ABSTRACT
BACKGROUND: It has been reported that patients with acute renal failure (ARF) requiring haemodialysis show an improved recovery of renal function when the dialysis treatment is performed using a biocompatible membrane rather than a bioincompatible membrane. However, most recent published human trials have not been able to confirm these findings. METHOD: Over a 2-year period, we prospectively studied 53 patients with ARF after cadaver renal transplantation who required haemodialysis and randomized them into two treatment groups. One group underwent dialysis with a cuprophane membrane and the other group underwent haemodialysis with a more biocompatible membrane, polysulfone. All patients received an immunosuppressive regimen which included azathioprine, prednisone and cyclosporine. RESULTS: There was no difference by patient characteristics or immunosuppressive regimen before acute tubular necrosis (ATN) recovery. In both groups the number of haemodialysis sessions required prior to the recovery of renal function (6.57+/-2.79 vs 6.05+/-2.40), the number of oliguric days (16.25+/-5.14 vs 14.40+/-4.67) and the number of hospital days (33.38+/-12.85 vs 30.10+/-11.00), were not statistically different. There was also no difference in long-term allograft outcome. CONCLUSION: Our data demonstrate that the use of a more biocompatible membrane had no influence on the recovery from acute renal failure after renal transplantation.
Subject(s)
Acute Kidney Injury/therapy , Biocompatible Materials , Kidney Transplantation , Membranes, Artificial , Renal Dialysis , Adult , Aged , Cadaver , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
We have reviewed records of 12 children underwent CAPD between January 84 and May 88, ranging in age from 7 month to 16 years (mean age 8.9 +/- 4.9 years). CAPD treatment lasted from 3 to 24 months (average 10.3 months). Exchanges of dialysis fluid were performed by parents (8 cases) or children (3); mean volume was 41.7 +/- 8.7 ml/kg/exchange (range 32-58 ml/kg). During 132 patient months of treatment laboratory data showed a good metabolic control expect a tendency to hypoalbuminemia. There were 3 catheter changes. Complications were: peritonitis (15 episodes or one infection every 8.8 patient/treatment/months), hypertension (5 cases), hypervolemia (2), cuff extrusion (4), local exit site (5) and tunnel (2) infections and hernias (2). CAPD has been continued in 3 children; 6 other received renal transplantation, one was switched to hemodialysis and 2 died. This study has demonstrated that CAPD was an effective treatment for renal failure in children waiting renal transplant. Cuff extrusion and hypoalbuminemia were common complications in our children.
