. 90.5{\%}; NS). Both treatments increased the mean arterial bicarbonate concentration over the first 48 hours (p=0.011 and p<0.0001, respectively). However, CVVH was associated with a lower incidence of metabolic acidosis (13.8{\%} for CVVH vs. 34.5{\%} for CVVHDF; p<0.0001) and a higher incidence of metabolic alkalosis (38.9{\%} vs. 1.1{\%}; p<0.0001) during the entire treatment period. Conclusions: CRRT strategies based on different techniques have a significantly different impact on sodium and bicarbonate control.",
keywords = "Acute renal failure, Bicarbonate, Hemodialysis, Hemofiltration, Potassium, Sodium",
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Continuous renal replacement therapy : Does technique influence electrolyte and bicarbonate control? / Morimatsu, H.; Uchino, S.; Bellomo, Rinaldo; Ronco, C.

In: International Journal of Artificial Organs, Vol. 26, No. 4, 01.04.2003, p. 289-296.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Continuous renal replacement therapy

T2 - Does technique influence electrolyte and bicarbonate control?

AU - Morimatsu, H.

AU - Uchino, S.

AU - Bellomo, Rinaldo

AU - Ronco, C.

PY - 2003/4/1

Y1 - 2003/4/1

N2 - Background and objectives: Different techniques of continuous renal replacement therapy (CRRT) might have different effects on electrolyte and acid-base control. The aim of this study was to determine whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) achieve better control of serum sodium, potassium and bicarbonate concentrations. Design: Retrospective controlled study. Setting: Two tertiary intensive care units. Patients: Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50). Interventions: Retrieval of daily morning sodium and potassium values and arterial bicarbonate levels from computerized biochemical records before and after the initiation of CRRT for up to 2 weeks of treatment. Statistical comparison of findings. Measurements and results: Before treatment, abnormal (high or low) values were frequently observed for sodium (65.1% for CVVHDF vs. 80.0% for CVVH; NS), potassium (45.9% vs. 34.0%; NS), and bicarbonate (73.3% vs. 68.0%; NS). After treatment, however, CVVHDF was more likely to achieve serum sodium concentrations within the normal range (74.1% vs. 62.9%; p=0.0026). Both treatments decreased the mean serum potassium concentration over the first 48 h (p=0.0059 and p>0.0001, respectively), but there was no difference in terms of the normalization of serum potassium concentration during the entire treatment period (88.3% vs. 90.5%; NS). Both treatments increased the mean arterial bicarbonate concentration over the first 48 hours (p=0.011 and p<0.0001, respectively). However, CVVH was associated with a lower incidence of metabolic acidosis (13.8% for CVVH vs. 34.5% for CVVHDF; p<0.0001) and a higher incidence of metabolic alkalosis (38.9% vs. 1.1%; p<0.0001) during the entire treatment period. Conclusions: CRRT strategies based on different techniques have a significantly different impact on sodium and bicarbonate control.

AB - Background and objectives: Different techniques of continuous renal replacement therapy (CRRT) might have different effects on electrolyte and acid-base control. The aim of this study was to determine whether continuous veno-venous hemodiafiltration (CVVHDF) or continuous veno-venous hemofiltration (CVVH) achieve better control of serum sodium, potassium and bicarbonate concentrations. Design: Retrospective controlled study. Setting: Two tertiary intensive care units. Patients: Critically ill patients with acute renal failure (ARF) treated with CVVHDF (n=49) or CVVH (n=50). Interventions: Retrieval of daily morning sodium and potassium values and arterial bicarbonate levels from computerized biochemical records before and after the initiation of CRRT for up to 2 weeks of treatment. Statistical comparison of findings. Measurements and results: Before treatment, abnormal (high or low) values were frequently observed for sodium (65.1% for CVVHDF vs. 80.0% for CVVH; NS), potassium (45.9% vs. 34.0%; NS), and bicarbonate (73.3% vs. 68.0%; NS). After treatment, however, CVVHDF was more likely to achieve serum sodium concentrations within the normal range (74.1% vs. 62.9%; p=0.0026). Both treatments decreased the mean serum potassium concentration over the first 48 h (p=0.0059 and p>0.0001, respectively), but there was no difference in terms of the normalization of serum potassium concentration during the entire treatment period (88.3% vs. 90.5%; NS). Both treatments increased the mean arterial bicarbonate concentration over the first 48 hours (p=0.011 and p<0.0001, respectively). However, CVVH was associated with a lower incidence of metabolic acidosis (13.8% for CVVH vs. 34.5% for CVVHDF; p<0.0001) and a higher incidence of metabolic alkalosis (38.9% vs. 1.1%; p<0.0001) during the entire treatment period. Conclusions: CRRT strategies based on different techniques have a significantly different impact on sodium and bicarbonate control.

KW - Acute renal failure

KW - Bicarbonate

KW - Hemodialysis

KW - Hemofiltration

KW - Potassium

KW - Sodium

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JO - International Journal of Artificial Organs

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