Continuous hemofiltration vs hemodialysis for the acute renal failure after cardiovascular surgery

Recently we have performed continuous hemofiltration (CHF) for the patients of acute renal failure after cardiovascular surgery. In this article, we discuss the effectiveness of CHF in the acute phase of renal failure after cardiovascular surgery compared with hemodialysis (HD). CHF group included 12 cases, and HD group included 19 cases. Two cases (16.7%) of CHF group and two cases (10.5%) of HD group were survived and discharged from hospital. Filtration volume of CHF (93.8 +/- 81.0 l) was significantly higher than that of HD (27.1 +/- 22.9 l), but filtration rate of CHF (410 +/- 87.4 ml/H) was significantly lower than that of HD (572 +/- 167 ml/H). Thus CHF removed excess water more gently and effectively than HD. Because the influence to the hemodynamics of CHF was much less than that of HD, we were able to start CHF (4.3 +/- 4.6 days after operation, BUN: 55.3 +/- 19.5 mg/dl), Cr: 3.95 +/- 0.63 mg/dl) significantly earlier than HD (7.8 +/- 4.1 days after operation, BUN: 113.1 +/- 29.4 mg/dl, Cr: 6.10 +/- 1.04 mg/dl). We needed high dose catecholamine or blood transfusion for the 11 cases (57.3%) of HD group during HD, but we needed them for only 1 case (8.3%) of CHF group. We concluded that CHF was safer and more useful than HD in the treatment of acute renal failure after cardiovascular surgery.