New Developments in Continuous Arteriovenous Hemofiltration/Dialysis

  • Ravindra L. Mehta

Abstract

There is a growing consensus that continuous renal replacement therapy (1–4) is preferable to intermittent renal replacement in treating patients with acute renal failure (ARF). Continuous therapies are not associated with the rapid “unphysiologic” shifts in fluid and solutes which characterize intermittent hemodialysis (IHD). Conventional IHD utilizes diffusion based transport of solutes and fluid across cellulose acetate and cuprophane membranes. New membranes which use polysulphone, polyacrylonitrile or polyamide as the basic material are more permeable than IHD membranes and have a higher molecular weight cut off for enhanced clearance of middle molecules (5). Alternate renal replacement therapies have evolved with the availability of these membranes (6). Continuous Arteriovenous Hemofiltration/HemoDialysis (CAVH/CAVHD) is a new therapy rapidly gaining acceptance worldwide as the treatment of choice for ARF in critically ill, hemodynamically unstable, patients (7–10). This review describes the current status and discusses new developments of these techniques.

Keywords

Permeability Catheter Citrate Cyclosporine Digoxin 

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Copyright information

© Springer-Verlag London Limited 1991

Authors and Affiliations

  • Ravindra L. Mehta
    • 1
  1. 1.Division of Nephrology, Department of MedicineUniversity of California San DiegoSan DiegoUSA

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